Health & Physical Assessment in Nursing, 4e (Fenske/Watkins/Saunders/D'Amico/Barbarito)

Chapter 3 Cultural and Spiritual Considerations

1. The nurse is preparing an educational program for the staff on cultural considerations. The nurse includes the following definition: "The adoption and incorporation of characteristics, customs, and values of the dominant culture by those new to that culture." Which term should the nursing staff understand this definition is being referred to?

1. Ethnicity.

2. Assimilation.

3. Ethnocentrism.

4. Culture.

Page Ref: 23

Cognitive Level: Remembering

Client Need & Sub: Psychosocial Integrity; Cultural Awareness/Cultural Influences on Health

Standards: QSEN Competencies: I.A.2. Describe how diverse cultural, ethnic, and social backgrounds function as sources of patient, family, and community values, | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Context and Environment: Transcultural approaches to health. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 3.1: Examine the components included in the definitions of culture and spirituality.

MNL Learning Outcome: 3.1: Examine the components included in the definitions of culture and spirituality.

1. The nurse is admitting a client of the Muslim faith during the holy month of Ramadan. The client tells the nurse that he must fast during this time. Which response by the nurse is the most appropriate?

1. "What can we do to accommodate your needs during your stay here?"

2. "I will let your healthcare provider know that you need to be discharged."

3. "Fasting may be harmful to your body during your illness."

4. "You must eat a high protein diet during times of illness."

Page Ref: 25

Cognitive Level: Applying

Client Need & Sub: Psychosocial Integrity; Cultural Awareness/Cultural Influences on Health

Standards: QSEN Competencies: I.A.2. Describe how diverse cultural, ethnic, and social backgrounds function as sources of patient, family, and community values. | AACN Essentials Competencies: VII.7. Collaborate with other healthcare professionals and patients to provide spiritually and culturally appropriate health promotion and disease and injury prevention interventions. | NLN Competencies: Context and Environment: Transcultural approaches to health. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 3.3: Describe the impact of culture and spirituality on health and wellness.

MNL Learning Outcome: 3.1: Examine the components included in the definitions of culture and spirituality.

1. The nurse is caring for an older adult Native American client who is experiencing severe chest pain. The client is accompanied by a tribesman at the insistence of the client. The tribesman tells the nurse that their culture teaches acceptance of death as part of the natural cycle of life and that treatments must be stopped. The client's son insists that his father be treated and states he feels the tribe's teachings are antiquated. Which action by the nurse is the most appropriate?

1. Call the social worker to plan a family meeting without the tribesman.

2. Interview the client and ascertain his wishes and beliefs.

3. Convene the hospital ethics committee.

4. Call the nursing supervisor.

Page Ref: 24

Cognitive Level: Applying

Client Need & Sub: Psychosocial Integrity; Cultural Awareness/Cultural Influences on Health

Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Context and Environment: Conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 3.4: Demonstrate cultural and spiritual sensitivity when interacting with patients.

MNL Learning Outcome: 3.4: Recognize the factors, assessment, and effects of spirituality on health and wellness.

1. The nurse is assessing an adolescent client fluent in English that immigrated to the United States at the age of 4. When asked what cultural preferences he has, he states "I am American." What should the client's statement indicate to the nurse?

1. He has no interest in the interview.

2. He is embarrassed about his ethnicity.

3. He is assimilated into the American culture.

4. He wishes to deny his Asian heritage.

Page Ref: 23

Cognitive Level: Applying

Client Need & Sub: Psychosocial Integrity; Cultural Awareness/Cultural Influences on Health

Standards: QSEN Competencies: I.A.2. Describe how diverse cultural, ethnic, and social backgrounds function as sources of patient, family, and community values. | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Context and Environment: Transcultural approaches to health. | Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 3.4: Demonstrate cultural and spiritual sensitivity when interacting with patients.

MNL Learning Outcome: 3.1: Examine the components included in the definitions of culture and spirituality.

