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Chapter 8: Culturally Specific Care
Multiple Choice
Identify the choice that best completes the statement or answers the question.
MULTIPLE CHOICE
1. ANS: B
Physical traits such as hair and eye color inherited from parents are part of the person’s ethnicity. Nonphysical
traits, coming from one's upbringing, family, beliefs, and community, are part of one's culture.
PTS: 1 KEY: Nursing Process Step: Not applicable | Patient Care Area: Not applicable
2. ANS: B
It is predicted that the population of the United States between now and 2050 will become older and more
diverse. The percentage of Hispanics, Asians, and blacks all will increase—Hispanics the most, blacks the
least.
PTS: 1 KEY: Nursing Process Step: Not applicable | Patient Care Area: Not applicable
3. ANS: D
Many black Muslims follow the Halal diet, which means they do not eat pork or any pork products. If he tells
you that he follows this diet, you should discuss it with the dietitian, who can see that he does not receive any
pork or pork products. Similarly, you should request that the pharmacy provide him only with nonpork
insulin. (Most insulin is made from pig pancreas.)
PTS: 1 KEY: Nursing Process Step: Not applicable | Patient Care Area: Nutrition, medication
4. ANS: B
The leading cause of death in black men 15 to 34 years old is homicide. Black men in general, including
older black men, have higher rates of coronary heart disease, prostate cancer, and AIDS than white men.
PTS: 1 KEY: Nursing Process Step: Not applicable | Patient Care Area: Not applicable
5. ANS: B
Sickle cell anemia is a chronic inherited disease in which structurally defective hemoglobin molecules lead to
hemolysis, anemia, and pain in areas of the body where the defective red blood cells block normal blood flow.
It occurs mostly in blacks and in some people from the Mediterranean region. In people with sickle cell
anemia, a crisis may be triggered by changes in altitude, dehydration, and infection. The patient’s ethnicity,
symptoms, and laboratory test results should suggest the possibility of sickle cell anemia more than TIA or
infection.
PTS: 1
KEY: Nursing Process Step: Not applicable | Patient Care Area: Hematological disorders
6. ANS: D
Alcoholism is the leading cause of death among Native Americans. Tuberculosis is second, followed by
diabetes mellitus. AIDS is not among the top seven killers of Native Americans, but suicide (fifth) and
homicide (seventh) are.
PTS: 1 KEY: Nursing Process Step: Not applicable | Patient Care Area: Not applicable
7. ANS: B
Many Native American tribes have a medicine man or woman, often called a Shaman, who may chant and
sing or use incense to help the ill person get well. The other responses are more apt to occur in other ethnic
groups—A with Muslims, C with Hispanics, and D with Japanese people.
PTS: 1 KEY: Nursing Process Step: Not applicable | Patient Care Area: Not applicable
8. ANS: C
The cancer survival rate among Native Americans is the lowest of any group in the United States. Responses
A, B, and D are incorrect.
PTS: 1 KEY: Nursing Process Step: Not applicable | Patient Care Area: Not applicable
9. ANS: D
Diabetes mellitus occurs in 20%, or 1 in 5, of Native Americans; this is compared with 1 in 10 in other ethnic
groups. This high incidence developed in the 20th century, perhaps as a result of changes in diet and exercise
habits.
PTS: 1 KEY: Nursing Process Step: Not applicable | Patient Care Area: Endocrine disorders
10. ANS: B
Although the use of acupuncture and acupressure has increased in Europe and the United States and among
many ethnic groups, it is most closely associated with Asians.
PTS: 1 KEY: Nursing Process Step: Not applicable | Patient Care Area: Pain control
11. ANS: B
In many Asian cultures, the oldest male family member (or if he is dead, the oldest female family member)
makes important decisions, such as decisions regarding an adult son’s health. The wife should not be ignored,
however. When speaking with the patient’s parents, look directly at them and speak formally (using “Mr. and
Mrs.”) and respectfully. Response A is incorrect because the oldest family member makes the decisions.
Response C is incorrect because it is too informal, and the wife should not be ignored. Response D is
inappropriate because the family member may ask medical-related or nursing-related questions; if necessary,
you can bring a translator with you to assist in communication.
PTS: 1 KEY: Nursing Process Step: Not applicable | Patient Care Area: Not applicable
12. ANS: B
Because many European countries have national health-care plans with socialized medicine, there is an
expectation that the federal government is responsible for each person’s health care. This is in sharp contrast
with Americans, who are more individualistic in terms of their health care. Health care in the United States is
seen as being reliant on family or extended family groups.
PTS: 1 KEY: Nursing Process Step: Not applicable | Patient Care Area: Not applicable
13. ANS: B
You should tell her that you noticed she is not eating enough and ask about her dietary preferences. Inform
her that if she wants a kosher menu, it can be provided. Response A is inappropriate and insensitive. She can
be provided the necessary nutrients with a different diet. Response C is also inappropriate because it does not
respect the patient and her wishes. Finally, response D is inappropriate and belittling to the patient.
PTS: 1 KEY: Nursing Process Step: Not applicable | Patient Care Area: Nutrition
14. ANS: B
Many Hispanics believe in “hot” and “cold” ideas about diseases and medications. A “hot” medication, such
as penicillin, should not be taken to treat a “hot” disease, such as diarrhea. “Hot” diseases should be treated
with “cold” medications and vice versa. Response A is contrary to the “hot-cold” belief system. Responses C
and D may or may not be true. Nothing in the question addresses these issues, so they are not the best
responses.
PTS: 1 KEY: Nursing Process Step: Not applicable | Patient Care Area: Medication beliefs
15. ANS: D
Responses A, B, and C are inappropriate and do not recognize the man’s cultural differences. For many
Hispanics, time is a relative concept, and minimal attention is given to the exact time of day.
