Cultural Awareness - NCLEX Style Questions

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Chapter 6: Cultural and Ethnic Consi...

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6.1. The ambulatory care nurse is discussing preoperative

procedures with a Japanese American client who is scheduled for surgery the following week. During the discussion, the client continually smiles and nods the head. How should the nurse interpret this nonverbal behavior?

• Reflecting cultural value
• An acceptance of treatment
• Client agreement to the required procedures
• Client understanding of the preoperative procedures

Answer: 1.

Rationale: Nodding or smiling by a Japanese American client may reflect only the cultural value of interpersonal harmony. This nonverbal behavior may not be an indication of acceptance of the treatment, agreement with the speaker, or understanding of the procedure.Test-Taking Strategy: Eliminate options 2 and 3 first because they are comparable or alike. From the remaining options, select the correct option because it is characteristic of Asian American cultures. In addition, option 4 is an incorrect interpretation of the client's nonverbal behavior.

Reference: Jarvis (2012), p. 43 & Saunders, p. 47.

6.2. When communicating with a client who speaks a

different language, which best practice should the nurse implement?

• Speak loudly and slowly.
• Arrange for an interpreter to translate.
• Speak to the client and family together.
• Stand close to the client and speak loudly.

Answer: 2.

Rationale: Arranging for an interpreter would be the best practice when

communicating with a client who speaks a different language. Options 1 and 4 are inappropriate and are ineffective ways to communicate. Option 3 is inappropriate because it violates privacy and does not ensure correct translation.

Test-Taking Strategy: Note the strategic word best in the question. Eliminate

option 3 first because it violates the client's right to privacy. Next, eliminate options 1 and 4 noting the world loudly in these options and because they are non therapeutic actions.

Reference: Jarvis (2012), p. 45-47 & Saunders, p. 47.

6.3. The nurse educator is providing in-service education

to the nursing staff regarding transcultural nursing care; a staff member asks the nurse educator to describe the concept of acculturation. The nurse educator should make which most appropriate response?

• "It is a process of learning a different culture to adapt a

new or changing environment."

• "It is a subjective perspective of the person's heritage

and a sense of belonging to a group."

• "It is a group of individuals in a society who are

culturally distinct and have a unique identity."

• "It is a group that shares some of the characteristics of

the larger population group of which it is a part."

Answer: 1.

Rationale: Acculturation is a process of learning a different culture to adapt to a new or changing environment. Option 2 describes ethnic identity. Option 3 describes an ethnic group. Option 4 describes a subculture.

Test-Taking Strategy: Note the strategic words most appropriate. Focus on the

subject, acculturation. Think about the definition of acculturation to help direct you to the correct option.Reference: Jarvis (2012), p. 16, Lewis et al (2011) p. 24, & Saunders, p. 47.

6.4. The nurse is providing discharge instructions to a

Chinese American client regarding prescribed dietary modifications. During the teaching session, the client continuously turns away from the nurse. The client should implement which best action.

• Continue with instructions, verifying client

understanding.

• Walk around the client so that the nurse constantly

faces the client.

• Give the client a dietary booklet and return later to

continue with instructions.

• Tell the client about the importance of the instructions

for the maintenance of health care.

Answer: 1.

Rationale: Most Chinese Americans maintain a formal distance with others, which

is a form of respect. Many Chinese Americans are uncomfortable with face-to- face communications, especially when eye contact is direct. If the client turns away from the nurse during a conversation the best action is to continue with the conversation. Walking around the client so that the nurse faces the client is in direct conflict with this cultural practice. The client may consider it a rude gesture if the nurse returns later to continue with the explanation. Telling the client about the importance of the instructions for the maintenance of health care may be viewed as degrading.

Test-Taking Strategy: Note the strategic word best. Focus on the subject, the

behavior of a Chinese American client. Eliminate options 3 and 4 first because these actions are nontherapeutic. To select from the remaining options, think about the cultural practices of Chinese Americans and recall that direct eye contact may be uncomfortable for the client.

