Old's Maternal-Newborn Nursing and Women's Health, 11e (Davidson/London/Ladewig)

Chapter 2 Families, Cultures, and Complementary Therapies

1. A couple who came to the United States two years ago with their two children are seeing the nurse in the community clinic. The nurse knows their family is acculturating when the mother makes which statement?
2. "The children are much less well-behaved than they used to be."
3. "Our diet now includes hamburgers and French fries."
4. "We celebrate the same holidays that we used to at home."
5. "When the children leave the house, I worry about them."

Page Ref: 20

Cognitive Level: Understanding

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

Standards: Q S E N Competencies: Ⅰ. B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | A A C N 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. | N L N Competencies: Relationship-Centered Care: Appreciate the patient as a whole person, with his or her own life story and ideas about the meaning of health or illness. | Nursing/Integrated Concepts: Nursing Process: Assessment.

Learning Outcome: 1 Compare the characteristics of different types of families.

M N L L O: Demonstrate ability to incorporate culturally competent care for patients and families.

1. Which of the following best describes a nuclear family?
2. An unmarried woman who chooses to conceive or adopt without a life partner.
3. Children live in a household with both biologic parents and no other relatives or persons.
4. A couple shares household and childrearing responsibilities with parents, siblings, or other relatives.
5. The head of the household is widowed, divorced, abandoned, separated, or most often, the mother remains unmarried.

Page Ref: 17

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Developmental Stages and Transitions

Standards: Q S E N Competencies: Ⅰ. A. 2. Describe how diverse cultural, ethnic, and social backgrounds function as sources of patient, family, and community values. | A A C N Essentials Competencies: Ⅶ. 3. Assess health/illness beliefs, values, attitudes, and practices of individuals, families, groups, communities, and populations. | N L N Competencies: Relationship-Centered Care: The role of family, culture, and community in a person's development. | Nursing/Integrated Concepts: Nursing Process: Assessment.

Learning Outcome: 1 Compare the characteristics of different types of families.

M N L L O: Demonstrate ability to incorporate culturally competent care for patients and families.

1. What is the term for when children alternate between two homes, spending varying amounts of time with each parent in a situation called co-parenting and usually involving joint custody?
2. Blended or reconstituted nuclear family
3. Extended kin network family
4. Binuclear family
5. Extended family

Page Ref: 18

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Developmental Stages and Transitions

Standards: Q S E N Competencies: Ⅰ. A. 2. Describe how diverse cultural, ethnic, and social backgrounds function as sources of patient, family, and community values. | A A C N Essentials Competencies: Ⅶ. 3. Assess health/illness beliefs, values, attitudes, and practices of individuals, families, groups, communities, and populations. | N L N Competencies: Relationship-Centered Care: The role of family, culture, and community in a person's development. | Nursing/Integrated Concepts: Nursing Process: Assessment.

Learning Outcome: 1 Compare the characteristics of different types of families.

M N L L O: Demonstrate ability to incorporate culturally competent care for patients and families.

1. Duvall's eight stages in the family life cycle of a traditional nuclear family have been used as the foundation for contemporary models that describe the developmental processes and role expectations for different family types. Which of the following is an example of Stage Ⅳ of this family life cycle?
2. Families launching young adults (all children leave home)
3. Families with preschool-age children (oldest child is between 2.5 and 6 years of age)
4. Middle-aged parents (empty nest through retirement)
5. Families with schoolchildren (oldest child is between 6 and 13 years of age)

Page Ref: 19

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Developmental Stages and Transitions

Standards: Q S E N Competencies: Ⅰ. A. 2. Describe how diverse cultural, ethnic, and social backgrounds function as sources of patient, family, and community values. | A A C N Essentials Competencies: Ⅶ. 3. Assess health/illness beliefs, values, attitudes, and practices of individuals, families, groups, communities, and populations. | N L N Competencies: Relationship-Centered Care: The role of family, culture, and community in a person's development. | Nursing/Integrated Concepts: Nursing Process: Implementation.

Learning Outcome: 2 Identify the stages of a family life cycle.

M N L L O: Demonstrate ability to incorporate culturally competent care for patients and families.