1. The nurse manager is discussing cultural considerations with a group of staff nurses. Which statements by the staff nurses indicate an appropriate understanding of cultural concepts? Select all that apply.

1. "Culture can best be described as an awareness of belonging to a group in which certain characteristics differentiate the members of one group from another."

2. "A good description of culture is one that recognizes socially transmitted beliefs, behaviors, values, customs, lifestyles, and ways of thinking of a specific population that guides an individual's worldview."

3. "Culture is the certainty that one's own beliefs, way of life, values, and customs are superior to others."

4. "Culture is the identification of an individual or group by shared genetic heritage and biologic characteristics."

5. "Decisions made by an individual are largely influenced by culture."

Page Ref: 21

Cognitive Level: Understanding

Client Need & Sub: Safe and Effective Care Environment; Concepts of Management

Standards: QSEN Competencies: I.A.2 Describe how diverse cultural, ethnic, and social backgrounds function as sources of patient, family, and community values. | AACN Essentials Competencies: I.5. Apply knowledge of social and cultural factors to the care of diverse populations. | NLN Competencies: Context and Environment: Transcultural approaches to health. | Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 3.1: Examine the components included in the definitions of culture and spirituality.

MNL Learning Outcome: 3.1: Examine the components included in the definitions of culture and spirituality.

1. The nurse is evaluating the subculture of a client. Which should the nurse recognize reflects a generational subculture?

1. A client whose parents were born in another country.

2. A client who was born during a specified period of time.

3. A client who was born in the Unites States but whose children are born elsewhere.

4. A client who was born in the United States but siblings were born in another country.

Page Ref: 21

Cognitive Level: Understanding

Client Need & Sub: Health Promotion and Maintenance; Lifestyle Choices

Standards: QSEN Competencies: I.A.2 Describe how diverse cultural, ethnic, and social backgrounds function as sources of patient, family, and community values. | AACN Essentials Competencies: I.5. Apply knowledge of social and cultural factors to the care of diverse populations. | NLN Competencies: Context and Environment: Transcultural approaches to health. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 3.1: Examine the components included in the definitions of culture and spirituality.

MNL Learning Outcome: 3.1: Examine the components included in the definitions of culture and spirituality.

1. The nurse is researching matriarchal cultures to understand how this family pattern affects healthcare. Which culture should the nurse anticipate to research?

1. Appalachian.

2. Italian

3. African American.

4. Filipino.

Page Ref: 24

Cognitive Level: Understanding

Client Need & Sub: Psychosocial Integrity; Cultural Awareness/Cultural Influences on Health

Standards: QSEN Competencies: I.A.2. Describe how diverse cultural, ethnic, and social backgrounds function as sources of patient, family, and community values. | AACN Essentials Competencies: I.1. Integrate theories and concepts from liberal education into nursing practice. | NLN Competencies: Context and Environment: Transcultural approaches to health. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 3.3: Describe the impact of culture and spirituality on health and wellness.

MNL Learning Outcome: 3.2: Recognize how cultural phenomena relates to healthcare.

1. The nurse is interviewing a client and wishes to determine the roles of various members of an extended family living together in one household. Which statement should the nurse use to assess this information? Select all that apply.

1. "What language is spoken in your house?"

2. "Is every member in your household employed?"

3. "Tell me about the responsibilities of family members in your home."

4. "Who makes the decisions for your family members?"

5. "Are you happy with your place in the family?"

Page Ref: 24

Cognitive Level: Applying

Client Need & Sub: Psychosocial Integrity; Cultural Awareness/Cultural Influences on Health

Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Context and Environment: Conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 3.4: Demonstrate cultural and spiritual sensitivity when interacting with patients.

MNL Learning Outcome: 3.3: Determine the components of a cultural assessment within a comprehensive health assessment.

1. The nurse is evaluating the nonmaterial culture of a client. Which should the nurse focus upon?

1. Social structure.

2. Clothing.

3. Heritage.

4. Religious affiliation.

Page Ref: 21

Cognitive Level: Understanding

Client Need & Sub: Psychosocial Integrity; Cultural Awareness/Cultural Influences on Health

Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Context and Environment: Conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 3.1: Examine the components included in the definitions of culture and spirituality.

