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Full Download Wongs Nursing Care of Infants and Children 11th Edition Hockenberry Test Bank
Full Download Wongs Nursing Care of Infants and Children 11th Edition Hockenberry Test Bank
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Chapter 02: Social, Cultural, Religious, and Family Influences on Child Health
Promotion
MULTIPLE CHOICE
1. Children are taught the values of their culture through observation and feedback relative to
their own behavior. In teaching a class on cultural competence, the nurse should be aware
that which factor may be culturally determined?
a. Ethnicity
b. Racial variation
c. Status
d. Geographic boundaries
ANS: C
Status is culturally determined and varies according to each culture. Some cultures ascribe
higher status to age or socioeconomic position. Social roles also are influenced by the
culture. Ethnicity is an affiliation of a set of persons who share a unique cultural, social,
and linguistic heritage. It is one component of culture. Race and culture are two distinct
attributes. Whereas racial grouping describes transmissible traits, culture is determined by
the pattern of assumptions, beliefs, and practices that unconsciously frames or guides the
outlook and decisions of a group of people. Cultural development may be limited by
geographic boundaries, but the boundaries are not culturally determined.
2. The nurse is aware that if patients’ different cultures are implied to be inferior, the
emotional attitude the nurse is displaying is what?
a. Acculturation
b. Ethnocentrism
c. Cultural shock
d. Cultural sensitivity
ANS: B
Ethnocentrism is the belief that one’s way of living and behaving is the best way. This
includes the emotional attitude that the values, beliefs, and perceptions of one’s ethnic
group are superior to those of others. Acculturation is the gradual changes that are
produced in a culture by the influence of another culture that cause one or both cultures to
become more similar. The minority culture is forced to learn the majority culture to
survive. Cultural shock is the helpless feeling and state of disorientation felt by an outsider
attempting to adapt to a different culture group. Cultural sensitivity, a component of
culturally competent care, is an awareness of cultural similarities and differences.
3. Which term best describes the sharing of common characteristics that differentiates one
group from other groups in a society?
4. After the family, which has the greatest influence on providing continuity between
generations?
a. Race
b. School
c. Social class
d. Government
ANS: B
Schools convey a tremendous amount of culture from the older members to the younger
members of society. They prepare children to carry out the traditional social roles that will
be expected of them as adults. Race is defined as a division of humankind possessing traits
that are transmissible by descent and are sufficient to characterize race as a distinct human
type; although race may have an influence on childrearing practices, its role is not as
significant as that of schools. Social class refers to the family’s economic and educational
levels. The social class of a family may change between generations. The government
establishes parameters for children, including amount of schooling, but this is usually at a
local level. The school culture has the most significant influence on continuity besides
family.
5. The nurse is planning care for a patient with a different ethnic background. Which should
be an appropriate goal?
a. Adapt, as necessary, ethnic practices to health needs.
b. Attempt, in a nonjudgmental way, to change ethnic beliefs.
c. Encourage continuation of ethnic practices in the hospital setting.
d. Strive to keep ethnic background from influencing health needs.
ANS: A
Whenever possible, nurses should facilitate the integration of ethnic practices into health
care provision. The ethnic background is part of the individual; it should be difficult to
eliminate the influence of ethnic background. The ethnic practices need to be evaluated
within the context of the health care setting to determine whether they are conflicting.
6. The nurse discovers welts on the back of a Vietnamese child during a home health visit.
The child’s mother says she has rubbed the edge of a coin on her child’s oiled skin. The
nurse should recognize this as what?
a. Child abuse
b. Cultural practice to rid the body of disease
c. Cultural practice to treat enuresis or temper tantrums
d. Child discipline measure common in the Vietnamese culture
ANS: B
This is descriptive of coining. The welts are created by repeatedly rubbing a coin on the
child’s oiled skin. The mother is attempting to rid the child’s body of disease. Coining is a
cultural healing practice. Coining is not specific for enuresis or temper tantrums. This is
not child abuse or discipline.
7. A Hispanic toddler has pneumonia. The nurse notices that the parent consistently feeds the
child only the broth that comes on the clear liquid tray. Food items, such as Jell-O,
Popsicles, and juices, are left. Which statement best explains this?
a. The parent is trying to feed the child only what the child likes most.
b. Hispanics believe the “evil eye” enters when a person gets cold.
c. The parent is trying to restore normal balance through appropriate “hot” remedies.
d. Hispanics believe an innate energy called chi is strengthened by eating soup.
