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4. Mr. Perez is a Mexican immigrant who migrated to the United States and lives in a
Spanish-speaking community with other relatives. He is taken to the ER following a fall
at work and is admitted to the hospital for observation. Which of the following is the
nurse caring for Mr. Perez aware that he is at risk for?
A) cultural assimilation
B) cultural shock
C) cultural imposition
D) cultural blindness
Page 1
5. What characteristic is used to describe racial categories?
A) language
B) skin color
C) music preferences
D) food likes and dislikes
6. A 20-year-old housekeeper, born and educated in Iraq, wears her traditional clothing
and head covering. A 50-year-old patient tells the nurse, “They are in America and
should dress like we do.” What is this statement an example of?
A) cultural assimilation
B) cultural blindness
C) cultural conflict
D) cultural imposition
7. A nurse walks by a patient's room and observes a Shaman performing a healing ritual
for the patient. The nurse then remarks to a coworker that the ritual is a waste of time
and disruptive to the other patients on the floor. This nurse is displaying the feelings
associated with:
A) culture conflict
B) cultural blindness
C) stereotyping
D) cultural shock
8. Which of the following statements accurately describe cultural factors that may
influence healthcare? Select all that apply.
A) Nurses and patients generally agree upon the health practices that are being
instituted.
B) Certain racial and ethnic groups are more prone to developing specific diseases and
conditions.
C) Although pain affects people differently, most people react to pain in the same
manner.
D) Most mental health norms are based on research and observations made of white,
middle-class people.
E) In many cultures, the man is the dominant figure and generally makes decisions for
all family members.
F) When people move to the United States, they may speak their own language
fluently but have difficulty speaking English.
Page 2
9. A nurse is doing preoperative teaching for an African American man before he has
abdominal surgery. What topic should be included in the teaching?
A) the possibility of developing a keloid over the healed incision
B) the increased risk of developing an infection in the incision
C) his racial characteristics that will slow healing
D) cultural influences on his response to surgery
10. A nurse is caring for a patient from Taiwan who constantly requests pain medication.
What should the nurse consider when assessing the patient's pain?
A) Most people react to pain in the same way.
B) Pain in adults in less intense than pain in children.
C) The patient is a constant complainer.
D) Pain is what the patient says it is.
11. A father, mother, grandmother, and three school-aged children have immigrated to the
United States from Thailand. Which member(s) of the family are likely to learn to speak
English more rapidly?
A) unemployed father
B) stay-at-home mother
C) grandmother
D) children
12. A 40-year-old nurse is taking a health history from a 20-year-old Hispanic man and
notes that he looks down at the floor when he answers questions. What should the nurse
understand about this behavior?
A) The patient is embarrassed by the questions.
B) This is culturally appropriate behavior.
C) The patient dislikes the nurse.
D) The patient does not understand what is being asked.
13. An older adult woman of Chinese ancestry refuses to eat at the nursing home, stating,
“I'm just not hungry.” What factors should the staff assess for this problem?
A) The woman does not like to eat with other residents of the home.
B) The woman is using this as a means of going home.
C) The food served may not be culturally appropriate.
D) The food served may violate religious beliefs.
Page 3
14. Although all of the following are factors to consider when caring for patients with
limited income, which one is the most important?
A) basic human needs may go unmet
B) limited access to reliable transportation
C) decreased access to healthcare services
D) risk for increased incidence of disease
15. The nurse is providing home care for a patient who traditionally drinks herbal tea to
treat an illness. How should the nurse respond to a request for the herbal tea?
A) “We do not allow our patients to drink herbal tea.”
B) “Why in the world would you want to drink that stuff?”
C) “Let me check with the doctor to make sure it is okay with your medicines.”
D) “I have to fill out a lot of forms that you will have to sign before I can do that.”
16. A nurse in a large metropolitan city enjoys working in a health clinic that primarily
serves Hispanic patients. What does this statement imply about the nurse?
A) The nurse's knowledge and skills are not adequate to care for patients with acute
illnesses.
B) The nurse respects and values providing culturally competent care.
C) The nurse is attempting to overcome cultural blindness.