MNL Learning Outcome: 3.1: Examine the components included in the definitions of culture and spirituality.

1. The nurse is assessing a client's ethnicity. Which statement should the nurse recognize reflects an American subculture?

1. "I am Chinese American."

2. "I am of Irish descent."

3. "I am British."

4. "I am multiethnic."

Page Ref: 21

Cognitive Level: Applying

Client Need & Sub: Psychosocial Integrity; Cultural Awareness/Cultural Influences on Health

Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Context and Environment: Conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 3.1: Examine the components included in the definitions of culture and spirituality.

MNL Learning Outcome: 3.1: Examine the components included in the definitions of culture and spirituality.

1. The nurse is preparing to obtain a mini heritage assessment on a client. Which question should the nurse include?

1. "What is your religious preference?"

2. "Do you speak English?"

3. "Are you able to adapt with other cultures?"

4. "What ethnicity do you identify with?"

Page Ref: 22

Cognitive Level: Applying

Client Need & Sub: Psychosocial Integrity; Cultural Awareness/Cultural Influences on Health

Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Context and Environment: Conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 3.2: Practice using terms related to culture and spirituality.

MNL Learning Outcome: 3.3: Determine the components of a cultural assessment within a comprehensive health assessment.

1. The nurse is reviewing overall cultural beliefs in relation to health and illness. Which should the nurse recognize is the basis for belief that centers around the cause of illness?

1. Behavior.

2. Germ theory.

3. Scientific theory.

4. Nonscientific theory.

Page Ref: 23

Cognitive Level: Applying

Client Need & Sub: Psychosocial Integrity; Cultural Awareness/Cultural Influences on Health

Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Context and Environment: Conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 3.2: Practice using terms related to culture and spirituality.

MNL Learning Outcome: 3.2: Recognize how cultural phenomena relates to healthcare.

1. The nurse is reviewing the temporal relationships of the Western society. Which should the nurse be mindful of when caring for clients of Western culture?

1. Flexible orientation.

2. Present moment.

3. Traditions of the past.

4. Future oriented.

Page Ref: 24

Cognitive Level: Applying

Client Need & Sub: Psychosocial Integrity; Cultural Awareness/Cultural Influences on Health

Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Context and Environment: Conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 3.3: Describe the impact of culture and spirituality on health and wellness.

MNL Learning Outcome: 3.2: Recognize how cultural phenomena relates to healthcare.

1. The educator has discussed with nursing staff the importance of recognizing the culturally specific roles and relationships that exist within a family. Which statement made by a nurse indicates an understanding of the information?

1. "The familial title of the family member will indicate what role they have."

2. "A family member's occupation will indicate what family role they have."

3. "The family member who has the highest educational level has the most significant role."

4. "A family member's age is significant when it comes to cultural roles and relationships."

Page Ref: 24

Cognitive Level: Applying

Client Need & Sub: Psychosocial Integrity; Cultural Awareness/Cultural Influences on Health

Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Context and Environment: Conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 3.3: Describe the impact of culture and spirituality on health and wellness.

MNL Learning Outcome: 3.2: Recognize how cultural phenomena relates to healthcare.

1. The nurse is assessing the client's ethnicity. Which should the nurse understand is included in the assessment? Select all that apply.

1. Religious preference.

2. Dietary practices.

3. Political beliefs.

4. Marital status.

5. Nationality.

Page Ref: 22

Cognitive Level: Analyzing

Client Need & Sub: Psychosocial Integrity; Cultural Awareness/Cultural Influences on Health

Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Context and Environment: Conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 3.1: Examine the components included in the definitions of culture and spirituality.

MNL Learning Outcome: 3.3: Determine the components of a cultural assessment within a comprehensive health assessment.

1. The new nurse expresses frustration to the preceptor about caring for clients with differing healthcare beliefs and practices. Which action should the preceptor take?