ANS: C
In several cultures, including Filipino, Chinese, Arabic, and Hispanic, hot and cold
describe certain properties completely unrelated to temperature. Respiratory conditions
such as pneumonia are “cold” conditions and are treated with “hot” foods. The child may
like broth but is unlikely to always prefer it to Jell-O, Popsicles, and juice. The evil eye
applies to a state of imbalance of health, not curative actions. Chinese individuals, not
Hispanic individuals, believe in chi as an innate energy.
Just before dinner there was a commotion close to our tents, and
we found that one of the soldiers of our escort had tried to stab
Walda Mariam,[82] the assistant of Johannes, with whom he had
come to meet us at Gallabat. We immediately disarmed the soldier,
and then discovered that both had been to a village near by to get
tedj, and were drunk. So we disarmed the deputy-interpreter also,
and I was sorry to see him in disgrace, for he had always been
willing, hard-working, and cheery on the journey. We placed the
soldier under arrest, and warned him that if he were found brawling
again he would be flogged. Then, order being restored, we went to
dinner.
In this part of Abyssinia the mountain air sharpened our appetites,
and I must own that we were sturdy trenchermen. Each would tackle
a whole guinea-fowl or duck for lunch, and be ready for another in
the evening. We had puddings “of sorts” too, and yet, like Oliver
Twist, we “asked for more.”
On the morning of January 26, the quarrelsome soldier, now
sober and crestfallen, was brought up for a formal reprimand. He
was told that his case would be reported at Gallabat, and that he
would be punished there according to military law. Then his arms
were returned to him. Walda Mariam also attended, looking sheepish
and sorry for himself, and his weapons too were restored to him.
After this the medicine-chest was unloaded, and I redeemed my
promise to patients. One family—father, mother, and two children—
had come from a distance to consult me at Korata. They had arrived
too late, and had followed us to Woreb. The father was suffering
from necrosis of the lower jaw, and I had to draw three teeth for him.
The mother had come to hear what instructions were given about the
children—a little boy and a little girl. They were suffering from
strumous, tuberculous glands of the neck. I had as “hospital orderly”
a soldier who understood Arabic and Amharic, and could therefore
put me en rapport with my patients. After an examination of the
children, I concluded that the right thing would be an operation with
the knife. I told this to the woman, and the soldier interpreted what I
said word for word. As soon as the little girl heard the word “knife,”
she gave vent to the loudest, most piercing scream that she could
utter, and fairly flew from the spot. The noise created a sensation
among the Habashes and boys, who seemed to think that I was
killing a patient. It would have been awkward in any case to operate
in camp, and on this occasion I had no opportunity. Nothing short of
brute force would have brought the little girl back, and I think the
word “knife” conveyed to her mother and brother the notion of the
butcher’s rather than the surgeon’s implement.
My companions had mounted their mules and started on an
exploring journey, intending to select a good site as a camping-
ground close to the river. But by the time they returned they had
decided that our present position could not be bettered, as the river-
banks were low ground covered with papyrus swamps, and any
halting-place there would be very unhealthy. They had also found
that all the points from which they wished to make observations were
easy of access from the spot that we had chosen.
I had a rather sharp touch of fever in the afternoon, and was
obliged to give up work and lie down. These attacks are unavoidable
at times in that country. They make one feel extremely helpless and
depressed while they last, but soon yield to quinine and a little rest.
The next morning, January 26, I was better, but felt shaky when I
got on my mule and started with my companions. At a short distance
from the camp we left the animals in a hollow and climbed a steep
hill about five hundred feet high. It was covered with tall grass and
the soil was stony, so that I was soon out of breath. But when we
reached the summit a lovely scene lay in front of us. The Blue Nile,
winding away from its outlet in the lake, was bright in the sunshine.
The green banks on either side were delightful to the eyes, and here
and there in the stream were little islands, vivid in colour, where the
papyrus grew to a height of twelve or fourteen feet. There were
many dark dots in the water—heads of hippopotami, which swarm in
these upper reaches of the Blue Nile. Mountains rise above the river-
valley on both sides, and the stream curves among the spurs at their
base, till it is lost to sight. The view from the high land is far-reaching,
and the clearness of the air makes even distant outlines very distinct.
I can scarcely imagine a scene at once so charming, tranquil, and
impressive as this prospect of lake, river, and mountains. It is
impossible to convey in words the effect of the simple, strong
colouring—the blue lake, the flashing stream, the verdurous islands
and swamps, the cloudless, lustrous sky, the chromes and grays and
purplish shadows among the ridges that sweep upward and recede
from the valley in splendid lines. And upon the peace of this
landscape at least, the personally conducted tripper will not intrude
just yet.
