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(Download PDF) Community Public Health Nursing Practice Health For Families and Populations 5th Edition Maurer Test Bank Full Chapter
(Download PDF) Community Public Health Nursing Practice Health For Families and Populations 5th Edition Maurer Test Bank Full Chapter
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Chapter 10: Relevance of Culture and Values for Community/Public Health Nursing
Test Bank
MULTIPLE CHOICE
1. Which of the following statistics related to diversity in the United States is accurate?
a. One per five people belongs to an ethnic or racial minority.
b. One per three people identifies with an ethnic or racial minority.
c. The percentage of people identifying with a minority group is decreasing.
d. The percentage of people identifying with a minority culture has become the
majority.
ANS: B
More than 110 million, or one per three, people self-identify with one or more of the federally
recognized racial and ethnic minority groups. Professionals are expected to respect all people.
There continues to be growth among racial and ethnic minority populations. Currently, the
majority of the population is composed of non-Hispanic white people (63.7%).
2. Which of the following groups is the largest ethnic minority in the United States?
a. African Americans
b. Asian immigrants
c. Hispanics
d. American Indians/Alaskan natives
ANS: C
Hispanics constitute the largest ethnic minority group, accounting for more than 16% of the
total U.S. population. Black people constitute the largest racial minority group, accounting for
12.6% of the total population. Asians constitute 4.8% of the total population, and American
Indians/Alaska Natives constitute 0.9%. All minority populations have grown.
5. A nurse was so angry at a family for not being home when the nurse arrived for their
appointment that the nurse wanted to drop the family from the agency caseload. What would
the agency supervisor need to point out to the nurse?
a. Clients can have emergencies that interfere with plans.
b. Communication about the time of the appointment may not have been clear.
c. Nurses expect promptness and compliance, but not all clients feel the same way.
d. Perhaps the nurse made an error in writing down the appointment date and time.
ANS: C
Although any of the reasons may have been true in this situation, the fact that the nurse was so
angry suggested that a cherished value had not been upheld. The nursing profession culture
includes values of promptness, neatness, and organization. Tardiness, disobedience, and
disorganization are antithetical to nursing values. The issue may have been a culture clash.
6. A nurse was proud of having completed a professional education program on cultural care of
Hispanics. It was surprising when the Hispanic client for whom the nurse had been caring did
not seem to act very “Hispanic.” Which of the following considerations is the nurse not
taking?
a. The client may have been trying to demonstrate behaviors to please the nurse.
b. The client may have customs that are not identical with the Hispanic culture.
c. The client may be in too much pain to demonstrate cultural behaviors
d. The client may not have been truthful when claiming to be Hispanic.
ANS: B
The nurse, who had just learned about the Hispanic culture, may have been assuming that a
given custom is shared by all members of a culture, which is not true.
7. Which of the following is a reason why each person is asked to report his or her race during
the U.S. census?
a. Race is a biologic reality defining persons with common biologic features.
b. Race is a crucial variable, which explains the differences among different groups
of people.
c. Race is a historical tradition that must be upheld.
d. Race is a way in which people identify themselves.
ANS: D
The census has historically included this question, on the basis of the traditional concept of
those who share common biologic features; however, there is no genetic difference among
people, and many people have argued that the concept of race should not be used. At this
point, race is primarily a concept reflecting how people identify themselves.
8. Why will the concept of ethnicity decrease in value to health professionals in the future?
a. Assessment and treatment will become more accurate according to a person’s race.
b. Ethnicity as a concept mainly helps clients have a sense of belonging and loyalty.
c. Persons from different ethnic groups are intermarrying, and their children are
multiracial.
d. The concept of ethnicity is less informative than the term race.
ANS: C
Ethnicity is used as a way of self-identification and gives a sense of belonging. However, its
usefulness to health professionals will decrease as groups intermarry and their children
become multiracial.
10. Which of the following is the best way for a nurse to determine a client’s ethnicity?
a. Analyzing the client’s actions and communication patterns
b. Closely observing behaviors and customs
c. Discussing with anthropologists how to recognize the various ethnic groups
d. Querying “How do you identify yourself?”