D) This employment makes the nurse feel superior to a minority group of people.
17. A nurse is providing care for a Cambodian patient. The nurse says, “You have to get up
and walk whether you want to or not.” What is this statement an example of?
A) culture shock
B) stereotyping
C) cultural imposition
D) cultural competence
18. Which of the following are considered cultural norms of the healthcare system? Select
all that apply.
A) inability to define health and illness
B) frequent use of jargon and documentation
C) professional deference to pecking order
D) use of a problem-solving methodology
E) belief in the fallibility of technology
F) use of certain procedures for birth and death
Page 4
19. A nurse is caring for an African American in an acute care setting. Which one of the
following might be a special nursing consideration for this patient?
A) The patient might request a visit from a folk healer.
B) The patient may be upset by drawing blood for a test.
C) The patient may perceive illness as a punishment from God.
D) The patient may expect the caregiver to deduce the problem by instinct.
20. In which of the following populations should the nurse carefully assess the patient's use
of over-the-counter medications?
A) African American
B) Hispanic
C) White middle class
D) Asian
21. A nurse is caring for an Appalachian patient following her hysterectomy. Which of the
following Appalachian values and beliefs should be considered when planning nursing
care for this patient? Select all that apply.
A) Isolation is considered as a way of life.
B) Dependence and self-determination are valued.
C) Lifestyle is more revered than compliance with healthcare issues.
D) They may be fatalistic about losses and deaths.
E) There is a deep love, respect, and affection between people and the land.
F) Death is seen as a part of life and not feared.
22. What is one way in which nurses can develop cultural self-awareness?
A) Ask peers and colleagues about practicing cultural competence.
B) Objectively examine own beliefs, values, and practices.
C) Realize nothing can be done to change one's values and beliefs.
D) Assert to others that personal biases cannot be changed.
23. A home health nurse is visiting a 60-year-old patient. During the initial visit, the
patient's husband answers all of the questions. What would the nurse assess based on
this behavior?
A) The patient does not want the nurse to visit.
B) The husband does not trust his wife to answer questions.
C) The patient is not able to answer the questions.
D) The husband is the dominant member of the family.
Page 5
Answer Key
1. C
2. A, D, E, F
3. A
4. B
5. B
6. D
7. A
8. B, D, E, F
9. A
10. D
11. D
12. B
13. C
14. A
15. C
16. B
17. C
18. B, C, D, F
19. A
20. C
21. A, B, D
22. B
23. D
Page 6
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FOOTNOTES
[1] Quarterly Review, October, 1870, pp. 143, 144.
[2] Wordsworth, Preface to Second Edition of Lyrical Ballads.
[3] Myosotis Alpestris.
[4] S. T. Coleridge, Lit. Biog. vol. ii. p. 23.
[5] Since writing the above passage, I have been pleased to
find in Mr. Hamerton’s Sylvan Year, the following passage, which
expresses more fully the same thought. He speaks (page 68) of
“the delight of the citizen in green leaves, and the intensity of
sensation about Nature which we find in poets who were bred in
towns; whilst those who have lived much in the country, though
they know and observe more, seem to feel more equably, and to
go to Nature with less of sensuous thirst and excitement.”
[6] Life of Sir Isaac Newton, by Sir David Brewster, vol. ii. pp.
407, 408.
[7] Mozley’s University Sermons, p. 141.
[8] See Müller’s Lectures on Language, 2d series, pp. 435, 436.
[9] Miss Wordsworth, p. 228.
[10] Essay on Keble.
[11] Trench on Parables, p. 13.
[12] Born 1621, died 1695.
[13] Dawson, Nature and the Bible, pp. 23, 24.
[14] Odyssey, B. vii. 112; Worsley, B. vii. 17th stanza.
[15] To this assertion I must make one exception. Since these
remarks were written, my attention has been kindly drawn by
Professor Campbell of St. Andrews to a passage in the ninth book
of Paradise Lost, in which Milton for a moment reverts to the old
rural freshness in something of the manner of his youth. It is the
place where the Tempter first catches sight of Eve:—
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