1. A 7-year-old client tells the nurse that "Grandpa, Mommy, Daddy, and my brother live at my house." The nurse identifies this as what type of family?
2. Binuclear
3. Extended
4. Gay or lesbian
5. Traditional

Page Ref: 17

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Developmental Stages and Transitions

Standards: Q S E N Competencies: Ⅰ. A. 2. Describe how diverse cultural, ethnic, and social backgrounds function as sources of patient, family, and community values. | A A C N Essentials Competencies: Ⅶ. 3. Assess health/illness beliefs, values, attitudes, and practices of individuals, families, groups, communities, and populations. | N L N Competencies: Relationship-Centered Care: The role of family, culture, and community in a person's development. | Nursing/Integrated Concepts: Nursing Process: Assessment.

Learning Outcome: 1 Compare the characteristics of different types of families.

M N L L O: Demonstrate ability to incorporate culturally competent care for patients and families.

1. A nurse is performing an assessment on a family with a father and mother who both work. What type of family does she record this family as being?
2. A traditional nuclear family
3. A dual-career/dual-earner family
4. An extended family
5. An extended kin family

Page Ref: 17

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Developmental Stages and Transitions

Standards: Q S E N Competencies: Ⅰ. A. 2. Describe how diverse cultural, ethnic, and social backgrounds function as sources of patient, family, and community values. | A A C N Essentials Competencies: Ⅶ. 3. Assess health/illness beliefs, values, attitudes, and practices of individuals, families, groups, communities, and populations. | N L N Competencies: Relationship-Centered Care: The role of family, culture, and community in a person's development. | Nursing/Integrated Concepts: Nursing Process: Assessment.

Learning Outcome: 1 Compare the characteristics of different types of families.

M N L L O: Demonstrate ability to incorporate culturally competent care for patients and families.

1. Why is it important for the nurse to understand the type of family that a client comes from?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Family structure can influence finances.
2. Some families choose to conceive or adopt without a life partner.
3. The nurse can anticipate which problems a client will experience based on the type of family the client has.
4. Understanding if the client's family is nuclear or blended will help the nurse teach the client the appropriate information.
5. The values of the family will be predictable if the nurse knows what type of family the client is a part of.

Page Ref: 17—19

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Developmental Stages and Transitions

Standards: Q S E N Competencies: Ⅰ. B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | A A C N Essentials Competencies: Ⅶ. 3. Assess health/illness beliefs, values, attitudes, and practices of individuals, families, groups, communities, and populations. | N L N Competencies: Relationship-Centered Care: Promote and accept the patient's emotions; accept and respond to distress in patient and self; facilitate hope, trust, and faith. | Nursing/Integrated Concepts: Nursing Process: Assessment.

Learning Outcome: 1 Compare the characteristics of different types of families.

M N L L O: Demonstrate ability to incorporate culturally competent care for patients and families.

1. The public health nurse is working with a student nurse. The student nurse asks which of the six groups of people they have seen today are considered to be families. How should the nurse respond?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. "The married heterosexual couple without children"
2. "The gay couple with two adopted children"
3. "The unmarried heterosexual couple with two biological children"
4. "The lesbian couple not living together that have no children"
5. "The married heterosexual couple with three children, living with grandparents"

Page Ref: 17

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Developmental Stages and Transitions

Standards: Q S E N Competencies: Ⅰ. C. 5. Recognize personally held attitudes about working with patients from different ethnic, cultural and social backgrounds. | A A C N Essentials Competencies: Ⅶ. 3. Assess health/illness beliefs, values, attitudes, and practices of individuals, families, groups, communities, and populations. | N L N Competencies: Relationship-Centered Care: Demonstrate self-awareness, self-care, self-growth, be open and nonjudgmental. | Nursing/Integrated Concepts: Nursing Process: Assessment.

Learning Outcome: 1 Compare the characteristics of different types of families.

M N L L O: Demonstrate ability to incorporate culturally competent care for patients and families.

1. In assessing a new family coming to the clinic, the nurse determines they are an extended kin family because the family exhibits what as characteristics of an extended kin network family?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. A sharing of a social support network
2. Each family establishes their own sources of goods and services
3. Elderly parents share housing
4. Children are members of two nuclear families
5. A sharing of goods and services

Page Ref: 17

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Developmental Stages and Transitions

Standards: Q S E N Competencies: Ⅰ. B. 1. Elicit patient values, preferences and expressed needs as part of clinical interview, implementation of care plan and evaluation of care. | A A C N Essentials Competencies: Ⅶ. 3. Assess health/illness beliefs, values, attitudes, and practices of individuals, families, groups, communities, and populations. | N L N Competencies: Relationship-Centered Care: Demonstrate self-awareness, self-care, self-growth; be open and non-judgmental. | Nursing/Integrated Concepts: Nursing Process: Assessment.