Reference: Jarvis (2012), p. 47 & Saunders, p. 47.

6.5. The nurse identifies low-risk therapies to a client and

should include which therapy(s) in the discussion? Select all that apply.

• Herbs
• Prayer
• Touch
• Massage
• Relaxation
• Acupuncture

Answer: 2, 3, 4, 5

Rationale: Low-risk therapies are therapies that have no adverse effects and, when implementing care, can be used by the nurse who has training and experience in their use. Low-risk therapies include meditation, relaxation techniques, imagery, music therapy, massage, touch, laughter and humor, and spiritual measures, such as prayer. The other options are not considered low-risk therapies.Test-Taking Strategy: Focus on the subject, low-risk therapies. Recalling that low- risk therapies are therapies that are noninvasive and have no adverse effects and can be used by the nurse that has training and experience will direct you to the correct options.

Reference: Lewis et al (2011), p. 91 & Saunders p. 48.

6.6. Which client(s) has a high risk of obesity and diabetes

mellitus? Select all that apply.

• A 40-year-old Latino American man.
• A 45-year old Native American woman.
• A 23-year-old Asian American woman.
• A 35-year-old Hispanic American woman.
• A 40-year-old African American woman.

Answer: 1, 2, 4, 5

Rationale: Because of their health and dietary practices. Native Americans, Latino Americans, Hispanic Americans, and African Americans have a high risk of obesity and diabetes mellitus.

Test-Taking Strategy: Focus on the subject, those with a high risk for diabetes

mellitus and obesity. Think about the health and dietary practices of each cultural group and note the ages of each client in the options to direct you to the correct option.

Reference: Lewis et al (2011), p. 946, 1235 & Saunders, p. 48.

6.7. The nurse is preparing a plan of care for a client who

is a Jehovah's Witness. The client has been told the surgery is necessary. The nurse considers the client's religious preferences in developing the plan of care and should document which information?

• The client believes the soul lives on after death.
• Medication administration is not allowed.
• Surgery is prohibited in this religious group.
• The administration of blood and blood products is not

allowed.

Answer: 4

Rationale: Among Jehovah's Witnesses, surgery is not prohibited, but the

administration of blood and blood products is forbidden. This religious group believes the soul cannot live after death. Administration of medication is an acceptable practice except if the medication is derived from blood products.

Test-Taking Strategy: Focus on the subject, beliefs of Jehovah's Witnesses.

Remember the administration of blood and any associated blood products is forbidden among Jehovah's witnesses.

Reference: Lewis et al (2011), p. 38 & Saunders, p. 48.

6.8. Which meal tray should the nurse deliver to a client of

Orthodox Judaism faith who follows a kosher diet?

• Pork roast, rice, vegetables, mixed fruit, milk
• Crab salad on a croissant, vegetables with dip, potato

salad, milk

• Sweet and sour chicken with rick and vegetables,

mixed fruit, juice

• Noodles and cream sauce with shrimp and vegetables,

salad, mixed fruit, iced tea

Answer: 3

Rationale: Orthodox Judaism believers adhere to dietary kosher laws. In this

religion, the dairy-meat combination is unacceptable. Only fish that have scales and fins are allowed; meats that are allowed include animals that are vegetable eaters, cloven-hoofed, and ritually slaughtered.Test-Taking Strategy: Focus on the subject, dietary kosher laws, and recall that the dairy-meat combination is unacceptable in the Orthodox Judaism group. Eliminate option one because this option contains port roast and milk. Next eliminate options 2 and 4 because both options contain shellfish.Reference: Lewis et al (2011), p. 28, Potter et al (2013), p.111, & Saunders, p. 48.

6.9. An Asian American client is experiencing a fever. The

nurse recognizes that the client is likely to self-treat the disorder, using which method?