1. Encourage the nurse to reduce expression for the values of others.

2. Encourage the nurse to closely examine their own cultural practices and beliefs.

3. Inform the manager of the concern for the nurse to be able to care for clients.

4. Recommend that the nurse meet with a counselor to discuss ethnic biases.

Page Ref: 22

Cognitive Level: Applying

Client Need & Sub: Safe and Effective Care Environment; Ethical Practice

Standards: QSEN Competencies: I.C.5. Recognize personally held attitudes about working with patients from different ethnic, cultural, and social backgrounds | AACN Essentials Competencies: VIII.6. Reflect on one's own beliefs and values as they relate to professional practice. | NLN Competencies: Personal and Professional Development: Ethical comportment and be aware of personal beliefs, values, and biases. | Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 3.4: Demonstrate cultural and spiritual sensitivity when interacting with patients.

MNL Learning Outcome: 3.4: Recognize the factors, assessment, and effects of spirituality on health and wellness.

1. The nurse would like to explore to what extent acculturalization has impacted the diet of a client that has recently immigrated to the United States. Which question should the nurse ask the client?

1. "Are there any foods you avoid for cultural reasons?"

2. "Has your diet changed in any way since you moved here?"

3. "Do you use any dietary health remedies or practices that are related to your culture?"

4. "Is there any time of the year that you change your diet for cultural reasons?"

Page Ref: 25

Cognitive Level: Applying

Client Need & Sub: Psychosocial Integrity; Cultural Awareness/Cultural Influences on Health

Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Context and Environment: Conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 3.4: Demonstrate cultural and spiritual sensitivity when interacting with patients.

MNL Learning Outcome: 3.4: Recognize the factors, assessment, and effects of spirituality on health and wellness.

1. The nurse has asked a client if there is anyone else that should be included in the nutritional conversation. Which should the nurse recognize is the cultural importance eliciting this information?

1. The client may defer to an elder when answering questions.

2. The client may not understand the information.

3. The client may not want to discuss nutritional information.

4. The client may not be the person that grocery shops.

Page Ref: 25

Cognitive Level: Applying

Client Need & Sub: Psychosocial Integrity; Cultural Awareness/Cultural Influences on Health

Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Context and Environment: Conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 3.3: Describe the impact of culture and spirituality on health and wellness.

MNL Learning Outcome: 3.3: Determine the components of a cultural assessment within a comprehensive health assessment.

1. The nurse educator discusses the expectations concerning the acceptance of a client's cultural beliefs with new nurses. Which statement made by the nurse should the educator recognize indicates the need for further teaching?

1. "The acceptance of different cultural values is needed to provide quality nursing care."

2. "Cultural values may dictate my client assignments on the nursing unit."

3. "My own cultural values are irrelevant to the acceptance of the values of others."

4. "I understand that my role as a nurse may be viewed differently based on the cultural beliefs."

Page Ref: 21

Cognitive Level: Applying

Client Need & Sub: Psychosocial Integrity; Cultural Awareness/Cultural Influences on Health

Standards: QSEN Competencies: I.A.2. Describe how diverse cultural, ethnic, and social backgrounds function as sources of patient, family, and community values. | AACN Essentials Competencies: VII.7. Collaborate with other healthcare professionals and patients to provide spiritually and culturally appropriate health promotion and disease and injury prevention interventions. | NLN Competencies: Context and Environment: Transcultural approaches to health. | Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 3.1: Examine the components included in the definitions of culture and spirituality.

MNL Learning Outcome: 3.1: Examine the components included in the definitions of culture and spirituality.

1. During an admission assessment, the client tells the nurse that they have been taking herbs to help lower the blood pressure. Which question should the nurse ask the client?

1. "What herbs have been used to manage your condition?"

2. "Have you shared this with your healthcare provider?"

3. "Where you aware that herbal preparations may interfere with your treatment?"

4. "When was the last dosage of the herbal remedies taken?"