Learning Outcome: 1 Compare the characteristics of different types of families.

M N L L O: Demonstrate ability to incorporate culturally competent care for patients and families.

1. The transcultural nursing theory was developed in 1961 by Dr. Madeleine Leininger. Its foundation is in which of the following?
2. The framework categorizes a family's progression over time
3. The family life cycle of a traditional nuclear family
4. Anthropology and nursing
5. Holistic health beliefs

Page Ref: 19

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: Q S E N Competencies: Ⅰ. B. 2. Describe how diverse cultural, ethnic, and social backgrounds function as sources of patient, family, and community values. | A A C N Essentials Competencies: Ⅶ. 3. Assess health/illness beliefs, values, attitudes, and practices of individuals, families, groups, communities, and populations. | N L N Competencies: Relationship-Centered Care: The role of family, culture, and community in a person's development. | Nursing/Integrated Concepts: Nursing Process: Assessment.

Learning Outcome: 3 Identify prevalent cultural norms related to childbearing and childrearing.

M N L L O: Demonstrate ability to incorporate culturally competent care for patients and families.

1. The nurse is preparing a community presentation on family development. Which statement should the nurse include?
2. The youngest child determines the family's current stage.
3. A family does not experience overlapping of stages.
4. Family development ends when the youngest child leaves home.
5. The stages describe the family's progression over time.

Page Ref: 19

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Developmental Stages and Transitions

Standards: Q S E N Competencies: Ⅰ. A. 2. Describe how diverse cultural, ethnic, and social backgrounds function as sources of patient, family, and community values. | A A C N Essentials Competencies: Ⅶ. 3. Assess health/illness beliefs, values, attitudes, and practices of individuals, families, groups, communities, and populations. | N L N Competencies: Relationship-Centered Care: The role of family, culture, and community in a person's development. | Nursing/Integrated Concepts: Nursing Process: Planning.

Learning Outcome: 2 Identify the stages of a family life cycle.

M N L L O: Demonstrate ability to incorporate culturally competent care for patients and families.

1. In learning about Duvall's life-cycle stages ascribed to traditional families, the nursing student recognizes that developmental tasks of each stage include which of the following?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Adjusting to new roles as mother and father
2. Working out authority and socialization roles with the school
3. Becoming a single parent with custodial responsibilities
4. Becoming a couple and dating
5. Adjusting to the loss of a spouse

Page Ref: 19

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Developmental Stages and Transitions

Standards: Q S E N Competencies: Ⅰ. A. 2. Describe how diverse cultural, ethnic, and social backgrounds function as sources of patient, family, and community values. | A A C N Essentials Competencies: Ⅶ. 3. Assess health/illness beliefs, values, attitudes, and practices of individuals, families, groups, communities, and populations. | N L N Competencies: Relationship-Centered Care: The role of family, culture, and community in a person's development. | Nursing/Integrated Concepts: Nursing Process: Assessment.

Learning Outcome: 2 Identify the stages of a family life cycle.

M N L L O: Demonstrate ability to incorporate culturally competent care for patients and families.

1. The nurse is planning a community education program on the role of complementary and alternative therapies during pregnancy. Which statement about alternative and complementary therapies should the nurse include?
2. "They bring about cures for illnesses and diseases."
3. "They are invasive but effective for achieving health."
4. "They emphasize prevention and wellness."
5. "They prevent pregnancy complications."

Page Ref: 27—30

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: Q S E N Competencies: Ⅱ. A. 2. Describe scopes of practice and roles of health care team members. | A A C N Essentials Competencies: Ⅶ. 3. Assess health/illness beliefs, values, attitudes, and practices of individuals, families, groups, communities, and populations. | N L N Competencies: Teamwork: Contribution of other individuals and groups in helping patient/family achieve health goals. | Nursing/Integrated Concepts: Nursing Process: Implementation.

Learning Outcome: 7 Differentiate between complementary and alternative therapies.

M N L L O: Demonstrate ability to incorporate culturally competent care for patients and families.

1. The nurse is preparing to assess the development of a family new to the clinic. The nurse understands that which of the following is the primary use of a family assessment tool?
2. Obtain a comprehensive medical history of family members.
3. Determine to which clinic the client should be referred.
4. Predict how a family will likely change with the addition of children.
5. Understand the physical, emotional, and spiritual needs of members.

Page Ref: 19

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N Essentials Competencies: Ⅳ. 1. Demonstrate skills in using patient care technologies, information systems, and communication devices that support safe nursing practice. | N L N Competencies: Quality and Safety: Carefully maintain and use electronic and/or written health records. | Nursing/Integrated Concepts: Nursing Process: Assessment.