• Prayer
• Magnetic therapy
• Foods considered to be yin
• Foods considered to be yang

Answer: 3

Rationale: In the Asian- American culture, health is believed to be a state of

physical and spiritual harmony with nature and a balance between positive and negative energy forces (yin and yang). Yin foods are cold and yang foods are hot.Cold foods are eaten when one has a hot illness (fever), and hot foods are eaten when one has a cold illness. Option 1 and 2 are not health practices specifically associated with the Asian-American culture or yin and yang theory.

Test-Taking Strategy: Focus on the subject, an Asian-American, and the client's

diagnosis, fever. Remember that cold foods (yin foods) are eaten when one has a hot illness, and hot foods (yang foods) are eaten when one has a cold illness.

Reference: Jarvis (2012), p. 21 & Saunders, p. 48.

6.10. The role of the nurse regarding complementary and

alternative medicine should include which action?

• Advising the client about "good" versus "bad" therapies
• Recommending herbal remedies that the client should

use

• Discouraging the client from using any alternative

therapies

• Educating the client about therapies that he or she is

using or is interested in using

Answer: 4

Rationale: Complementary (alternative) therapies include a wide variety of

treatment modalities that are used in addition to conventional therapy to treat a disease or illness. Educating the client about therapies that he or she uses or is interested in using is the nurse's role. Options 1, 2, and 3 are inappropriate actions for the nurse to take because they provide advice to the client.

Test-Taking Strategy: Use therapeutic communication techniques. Eliminate

options 1, 2, and 3 because they are nontherapeutic. Recommending an herbal remedy or discouraging a client from doing something is not within the role of practices of the nurse. In addition, it is nontherapeutic to advise a client to do something.

Reference: Potter et al (2013), p. 643-646 & Saunders, p. 48

6.11. An antihypertensive medication has been prescribed

for a client with hypertension. The client tells the clinic nurse that they would like to take an herbal substance to help lower their blood pressure. The nurse should take which action?

• Tell the client herbal substances are not safe and

should never be used.

• Teach the client how to take their blood pressure so

that is can be monitored closely.

• Encourage the client to discuss the use of an herbal

substance with the health care provider.

• Tell the client that if they take the herbal substance

they will need to have their blood pressure checked frequently.

Answer: 3

Rationale: Although herbal substance may have some beneficial effects, not all

herbs are safe to use. Clients who are being treated with conventional medication therapy should be encourage d to avoid herbal substances with similar pharmacological effects because the combination may lead to an excessive reaction or to unknown interaction effects. The nurse should advise the client to discuss the use of the herbal substance with the HCP. Therefore, options 1, 2, and

• are inappropriate nursing actions.

Test-Taking Strategy: Eliminate option 1 first because of the close-ended word

never. Next, eliminate options 2 and 4 because they are comparable or alike and relate to blood pressure monitoring.References: Lewis et al (2011), p. 93, Ulbricht (201), p. 4, & Saunders p. 49

6.12. The nurse educator asks a student to list the five

categories of complementary and alternative medicine (CAM), developed by the National Center for Complementary and Alternative Medicine. Which statement, if made by the nursing student, would indicate an understanding of the five categories of CAM?

• Herbology, hydrotherapy, acupuncture, nutrition, and

chiropractic care

• Mind-body medicine, traditional Chinese medicine,

homeopathy, naturopathy, and healing touch

• Biologically based practices, body-based practices,

magnetic therapy, massage therapy, and aroma therapy

• Whole medical systems, mind-body medicine,

biologically based practices, manipulative and body- based practices, and energy medicine

Answer: 4

Rationale: The five categories of complementary and alternative medicine (CAM)

include whole medical systems, mind-body medicine, biologically based practices, manipulative and body-based practices, and energy medicine. The other options contain therapies within each category of CAM.Test-Taking Strategy: Focus on the subject of the question, the five categories of CAM. Nothing that the question asks about categories, not therapies, will assist in directing you to the correct option.

References: Potter et al (2013), p. 643-646 & Saunders, p. 49.