Page Ref: 25

Cognitive Level: Analyzing

Client Need & Sub: Pharmacological and Parenteral Therapies; Adverse Effects/Contraindications/Side Effects/Interactions

Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | AACN Essentials Competencies: VII.7. Collaborate with other healthcare professionals and patients to provide spiritually and culturally appropriate health promotion and disease and injury prevention interventions. | NLN Competencies: Context and Environment: Transcultural approaches to health. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 3.4: Demonstrate cultural and spiritual sensitivity when interacting with patients.

MNL Learning Outcome: 3.4: Recognize the factors, assessment, and effects of spirituality on health and wellness.

1. The nurse is caring for a non-English speaking client suspected of having food borne illness. Which information should the nurse focus on?

1. Inquire as to whether the client has eaten a newer version of a traditional diet.

2. Inquire as to whether new foods have been added to traditional foods.

3. Inquire about the type of food preparation methods that are used.

4. Inquire about common dietary staples used in the food.

Page Ref: 25

Cognitive Level: Analyzing

Client Need & Sub: Physiological Integrity; Illness Management

Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | AACN Essentials Competencies: VII.7. Collaborate with other healthcare professionals and patients to provide spiritually and culturally appropriate health promotion and disease and injury prevention interventions. | NLN Competencies: Context and Environment: Transcultural approaches to health. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 3.3: Describe the impact of culture and spirituality on health and wellness.

MNL Learning Outcome: 3.2: Recognize how cultural phenomena relates to healthcare.

1. The nurse has provided discharge teaching using an interpreter for a non-English-speaking client. Which additional material should the nurse provide the client?

1. A medical language translation dictionary.

2. Instructions written in the client's native language.

3. Discharge information with pictures and drawings.

4. The number for language interpretation.

Page Ref: 24

Cognitive Level: Applying

Client Need & Sub: Safe and Effective Care Environment; Concepts of Management

Standards: QSEN Competencies: I.A.9. Discuss principles of effective communication. | AACN Essentials Competencies: VII.7. Collaborate with other healthcare professionals and patients to provide spiritually and culturally appropriate health promotion and disease and injury prevention interventions. | NLN Competencies: Context and Environment: Conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 3.4: Demonstrate cultural and spiritual sensitivity when interacting with patients.

MNL Learning Outcome: 3.4: Recognize the factors, assessment, and effects of spirituality on health and wellness.

1. The nurse is caring for a client in a lower socioeconomic group. When caring for the client, which should the nurse understand is a common healthcare practice?

1. The client is more likely to use the emergency room for routine care.

2. Episodic acute care is usually sought.

3. The client has a mistrust of the healthcare system.

4. There is a knowledge deficit about the illness.

Page Ref: 25

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance; Self-Care

Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Context and Environment: Conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 3.3: Describe the impact of culture and spirituality on health and wellness.

MNL Learning Outcome: 3.2: Recognize how cultural phenomena relates to healthcare.

1. The educator is reviewing with a new nurse the factors that ethnicity and culture can influence in a client. Which factors should the educator include? Select all that apply.

1. Roles.

2. Nonverbal communication.

3. Occupation.

4. Health practices.

5. Relationships.

Page Ref: 26

Cognitive Level: Applying

Client Need & Sub: Psychosocial Integrity; Cultural Awareness/Cultural Influences on Health

Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Context and Environment: Conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 3.4: Demonstrate cultural and spiritual sensitivity when interacting with patients.

MNL Learning Outcome: 3.4: Recognize the factors, assessment, and effects of spirituality on health and wellness.

1. The nurse is performing a mini cultural assessment. Which question should the nurse include?

1. "Do you participate in ethnic activities?"

2. "Do you have extended family nearby?"

3. "Do you identify with a specific ethnic or group?"

4. "Where were your parents and grandparents born?"

Page Ref: 26

Cognitive Level: Applying

Client Need & Sub: Psychosocial Integrity; Cultural Awareness/Cultural Influences on Health

Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Context and Environment: Conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 3.4: Demonstrate cultural and spiritual sensitivity when interacting with patients.

MNL Learning Outcome: 3.4: Recognize the factors, assessment, and effects of spirituality on health and wellness.