Learning Outcome: 1 Compare the characteristics of different types of families.

M N L L O: Demonstrate ability to incorporate culturally competent care for patients and families.

1. The nurse in the community should use a family assessment tool to obtain what type of information?
2. How long the family has lived at its current address
3. What other health insurance the family has had in the past
4. How the family meets its nutritional needs and obtains food
5. What eye color the family desires in its unborn child

Page Ref: 19

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: Q S E N Competencies: Ⅵ. A. 2. Identify essential information that must be available in a common database to support patient care. | A A C N Essentials Competencies: Ⅳ. 7. Recognize the role of information technology in improving patient care outcomes and creating a safe care environment. | N L N Competencies: Quality and Safety: Carefully maintain and use electronic and/or written health records. | Nursing/Integrated Concepts: Nursing Process: Assessment.

Learning Outcome: 1 Compare the characteristics of different types of families.

M N L L O: Demonstrate ability to incorporate culturally competent care for patients and families.

1. In assessing a family, the community nurse uses a family assessment tool, which provides an organized framework to collect data concerning which of the following?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Access to laundry and grocery facilities
2. Access to health care
3. Sharing of religious beliefs and values
4. Acculturation to traditional lifestyles
5. Ability to include a new spouse into the family unit

Page Ref: 19

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: Q S E N Competencies: Ⅵ. B. 1. Seek education about how information is managed in care settings before providing care. | A A C N Essentials Competencies: Ⅳ. 1. Demonstrate skills in using patient care technologies, information systems, and communication devices that support safe nursing care. | N L N Competencies: Quality and Safety: Carefully maintain and use electronic and/or written health records. | Nursing/Integrated Concepts: Nursing Process: Assessment.

Learning Outcome: 1 Compare the characteristics of different types of families.

M N L L O: Demonstrate ability to incorporate culturally competent care for patients and families.

1. The nurse is assessing a client who reports seeing an acupuncturist on a weekly basis to treat back pain. The nurse understands that acupuncture is an example of what?
2. A risky practice without evidence of efficacy
3. A folk remedy
4. A complementary therapy
5. An alternative therapy

Page Ref: 29

Cognitive Level: Understanding

Client Need/Sub: Physiological Integrity: Basic Care and Comfort

Standards: Q S E N Competencies: Ⅱ. A. 2. Describe scope of practice and roles of health care team members. | A A C N Essentials Competencies: Ⅸ. 17. Develop a beginning understanding of complementary and alternative modalities and their role in health care. | N L N Competencies: Teamwork: Contribution of other individuals and groups in helping patient/family achieve health goals. | Nursing/Integrated Concepts: Nursing Process: Diagnosis.

Learning Outcome: 7 Differentiate between complementary and alternative therapies.

M N L L O: Demonstrate ability to incorporate culturally competent care for patients and families.

1. In working with immigrants in an inner-city setting, the nurse recognizes that acculturation of immigrants often brings with it which of the following benefits?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Improved socioeconomic status
2. Use of preventive care services
3. Better nutrition
4. Increase in substance abuse over time
5. More physician visits due to language barriers

Page Ref: 20

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Management of Care

Standards: Q S E N Competencies: Ⅰ. B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | A A C N 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. | N L N Competencies: Relationship-Centered Care: Appreciate the patient as a whole person, with his or her own life story and ideas about the meaning of health or illness. | Nursing/Integrated Concepts: Nursing Process: Assessment.

Learning Outcome: 3 Identify prevalent cultural norms related to childbearing and childrearing.

M N L L O: Demonstrate ability to incorporate culturally competent care for patients and families.

1. The nurse is caring for a postpartal client of Hmong descent who immigrated to the United States 5 years ago. The client asks for the regular hospital menu because American food tastes best. The nurse assesses this response to be related to which of the following cultural concepts?
2. Acculturation
3. Ethnocentrism
4. Enculturation
5. Stereotyping

Page Ref: 20

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Management of Care

Standards: Q S E N Competencies: Ⅰ. B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | A A C N 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. | N L N Competencies: Relationship-Centered Care: Appreciate the patient as a whole person, with his or her own life story and ideas about the meaning of health or illness. | Nursing/Integrated Concepts: Nursing Process: Assessment.

Learning Outcome: 3 Identify prevalent cultural norms related to childbearing and childrearing.

M N L L O: Demonstrate ability to incorporate culturally competent care for patients and families.