PTS: 1 KEY: Nursing Process Step: Not applicable | Patient Care Area: Not applicable
16. ANS: D
Traditional Asian culture holds elderly adults in great respect. They live with and are cared for by family
members when they reach an age where they need assistance. Only elderly adults who do not want to be
around children or who have no family are placed in nursing homes. There are only five nursing homes in all
of China.
PTS: 1 KEY: Nursing Process Step: Not applicable | Patient Care Area: Not applicable
17. ANS: B
Many Native Americans find the questions asked during an initial assessment and history offensive and
intrusive. It is sometimes wiser to ask younger members of the family about a patient’s history. Although
Native Americans are great storytellers, they do not like to reveal much about their personal lives to strangers,
so response A is not the best choice. Responses C and D are incorrect. Native Americans are often a caught in
limbo in terms of modern health care. They are caught between their traditions and modern treatment—the
Shaman and the physician. Finally, they often are “lost” between the Indian Health Care Services and other
health-care services available in the United States.
PTS: 1 KEY: Nursing Process Step: Not applicable | Patient Care Area: Not applicable
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Blätter mußte ich eifrigst eintreten, um es der geplanten Ausgabe zu
erhalten, und so haben denn schließlich vierhundertfünfzig Blatt die
Revue passiert. Die Verlagshandlung berichtet bei dieser Ausgabe,
daß Richter sich zu dem echt volkstümlichen, gemütreichen Ton der
Hornschen Erzählungen so hingezogen fühlte, daß er sich bereits
1847 um deren Illustrierung selbst bewarb und mit ganzer
Hingebung über ein Jahrzehnt dafür wirkte. Sein 1859 eingetretenes
Augenleiden zwang ihn, die ihm lieb gewordene Arbeit aufzugeben.
In der Vorrede schreibt Dr. Weißmann am 28. August 1873: „Wenn
einer der Volksschriftsteller unserer Tage würdig gewesen, von
Ludwig Richter illustriert zu werden, so ist es Horn. Hat doch kein
Künstler das deutsche Volk in seiner Erscheinung verstanden und
sein ganzes Gebaren in Leid und Freud, in ruhigem Behagen, wie in
leidenschaftlicher Erregtheit, in der naiven Lust der Kindheit, in der
herzigen Verschämtheit und Unbeholfenheit der Jugend, wie in der
steifen Selbständigkeit und in der ehrwürdigen Entsagung des Alters
dem Auge darzustellen gewußt, wie Ludwig Richter. ‚Traulich mit
dem Volke verkehren,‘ sagt Horn an einer Stelle, ‚bringt reichen
Lohn. O wieviel Tüchtiges und Treffliches umschließt das tiefe
Gemüt des Volkes! Wieviel Poesie liegt da verborgen!‘ Das hat auch
Richter erkannt, und wenn er vielleicht auch nicht in dem Maße, wie
durch seinen Seelsorgerberuf der Dichter, eindringen konnte in das
innere Leben, sein treues Auge und sein liebevolles Herz hat ihn
nicht minder vertraut gemacht mit dem Volke.“ Von den uns zur
Verfügung stehenden Handzeichnungen zu dieser Publikation
bringen wir die Blätter Abb. 68 bis 76. Die beiden Zeichnungen zu
der Geschichte „Jörjakob“, gezeichnet um 1860, sind von seltener
Schärfe der Charakteristik und erschütternd im Ausdruck. Der Knabe
am Bett der sterbenden Mutter, seine Hand auf die ihrige legend,
lauscht schmerzbewegt ihren letzten Segensworten (Abb. 74). Und
weiter dann die Frau und die Kinder am Bett des verstorbenen
Mannes und Vaters (Abb. 75)! Der letzte Atemzug ist getan, die
Seele aus dem Körper geschieden. Wie ist das Weib groß und echt
und wahr gezeichnet, wie sie laut schluchzend, mit beiden Händen
die Schürze vors Gesicht hält, und die Kinder, wie sie in ihrem
Schmerze an der entseelten Hülle ihres geliebten Vaters knieen. Das
Kleinste steht so unbeholfen und erstaunt neben der Mutter, wie
Schutz suchend, das kleine Wesen begreift noch gar nicht, was
vorgegangen ist. Dieses Blatt hat etwas von der Größe und Wucht
und Charakteristik Rethelscher Art. Das prächtige, höchst geistreich
leicht gefärbte Blatt „Unterredung“ (Abb. 77) ist möglicherweise eine
Vorarbeit zu „Eine Geschichte, wie sie leider oft passiert“ aus den
Spinnstubengeschichten von 1851.
und dann „Der Müllerin Reue“. Wie muten uns diese Bilder so
wohltuend an! Zu den hervorragendsten dieser Bilder gehören die
Zeichnungen zu „Hermann und Dorothea“, von denen wir Abb. 111
bringen: „Und so saß das trauliche Paar, sich unter dem Torweg über
das wandernde Volk mit mancher Bemerkung ergötzend.“ Es atmet
dieses Blatt die friedliche Stille und Behaglichkeit der kleinen Stadt!
Trefflich sind die Bilder zu „Götz von Berlichingen“: „Schreiben ist ein
geschäftiger Müßiggang“ (Abb. 112) und „Es war einmal“ (Abb. 113).
Wie lauschig ist das behagliche Turmstübchen, und von welcher
Anmut das Figürchen der Maria! Wie ist das alles deutsch gedacht
und empfunden!
Abb. 88. E r h a l t G o t t m e i n e n
Friedel.
Hebels alemannische Gedichte. 1851.
(Zu Seite 63.)
Abb. 89. D e r B e t t l e r . Hebels alemannische Gedichte.
1851. (Zu Seite 63.)