ANS: D
Although it certainly would be useful to observe and analyze a client’s beliefs, actions,
behaviors, and communication patterns, the easiest and most efficient way to determine
ethnicity is simply to ask the client.
11. What is the primary reason why there are differences in health outcomes among the various
ethnic groups?
a. There is decreased access to health care and few care providers from their ethnic
group.
b. Members of ethnic groups rarely have life insurance, so they cannot afford to
obtain care.
c. Professionals engage in discrimination, stereotyping, and uncertainty.
d. Minorities are less educated, so they do not take care of themselves appropriately.
ANS: C
Disparities exist because of the operation of the health care system and discrimination, biases,
stereotyping, and uncertainty of the clinicians.
12. Which of the following is the most significant barrier to Americans seeking appropriate health
care?
a. Culture
b. Ethnicity
c. Lack of insurance
d. Race
ANS: C
Although all the options can be barriers to seeking and obtaining appropriate health care, lack
of insurance or other means to pay for health care is the most crucial barrier.
13. A nurse stressed to an oncology patient the importance of returning to the outpatient clinic
promptly at 8 AM for the next treatment, but the client arrived at 3 PM. Which of the following
would be the most likely explanation for the client’s tardiness?
a. The client needed the appointment written down so the client could remember the
exact time.
b. The client’s employment had to come first, so the clinic visit was second in
priority.
c. The client’s perception of time was not linear or future oriented.
d. The client was having too much discomfort from the treatment to have another
treatment so soon.
ANS: C
Although all the options could be true, the least obvious but perhaps most important was that
the client’s perception of time may have differed from that of the nurse. Nurses focus on
linear time, watches, and being accurate and punctual. Some persons see time as circular and
never ending and as a gift to be enjoyed, so they may not be concerned with punctuality.
14. A nurse was teaching a client how to plan his diabetic diet. The client explained that he was
on the road a lot and ate in truck stops where they did not serve that kind of food.
Furthermore, both his mother and father had died of diabetic complications, and he knew he
would probably have the same fate. Which of the following would be the most appropriate
action for the nurse?
a. Explaining why the client might have to change careers and be more optimistic
b. Recognizing that the client has a present time orientation and stop wasting effort
on teaching him about a diet he will not follow
c. Reviewing the client’s priorities and see what compromises in nutrition might be
possible in his job
d. Trying to help the client see the importance of planning for the future
ANS: C
Although the client seems focused on present time orientation and is rather fatalistic,
immediately giving up is not a viable option. The client’s occupation and lifestyle probably
cannot be changed immediately; therefore, only compromises are realistic. The nurse and the
client will have to discuss what changes can be made in his eating habits.
15. A nurse saw a man from an Arab country asking a physician how his wife was doing. As the
physician responded to the question, the physician backed away. The man again moved up
close to the physician to ask another question, which the physician answered while again
backing up. Which of the following conclusions can be drawn by the nurse?
a. Both were trying to arrange the space between them to be comfortable.
b. The man had poor personal hygiene, so the physician was distancing himself from
the client.
c. The physician did not want to stand that close to an Arab.
d. These things happen; there is no particular meaning to this event.
ANS: A
Space is a physical boundary. As the gentleman from the Arab country tried to set up the
appropriate amount of space for a fairly intimate conversation, the American backed up to add
the social space expected for a professional conversation.
16. A nurse was assigned to care for a client who was speaking with his young daughter in an
Asian language. Because the nurse spoke only English, which of the following actions should
be taken by the nurse?
a. Ask the young daughter whether she knew English and could translate.
b. Ask the young daughter whether the client’s wife was available to translate.
c. Call the nursing office to see whether any nurse in the hospital spoke the client’s
language.
d. Check the hospital resource manual for the telephone number of a translator who
spoke an Asian language.
ANS: C
The best choice, if available, would be a nurse who was bilingual. If not, an interpreter,
preferably of the same gender, would be sought among the staff or by phone. Although the
young daughter or the wife might know English, because of age and gender differences,
having either translate would not be appropriate.