1. The nurse is teaching a community education class on complementary and alternative therapies. To assess learning, the nurse asks, "In traditional Chinese medicine, what is the invisible flow of energy in the body that maintains health and ensures physiologic functioning?" Which answer indicates that teaching was successful?
2. Meridians
3. Chi
4. Yin
5. Yang

Page Ref: 28

Cognitive Level: Remembering

Client Need/Sub: Physiological Integrity: Basic Care and Comfort

Standards: Q S E N Competencies: Ⅰ. A. 2. Describe how diverse cultural, ethnic, and social backgrounds function as sources of patient, family, and community values. | A A C N Essentials Competencies: Ⅶ. 3. Assess health/illness beliefs, values, attitudes, and practices of individuals, families, groups, communities, and populations. | N L N Competencies: Relationship-Centered Care: The role of family, culture, and community in a person's development. | Nursing/Integrated Concepts: Nursing Process: Evaluation.

Learning Outcome: 7 Differentiate between complementary and alternative therapies.

M N L L O: Demonstrate ability to incorporate culturally competent care for patients and families.

1. During the assessment phase of a family, the community nurse recognizes that culture influences childrearing and childbearing in which of the following ways?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Beliefs about the importance of children
2. Beliefs and attitudes about pregnancy
3. Norms regarding infant feeding
4. Acculturation is important in rearing children
5. Time orientation to the future is very important

Page Ref: 19

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance: Developmental Stages and Transitions

Standards: Q S E N Competencies: Ⅰ. C. 1. Value seeing health care situations "through patient's eyes." | A A C N Essentials Competencies: Ⅶ. 3. Assess health/illness beliefs, values, attitudes, and practices of individuals, families, groups, communities, and populations. | N L N Competencies: Relationship-Centered Care: Affirm and value diversity. | Nursing/Integrated Concepts: Nursing Process: Assessment.

Learning Outcome: 3 Identify prevalent cultural norms related to childbearing and childrearing.

M N L L O: Demonstrate ability to incorporate culturally competent care for patients and families.

1. The nurse is teaching a class to the community on mind-based therapies. A class participant gives an example of a friend with leukemia who was taught by her complementary therapist to concentrate on making antibodies that will fight and kill the cancer cells in the bloodstream. How would the nurse identify this technique?
2. Guided imagery
3. Qigong
4. Biofeedback
5. Homeopathy

Page Ref: 29

Cognitive Level: Understanding

Client Need/Sub: Physiological Integrity: Physiological Adaptation

Standards: Q S E N Competencies: Ⅰ. A. 6. Describe strategies to empower patients or families in all aspects of the health care process. | A A C N Essentials Competencies: Ⅸ. 3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across the lifespan and in all healthcare settings. | N L N Competencies: Relationship-Centered Care: Respect the patient's dignity, uniqueness, integrity, and self-determination and his or her own power and self-healing process. | Nursing/Integrated Concepts: Nursing Process: Assessment.

Learning Outcome: 8 Summarize the benefits and risks of complementary health approaches.

M N L L O: Demonstrate ability to incorporate culturally competent care for patients and families.

1. The nurse is admitting a Hispanic woman scheduled for a cholecystectomy. The nurse uses a cultural assessment tool during the admission. Which question would be most important for the nurse to ask?
2. "What other treatments have you used for your abdominal pain?"
3. "In what country were you were born?"
4. "When you talk to family members, how close do you stand?"
5. "How would you describe your role within your family?"

Page Ref: 21

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: Q S E N Competencies: Ⅰ. B. 1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan and evaluation of care. | A A C N Essentials Competencies: Ⅶ. 3. Assess health/illness beliefs, values, attitudes, and practices of individuals, families, groups and communities, and populations. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Planning.

Learning Outcome: 4 Summarize the importance of cultural competency in providing nursing care.

M N L L O: Demonstrate ability to incorporate culturally competent care for patients and families.

1. The nurse works in a facility that cares for clients from a broad range of racial, ethnic, cultural, and religious backgrounds. Which statement should the nurse include in a presentation to recently hired nurses on the client population of the facility?
2. "Our clients come from a broad range of backgrounds, but we have a good interpreter service."
3. "Many of our clients come from backgrounds different from your own, but it doesn't cause problems for the nurses."
4. "Because most of the doctors are bilingual, we don't have to deal with the differences in cultural backgrounds of our clients."
5. "Understanding the common values and health practices of our diverse clients will facilitate better care and health outcomes."