1. The nurse admitting a client to the unit is obtaining information regarding the client's spiritual practices. Which questions should the nurse include in the assessment? Select all that apply.

1. "Are there any dietary restrictions associated with your spiritual practice?"

2. "Would you feel more comfortable with your family present?"

3. "How do your spiritual beliefs influence your health?"

4. "Do you have any rituals that you perform at certain times of the day?"

5. "Would you like your spiritual leader to be contacted?"

Page Ref: 29

Cognitive Level: Applying

Client Need & Sub: Psychosocial Integrity; Cultural Awareness/Cultural Influences on Health

Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Context and Environment: Conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 3.3: Describe the impact of culture and spirituality on health and wellness.

MNL Learning Outcome: 3.3: Determine the components of a cultural assessment within a comprehensive health assessment.

1. The educator is reviewing the nursing staff's spiritual care competence. Which statement made by a nurse should the educator be concerned with?

1. "I have provided care for a client that was experiencing spiritual distress."

2. "I do not think that clients are comfortable talking about their spiritual preferences."

3. "I am not comfortable praying with a client so when a client requests to pray, I offer to call the Chaplain."

4. "I will ask the client to explain their prayer ritual if I do not understand it."

Page Ref: 29

Cognitive Level: Applying

Client Need & Sub: Safe and Effective Care Environment; Ethical Practice

Standards: QSEN Competencies: I.C.5. Recognize personally held attitudes about working with patients from different ethnic, cultural, and social backgrounds. | AACN Essentials Competencies: VIII.6. Reflect on one's own beliefs and values as they relate to professional practice. | NLN Competencies: Personal and Professional Development: Ethical Comportment and be aware of personal beliefs, values, and biases. | Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 3.1: Examine the components included in the definitions of culture and spirituality.

MNL Learning Outcome: 3.1: Examine the components included in the definitions of culture and spirituality.

1. The nurse receiving report on a patient is told the client is experiencing spiritual distress. Which should the nurse understand the client may exhibit?

1. Withdrawal.

2. Aggression.

3. Hostility.

4. Emptiness.

5. Nightmares.

Page Ref: 28

Cognitive Level: Applying

Client Need & Sub: Psychosocial Integrity; Cultural Awareness/Cultural Influences on Health

Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Context and Environment: Conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 3.4: Demonstrate cultural and spiritual sensitivity when interacting with patients.

MNL Learning Outcome: 3.4: Recognize the factors, assessment, and effects of spirituality on health and wellness.

1. The nurse is assessing a client's spiritual strengths using the interpretive framework from a narrative spiritual assessment. Which question should the nurse ask the client to assess their communion?

1. "How does your spirituality affect your joy, sorrow, and coping?"

2. "What is your relationship with God?"

3. "Describe your values?"

4. "Have you experienced any spiritual hunches?"

Page Ref: 30

Cognitive Level: Applying

Client Need & Sub: Psychosocial Integrity; Cultural Awareness/Cultural Influences on Health

Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Context and Environment: Conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 3.3: Describe the impact of culture and spirituality on health and wellness.

MNL Learning Outcome: 3.3: Determine the components of a cultural assessment within a comprehensive health assessment.

1. The nurse educator is presenting information on culture and ethnicity to the nurses on the unit. Which statement by a nurse should the educator recognize indicates further teaching is required?

1. "I noticed that clients of different cultures have more than one different belief."

2. "When identifying individuals of the same race, they will have shared genetic heritage, biologic and physiologic characteristics."

3. "Ethnic groups share common values over generations."

4. "An individual may self-identify with an ethnic group that is different from the ethnic group of their birth or race."

Page Ref: 22

Cognitive Level: Applying

Client Need & Sub: Psychosocial Integrity; Cultural Awareness/Cultural Influences on Health

Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Context and Environment: Conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 3.1: Examine the components included in the definitions of culture and spirituality.

MNL Learning Outcome: 3.1: Examine the components included in the definitions of culture and spirituality.