18. The administrative team at a home care agency is discussing how they meet the Culturally and
Linguistically Appropriate Services (CLAS) standards. Which of the following actions
demonstrates the incorporation of these standards in practice?
a. Requiring a small fee so that all patients will have a translator immediately
available
b. Using hand motions, pantomime, and touch to convey information
c. Requiring all staff nurses employed in the hospital to be bilingual
d. Using a computer to print index cards with essential phrases both in English and in
the patient’s language
ANS: D
The CLAS standards suggest free language assistance, whereby bilingual staff and interpreter
services are preferred. Although hand motions and pantomime may be used on a temporary
basis, they are very prone to misinterpretation, and interpreters or a bilingual staff member
must be sought immediately. The hospital cannot require any nurse to be bilingual, although
such nurses should be actively recruited. Use of index cards is suggested in the text. In some
geographic areas, so many ethnic groups use a particular hospital that having a computer
program that could print the information needed in this instance would be a cost-effective way
of being prepared.
19. Which of the following is the best definition of a family for a nurse to use when planning
nursing care?
a. Related legally or by blood
b. Considered “family” by the legal system
c. Living in the same household
d. Any person the client reports as being family
ANS: D
Although all definitions are correct, the nurse will find it most helpful to include any person
the client wants included.
21. The community/public health nurse was conducting a blood pressure clinic. The nurse noted
that a Chinese client’s blood pressure was 80/50. The client stated that he was taking
propranolol for hypertension. Which of the following would be the most probable reason for
this low blood pressure?
a. The client may be more sensitive to the effects of beta-blockers.
b. The client may never really have had hypertension.
c. The client may have taken too much of the medication each day.
d. The client may not have told the physician all the other medications he was taking.
ANS: A
Some Chinese people are considerably more sensitive than are white people to the effects of
beta-blockers on heart rate and blood pressure. Biologic differences can be a factor because
drugs are standardized primarily on data from white men.
22. A man was badly hurt in a car accident caused by a drunk driver and was having a large
amount of pain. The man cried, “What did I do to deserve this? I wasn’t the one drinking.”
Which of the following would be the most appropriate response by the nurse?
a. “There is always a reason behind any accident and injury.”
b. “The pain will start to improve. You just need to give it some time.”
c. “I’m sorry you have so much pain. How have you been dealing with it?”
d. “Can I get you more pain medication?”
ANS: C
Each response reflects a particular perspective on pain and suffering. Because the nurse has no
data as to the client’s perspective, the nurse must ask questions related to the pain until the
nurse has a clearer understanding of the client’s beliefs. This action would be the priority and
then the next step would be to administer pain medication if necessary.
24. Which of the following criteria would be useful for a nurse in choosing a good informant who
can explain what is and what is not appropriate behavior in a group?
a. Being in a position of power and authority and having an appropriate title
b. Being careful to describe reality as the nurse wants to hear it
c. Being a member of the culture who has been actively involved for a long time
d. Being willing to explain as long as his or her knowledge is financially recognized
ANS: C
A good informant is thoroughly acculturated and currently involved, describes reality in local
terms rather than the way the informant thinks the nurse wants to hear it, and is willing to
share his or her time and knowledge.
25. A nurse was very excited at being given the opportunity to spend a year working in Botswana.
After 2 months, however, the nurse was feeling both depressed and angry. Knowing the
agreement was to stay a calendar year made the nurse feel panic-stricken. Which of the
following problems is the nurse most likely experiencing?
a. Culture shock from being in a culture very different from that at home
b. Fatigue from having to constantly ask a translator to explain what clients are
saying
c. Frustration because high-technology equipment is not available in this developing
country
d. Tiredness from learning all the differences in nursing techniques in this clinical
setting
ANS: A
Anger, depression, panic, denial, and depression may all result from culture shock. Culture
shock can have serious consequences. It can lead to acts of aggression toward self or others, a
loss of appetite and sleep, and general malaise that can result in death. Fatigue, frustration,
and tiredness are all possible explanations; however, the most likely problem is culture shock.
26. The difference between an immigrant and a refugee is that the immigrant
a. Has legal permission to receive government benefits, whereas the refugee does not.
b. Is a legal member of society, whereas refugees have come into the country
illegally.
c. Is a member of a group that America wishes to welcome, whereas a refugee is not.
d. Wants permanent residence, whereas refugees wish to escape persecution.