Page Ref: 21—22

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: Q S E N Competencies: Ⅰ. B. 1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan and evaluation of care. | A A C N Essentials Competencies: Ⅶ. 3. Assess health/illness beliefs, values, attitudes, and practices of individuals, families, groups, communities, and populations. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Planning.

Learning Outcome: 4 Summarize the importance of cultural competency in providing nursing care.

M N L L O: Demonstrate ability to incorporate culturally competent care for patients and families.

1. The nurse manager in a hospital with a large immigrant population is planning an in-service. Aware of how ethnocentrism affects nursing care, the nurse manager asks, "The belief that one's own values and beliefs are the only or the best values has which of the following results?"
2. It implies newcomers to the United States should adopt the norms and values of the country.
3. It can create barriers to communication through misunderstanding.
4. It leads to an expectation that all clients will exhibit pain the same way.
5. It improves the quality of care provided to culturally diverse client bases.

Page Ref: 24

Cognitive Level: Understanding

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

Standards: Q S E N Competencies: Ⅰ. C. 1. Value seeing health care situation "through patients' eyes." | A A C N Essentials Competencies: Ⅶ. 3. Assess health/illness beliefs, values, attitudes, and practices of individuals, families, groups, communities, and populations. | N L N Competencies: Relationship-Centered Care: Appreciate the patient as a whole person, with his or her own life story and ideas about the meaning of health or illness. | Nursing/Integrated Concepts: Nursing Process: Planning.

Learning Outcome: 4 Summarize the importance of cultural competency in providing nursing care.

M N L L O: Demonstrate ability to incorporate culturally competent care for patients and families.

1. The client reports using an alternative therapy that involves the manipulation of soft tissues. This therapy has reduced the client's stress, diminished pain, and increased circulation. Which therapy has this client most likely received?
2. Guided imagery
3. Homeopathy
4. Massage therapy
5. Reflexology

Page Ref: 29

Cognitive Level: Understanding

Client Need/Sub: Physiological Integrity: Basic Care and Comfort

Standards: Q S E N Competencies: Ⅰ. B. 2. Communicate patient values, preferences, and expressed needs to other members of the health care team. | A A C N Essentials Competencies: Ⅸ. 17. Develop a beginning understanding of complementary and alternative modalities and their role in health care. | N L N Competencies: Relationship-centered Care: Appreciate the patient as a whole person, with his or her own life story and ideas about the meaning of health or illness. | Nursing/Integrated Concepts: Nursing Process: Assessment.

Learning Outcome: 8 Summarize the benefits and risks of complementary health approaches.

M N L L O: Demonstrate ability to incorporate culturally competent care for patients and families.

1. A nurse is working in a clinic where clients from several cultures are seen. As a first step toward the goal of personal cultural competence, the nurse will do which of the following?
2. Enhance cultural skills.
3. Gain cultural awareness.
4. Seek cultural encounters.
5. Acquire cultural knowledge.

Page Ref: 23

Cognitive Level: Understanding

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

Standards: Q S E N Competencies: Ⅰ. B. 1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan and evaluation of care. | A A C N Essentials Competencies: . 2. Use inter- and intraprofessional communication and collaborative skills to deliver evidence-based, patient-centered care. | N L N Competencies: Relationship-centered Care: Communicate information effectively: listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Planning.

Learning Outcome: 4 Summarize the importance of cultural competency in providing nursing care.

M N L L O: Demonstrate ability to incorporate culturally competent care for patients and families.

1. When teaching a culturally diverse group of childbearing families about hospital birthing options, the culturally competent nurse does which of the following?
2. Understands that the families have the same values as the nurse
3. Teaches the families how childbearing takes place in the United States
4. Insists that the clients answer questions instead of their husbands
5. Incorporates the specific beliefs of the cultural groups that are attending the class

Page Ref: 23

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: Q S E N Competencies: Ⅰ. B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | A A C N Essentials Competencies: Ⅵ. 2. Use inter- and intraprofessional communication and collaborative skills to deliver evidence-based, patient-centered care. | N L N Competencies: Relationship-centered Care: Communicate information effectively: listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Planning.

Learning Outcome: 4 Summarize the importance of cultural competency in providing nursing care.

M N L L O: Demonstrate ability to incorporate culturally competent care for patients and families.

1. Which questions are appropriate for the nurse to ask during a cultural assessment of a client who is new to the clinic?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. What genetic and other biological differences affect caregiving?
2. Which family member must be consulted for decisions about care?
3. What type of healthcare provider is the most appropriate?
4. Does the client have beliefs or traditions that might impact the care plan?
5. Are communications patterns established?