I noticed several cataracts, but none of any great extent. The
water in these rapids was rushing over and between rocks, and they
must be ugly places when the lake rises. In other parts the river was
smooth and still. In one pool we counted eighteen hippos taking the
air, just their snouts being out of water.
Almost at once we set to work and piled up a heap of stones, and
fixed in the centre of it a long pole as a landmark. This was a
straight, thin branch which we cut from a tree near at hand. After this
we set up three more “cairns” on selected spots, and then
descended to the low ground, where the mules were waiting. I
remained in the valley, for exertion soon tires one out after the fever.
My friends climbed other hills and erected more landmarks before
returning to lunch. In the meanwhile I tried my luck at angling in the
river, but caught nothing, and soon gave up the attempt, and lounged
under a palm-tree, reading.
My companions started on their mules after lunch to continue their
survey, and I went back to camp and was glad to be idle. The day’s
work was ended before evening, and I believe we were the first
Britishers who had five-o’clock tea beside the head waters of the
Blue Nile.
Next morning (January 27) I had instructions to set up a stone-
heap on a little hill about four miles from camp. I made my way to it
direct through a tangle of jungle-growths, and from the summit
obtained the photograph of the source of the river at the point of
outflow from the lake which forms the frontispiece of this book. I
believe this to be the only photo of the place in existence.
I descended the hill, and walked along the riverbank towards the
place where we had arranged to lunch. The soil was boggy, covered
in some parts by reed-grass and in others by jungle-growths. Hippo
spoor was everywhere. This tract is not well-wooded; there are a few
palms, and some scattered trees of other kinds, chiefly mimosas.
The bed of the river is hard rock, and the water was clear and
drinkable. The depth varied very greatly, from a few inches in the
rapids to some six metres in the pools. I saw the stream at its lowest.
Watermarks showed clearly that in flood time it rises sixteen to
eighteen feet above this level.
When I reached the place where we were to lunch, I saw a big
herd of hippos basking on the surface of the river. Crawley and I
walked towards them, and when they saw us, they sank, leaving only
their snouts visible. These offered an interesting target for rifle-fire,
and for awhile the hippos watched our practice with unconcern. Then
a shot told—there was a “general post”—and not a sign of the huge
beasts remained in sight.
After this I took my rod and tried for a fish in a pool below a rapid.
While I was standing there, I saw a large white eagle, a splendid
fellow, which had been watching me fishing, swoop from the branch
of a high tree. He circled twice above me, and then pounced upon a
young duck, that was hiding under a ledge in the river-bed, and bore
it off. The parent birds were close at hand, and I heard their loud,
frightened, and indignant cackling. I do not think wild duck are
plentiful hereabouts. No doubt they are harried by these eagles and
have to find safer breeding-places. We saw only a very few. I landed
a plump fish of the perch tribe, which weighed about four pounds. He
showed no fight, but came tamely into shallow water, where the boy
who was with me picked him up. My friends came late into camp
after a hard day’s work upon their survey.
The high ground beside the head waters of the Blue Nile is
pleasant and healthy and could support a large population. The
maximum temperature in the day, when we were there, was about
eighty-five degrees. Usually a cool, exhilarating breeze was blowing,
and we did not feel the heat disagreeably. If this place were more
easily accessible, it would be a perfect pleasure-resort and a most
valuable sanatorium for residents in the Soudan.
The event of January 28, was the appearance of potatoes at
table. I had often gazed at this unvarying factor in one’s diet with
indifference if not slightingly, and had wondered why the things were
served so constantly at European tables. It was not till we missed the
daily luxury that we appreciated it. The roast fowl was another bird
with this accompaniment. These were the only potatoes that we saw
in Abyssinia; they were very small. The cook had discovered them in
a remote hamlet. I can offer no explanation of their presence in that
place. He purchased a sackful for one salt and an empty lime-juice
bottle, and returned to camp in triumph, shouting at the top of his
voice that he had found “batatas” at last. Perhaps as he failed to
discover any more, the expedition denuded the country of its whole
stock.
CHAPTER X
Insects are an annoying pest in this part of the lake side. Hosts of
mosquitoes and small beetles of a peculiar species appeared on the
flat ground at sunset, and swarmed throughout the neighbourhood
for an hour afterwards. The beetles settled upon us in throngs, and
crawled into our noses and ears and under our clothes, and we
could not even crush them on account of the unendurable smell
which their bodies then gave forth. When the first hour after sundown