ANS: D
An immigrant is seeking permanent residence with documentation and permission, whereas
refugees are migrating to escape persecution that is based on race, religion, political
persuasion, or nationality. Both may be legal residents, although achieving that status is more
difficult for refugees.
27. A nurse has been assigned to care for a bisexual client. Which of the following would be
important for the nurse to recognize about this client?
a. The client may have experienced disparities in health status and care.
b. The client has received care similar to that of all other U.S. citizens.
c. The client may be resistant to education by the nurse.
d. The client has resisted mainstream lifestyles and behaviors.
ANS: A
This client is a member of the lesbian, gay, bisexual, transgendered, or intersex (physically
ambiguous gender) (LGBTI) group. LGBTI individuals may have suffered significant
disparities in health status and health care in relation to their sexual identity and behavior and
unique needs. Thus, their health care has not been similar to that of other U.S. citizens. There
is no evidence that they would not be receptive to education from the nurse. Moreover,
although the client has resisted mainstream lifestyles and behaviors, this would not be as
important to consider in providing care.
28. Why would a nurse attend a professional development program about personal beliefs, values,
and ethnic heritage?
a. It will be worth sharing with other staff at the agency.
b. It will decrease the nurse’s racism.
c. It will help the nurse recognize her own ethnic perspective.
d. It will help the nurse work better with others.
ANS: C
Such professional education programs help attendees recognize their own beliefs and values
and realize that other people might have differing values.
MULTIPLE RESPONSE
1. A middle-aged woman had decided against getting treatment for her just-diagnosed uterine
cancer, explaining to the nurse that the family needed to keep its resources for her daughter’s
new baby. Which of the following is the most likely explanation for the nurse’s frustration
with the client? (Select all that apply.)
a. A belief that the individual must protect personal life and health
b. Inability to accept that some cultures put group needs before individual needs
c. Lack of understanding the importance of childbirth in some cultures
d. Feeling strongly that disease must be fought, not accepted
e. Seeing time as linear, with every second irreplaceable and passing quickly
f. Being unsuccessful at getting the client to understand that the cancer could kill her
ANS: A, B, D, E
Most cultures have strong values about childbirth, so that should not be the problem. Many
Americans see time as linear, rapidly passing, and as something to be used efficiently,
whereas other people see time as circular and never ending. To someone who is a professional
and acculturated to dominant American values, wasting time before beginning treatment
would be nonsensical. Disease must be fought, and clients are supposed to cooperate with
health care professionals’ suggestions. Other cultures may be group oriented rather than
individual oriented and accept disease.
2. A nurse, who is of German descent, was told to watch a newly admitted African American
client for any signs of cyanosis or pallor. Which of the following actions should be taken by
the nurse? (Select all that apply.)
a. Applying pressure to the nail bed and observing how quickly color returns
b. Asking the visiting family members to tell the nurse if they notice such signs
c. Checking the palms of the hands and the soles of the feet
d. Consistently checking the blood pressure and pulse rate every 15 minutes
e. Looking between the strands of hair on the head for evidence
f. Telling the nurse in charge of the floor to have someone else, preferably an African
American nurse, care for the client
ANS: A, C
Although none of these actions is totally inappropriate, the most effective would be to apply
pressure to the nail bed and observe the rapidity of color return and to check the surfaces with
the least amount of pigmentation (forearms, soles of feet, palms of the hand, abdomen, and
buttocks).
3. Of the following statements about anorexia nervosa, which are accurate? (Select all that
apply.)
a. It is an eating disorder that results in extreme obesity.
b. It is considered a culture-bound syndrome.
c. It is an epidemic among American teenagers.
d. It is often discovered only when friends see the person vomiting meals.
e. It is seen in socioeconomic classes that emphasize thinness.
f. It is seen in very low income, lower socioeconomic class women.
ANS: B, E
Anorexia nervosa is considered a culture-bound syndrome because it is found only in certain
population groups, specifically Western cultures with sociocultural emphasis on body type
and excessive preoccupation with thinness. The disease represents self-imposed starvation.
Language: French
RÊVE BLANC
PARIS
LIBRAIRIE PLON
E. PLON, NOURRIT ET Cie, IMPRIMEURS-ÉDITEURS
RUE GARANCIÈRE, 10
Très affectueusement,
H. A.
RÊVE BLANC