Page Ref: 27

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: Q S E N Competencies: Ⅰ. B. 1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan and evaluation of care. | A A C N Essentials Competencies: Ⅵ. 2. Use inter- and intraprofessional communication and collaborative skills to deliver evidence-based, patient-centered care. | N L N Competencies: Relationship-centered Care: Communicate information effectively: listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Assessment.

Learning Outcome: 4 Summarize the importance of cultural competency in providing nursing care.

M N L L O: Demonstrate ability to incorporate culturally competent care for patients and families.

1. The nurse is working with a client whose religious beliefs differ from those of the general population. What is the best nursing intervention to use to meet the specific spiritual needs of this family?
2. Ask how important the client's religious and spiritual beliefs are when making decisions about health care.
3. Show respect while allowing time and privacy for religious rituals.
4. Ask for the client's opinion on what caused the illness.
5. Identify healthcare practices forbidden by religious or spiritual beliefs.

Page Ref: 22—23

Cognitive Level: Understanding

Client Need/Sub: Psychosocial Integrity: Religious and Spiritual Influences on Health

Standards: Q S E N Competencies: Ⅰ. C. 2. Respect and encourage individual expression of patient values, preferences, and expressed need. | A A C N Essentials Competencies: Ⅷ. 1. Demonstrate the professional standards of moral, ethical, and legal conduct. | N L N Competencies: Relationship-Centered Care: Appreciate the patient as a whole person with his or her own life story and ideas about the meaning of health or illness. | Nursing/Integrated Concepts: Nursing Process: Implementation.

Learning Outcome: 6 Identify key considerations in providing spiritually sensitive care.

M N L L O: Demonstrate ability to incorporate culturally competent care for patients and families.

1. The labor and delivery nurse is caring for a laboring client who has asked for a priest to visit her during labor. The client's mother died during childbirth, and although there were no complications during her pregnancy, the client is fearful of her own death during labor. What would be the best way for the nurse to respond?
2. "Nothing is going to happen to you. We'll take very good care of you during your birth."
3. "Would you like to have an epidural so that you won't feel the pain of the contractions?"
4. "The priest won't be able to prevent complications, and might get in the way of your providers."
5. "Would you like me to contact someone from your parish or our hospital chaplain to come see you?"

Page Ref: 26

Cognitive Level: Applying

Client Need/Sub: Psychosocial Integrity: Religious and Spiritual Influences on Health

Standards: Q S E N Competencies: Ⅰ. C. 2. Respect and encourage individual expression of patient values, preferences, and expressed need. | A A C N Essentials Competencies: Ⅷ. 1. Demonstrate the professional standards of moral, ethical, and legal conduct. | N L N Competencies: Relationship-Centered Care: Appreciate the patient as a whole person with his or her own life story and ideas about the meaning of health or illness. | Nursing/Integrated Concepts: Nursing Process: Planning.

Learning Outcome: 6 Identify key considerations in providing spiritually sensitive care.

M N L L O: Demonstrate ability to incorporate culturally competent care for patients and families.

1. The client reports relief from headaches when she rubs the temples on each side of her head. The nurse understands that this is a form of which of the following?
2. Acupressure
3. Acupuncture
4. Reflexology
5. Hydrotherapy

Page Ref: 29

Cognitive Level: Understanding

Client Need/Sub: Physiological Integrity: Basic Care and Comfort

Standards: Q S E N Competencies: Ⅰ. A. 2. Describe strategies to empower patients or families in all aspects of the health care process. | A A C N Essentials Competencies: Ⅸ. 17. Develop a beginning understanding of complementary and alternative modalities and their role in health care. | N L N Competencies: Relationship-Centered Care: Appreciate the patient as a whole person, with his or her own life story and ideas about the meaning of health and illness. | Nursing/Integrated Concepts: Nursing Process: Assessment.

Learning Outcome: 8 Summarize the benefits and risks of complementary health approaches.

M N L L O: Demonstrate ability to incorporate culturally competent care for patients and families.

1. The nurse is reviewing a list of families scheduled for community health visits. To visit these families according to the family life cycle each is in, in which order from first to last should the nurse visit these families?
2. Family with a 12-month-old child
3. Family whose oldest child is in the 5th grade
4. Family whose oldest child is attending college
5. Family whose youngest child just got a driver's license
6. Family whose youngest child got married last weekend
7. Family whose male partner retired from full-time employment

Page Ref: 19

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance

Standards: Q S E N Competencies: Ⅰ. A. 2. Describe how diverse cultural, ethnic and social backgrounds function as sources of patient, family, and community values. | A A C N Essentials Competencies: Ⅸ. 5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | N L N Competencies: Relationship Centered Care; Knowledge; The role of family, culture, and community in a person's development. | Nursing/Integrated Concepts: Planning; Nursing Process.

Learning Outcome: 2 Identify the stages of a family life cycle.

M N L L O: Demonstrate ability to incorporate culturally competent care for patients and families.

1. The community nurse is planning to visit a family. The grandparents are helping the adult parents with child-rearing activities. For which type of family should the nurse plan care?
2. Nuclear
3. Blended
4. Binuclear
5. Extended

Page Ref: 17

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance

Standards: Q S E N Competencies: Ⅰ. A. 2. Describe how diverse cultural, ethnic and social backgrounds function as sources of patient, family, and community values. | A A C N Essentials Competencies: Ⅸ. 5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | N L N Competencies: Relationship Centered Care; Knowledge; The role of family, culture, and community in a person's development. | Nursing/Integrated Concepts: Planning; Nursing Process.

Learning Outcome: 1 Compare the characteristics of different types of families.

M N L L O: Demonstrate ability to incorporate culturally competent care for patients and families.

1. A pregnant patient from a culture that treats hot and cold conditions with food is experiencing a severe lower back ache. According to the table shown here, which food should the nurse provide to help this patient?

Table 2-2 Hot and Cold Conditions and Foods

Source: Data from Purnell, L.D. (2009). Guide to culturally competent health care. Philadelphia, P A: F.A. Davis; Purnell, L.D. (2013). Transcultural health care: A culturally competent approach (4^th ed.). Philadelphia, P A: F.A. Davis; Spector, R.E. (2013). Cultural diversity in health and illness (8^th ed.). Upper Saddle River, N J: Pearson.

1. Green salad
2. Glass of milk
3. String cheese
4. Sliced orange

Page Ref: 21

Cognitive Level: Applying

Client Need/Sub: Psychosocial Integrity

Standards: Q S E N Competencies: Ⅰ. A. 2. Describe how diverse cultural, ethnic and social backgrounds function as sources of patient, family, and community values. | A A C N Essentials Competencies: Ⅸ. 5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | N L N Competencies: Relationship Centered Care; Knowledge; The role of family, culture, and community in a person's development. | Nursing/Integrated Concepts: Implementation; Nursing Process.

Learning Outcome: 5 Discuss the use of a cultural assessment tool as a means of providing culturally sensitive care.

M N L L O: Demonstrate ability to incorporate culturally competent care for patients and families.

1. A pregnant patient is attending a class to learn the movements identified in the following photo. What is the primary reason for the patient to learn these movements?

1. Stimulate the flow of chi
2. Stimulate pressure points
3. Mind control over the body
4. Correct spinal misalignment

Page Ref: 29

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance

Standards: Q S E N Competencies: Ⅰ. A. 2. Describe how diverse cultural, ethnic and social backgrounds function as sources of patient, family, and community values. | A A C N Essentials Competencies: Ⅸ. 17. Develop a beginning understanding of complementary and alternative modalities and their role in health care | N L N Competencies: Relationship Centered Care; Knowledge; The role of family, culture, and community in a person's development. | Nursing/Integrated Concepts: Planning; Nursing Process.

Learning Outcome: 7 Differentiate between complementary and alternative therapies.

M N L L O: Demonstrate ability to incorporate culturally competent care for patients and families.

1. During a home visit the nurse observes a new mother performing the following action. What should the nurse document that the mother is doing with the child?

1. Massage
2. Acupressure
3. Biofeedback
4. Moxibustion

Page Ref: 30

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance

Standards: Q S E N Competencies: Ⅰ. A. 2. Describe how diverse cultural, ethnic and social backgrounds function as sources of patient, family, and community values. | A A C N Essentials Competencies: Ⅸ. 17. Develop a beginning understanding of complementary and alternative modalities and their role in health care. | N L N Competencies: Relationship Centered Care; Knowledge; The role of family, culture, and community in a person's development.

Nursing/Integrated Concepts: Assessment; Communication and Documentation.

Learning Outcome: 9 Describe complementary therapies appropriate for the nurse to use with childbearing and childrearing families.

M N L L O: Demonstrate ability to incorporate culturally competent care for patients and families.