Multiple Choice Questions:

1. The nurse is completing a survey that includes questions about different aspects of cultural competence. What is the purpose of this survey?

a. Assessment of cultural competence

b. Manage the dynamics of difference

c. Value diversity

d. Institutionalize cultural knowledge

2. The nurse is planning care to address health care needs for a non-English-speaking patient and family. What would the nurse use as a guide for this care?

a. Standardized care plan

b. Checklist

c. Nursing textbook

d. Care map

3. Unlicensed assistive personnel (UAP) ask the nurse to explain the difference between cultural care and other types of care. What would the nurse say in response to the UAP?

a. It focuses on scientific theory.

b. It is a fad.

c. It is holistic.

d. It is a belief system.

4. The nurse is struggling with providing culturally competent care to non-English-speaking patients because the organization does not have any resources to support the patients' care needs. What is this nurse experiencing?

a. Compromise

b. Dissonance

c. Confusion

d. Distress

5. The nurse is disappointed with not being able to provide educational materials in a non-English-speaking patient's primary language. What can the nurse do to serve as an advocate when providing culturally competent care?

a. Ask the physician to talk with the patient.

b. Teach the patient in English.

c. Provide educational materials written in English.

d. Find or create materials to meet the patients' needs.

6. The staff development instructor is planning a seminar that focuses on the variables leading to generational conflict. What will the instructor include in this content?

a. Decade of birth

b. Generation in the United States

c. Class

d. All of the above

7. The nurse is planning care for a group of patients from different cultural backgrounds. What aspects of the nurse will impact how the patients access and respond to health care services?

a. Cultural background

b. Heritage

c. Language

d. All of the above.

8. The nurse manager has several staff members from Generation X born between 1975 and 1990. Which workplace ethic will these staff members most likely demonstrate when providing patient care?

a. Work scheduled to fit their lifestyle

b. Seeking maximum financial gain

c. Loyal to one's skills in the marketplace

d. Employer loyalty

9. Which action exemplifies ethnocentrism in nursing?

a. See nursing as the only method to address health concerns

b. Will only care for members of their own ethnic group

c. Are ambivalent to health concerns of groups beyond their dominant social group

d. Are willing to acknowledge other methods beyond nursing to address health concerns

10. A patient from a different culture tells the nurse about eating specific foods during pregnancy and after childbirth to ensure a healthy mother and infant. Which cultural phenomena does this behavior exemplify?

a. Time orientation

b. Social organization

c. Environmental control

d. Biological variation

11. Why does the nurse stop and think before implementing touch when providing care to a patient from a different culture?

a. Influences the patient's personal space

b. Influences environmental control

c. Impacts time orientation

d. Alters social organization

12. The health care team is having difficulty communicating with a patient from a non-English-speaking culture. An interpreter has not yet been located. Which behaviors might the patient demonstrate because of this communication issue?

a. Withdrawing

b. Hostility

c. Belligerence

d. All of the above.

13. Which action would the home care nurse take to demonstrate a respect of time?

a. Informing the patient of the approximate time the visit will be made

b. Showing up when able at the patient's home without informing the patient first

c. Bringing a gift to the patient's home on the initial visit

d. Giving a general idea of when the visit will be made

14. Prior to caring for a Native American patient, the nurse reviews the diseases that are more prevalent in this culture. What is the nurse taking into consideration when caring for this patient?

a. Environmental control

b. Biological variation

c. Social organization pattern

d. Component of heritage consistency

15. Prior to completing an admission assessment, a foreign-born patient provides the nurse with a green card. What does this green card represent?

a. Restrictions to become a citizen

b. Automatic US citizenship

c. Inability to vote

d. None of the above.

16. A foreign-born patient tells the nurse about preparing for the naturalization exam. What kinds of questions will be on this exam?

a. Questions about the Constitution

b. Names of Justices on the Supreme Court

c. Words of the US national anthem

d. All of the above.

17. Among the very real concerns for all residents of the United States, both citizens and legal permanent residents, is the rise in undocumented people entering the country. What impact is this having on health care?

a. Increased numbers of undocumented people are straining health care resources.

b. There is a concern that undocumented people will lead to bioterrorist attacks.

c. Health insurance is being given to all people in the country, ensuring universal coverage.

d. The rise in undocumented people is contributing to the rise in exotic and rare diseases in the country.

18. Which criterion limits access to health care?

a. Employment opportunities

b. No public transportation

c. Transition programs for newly arrived legal residents

d. Advocacy groups for immigrants

19. Statistics for 2008 to 2009 indicated that 20.7% of children lived in poverty. What health implications can be drawn from this statistic?

a. Increased funding for children's health has resulted from these statistics

b. Public health clinics can provide preventive care

c. Medicaid assistance can enable these children to receive health care

d. All of the above.

20. Why would a patient who has a higher income generally have better health outcomes?

a. Have better access to health care

b. Have better job skills

c. Can afford private transportation

d. Can afford private insurance

21. While taking the health history, a Black Hispanic patient tells the nurse about having difficulty finding employment. The nurse realizes that which is a factor that causes income disparity within this segment of the population?

a. Increase in the real minimum wage potential

b. Shift to labor requiring higher technological skills

c. Increase in traditional labor skills for these groups

d. Shift of skilled jobs to unskilled labor

22. A patient comes to a health care provider concerned about a family history of diabetes. The provider addresses the patient's concerns and suggests interventions to diminish the patient's chances of developing the disease. What is this action considered?

a. Perceived benefits

b. Demographic variables

c. Perceived seriousness

d. Sociopsychological variables

23. After learning about a health problem, a patient is reluctant to take action. Which barriers could be influencing this patient's decision about taking action?

a. Cost

b. Availability

c. Time

d. All of the above.

24. A patient does not understand what the health care provider is describing about a health problem. What is this discrepancy considered?

a. Sociopsychological variable

b. Demographic variable

c. Structural variable

d. Perceived susceptibility

25. A person comes to the Emergency Department seeking medical care for symptoms of an illness. What will legitimize the illness for the patient?

a. The person having the illness

b. The insurance company that pays for the illness treatment

c. Society's view of the illness

d. None of the above.

26. A patient is experiencing symptoms of an illness. Which behaviors would the patient demonstrate as part of the sick role?

a. Asking friends and family to help diagnose the problem

b. Taking prescribed medications

c. Changing the diet and resting as prescribed

d. b and c only

27. Which is an obligation of a person who is assuming the sick role?

a. Seeking help and following it to promote recovery

b. Stay away from others to prevent them from becoming ill

c. Follow health orders without question

d. Appear to be sick

28. The nurse determines that a patient is in the onset stage of an illness. What did the nurse observe in the patient?

a. There is a gradual resumption of normal roles and activities.

b. The first symptoms of a given problem are experienced.

c. The sick role becomes that of being a patient.

d. The disease is identified and socially sanctioned.

29. Which activities does the nurse recognize as being used by a patient to restore health?

a. Drinking herbal tea

b. Using massage

c. Prayer

d. All of the above.

30 The nurse is trying to determine if a treatment that a patient has been taking for an illness is considered a homeopathic remedy. Which are criteria of homeopathy?

a. Spinal manipulation realigns mental impulses

b. Application of magnets to cure an illness

c. A substance used would cause symptoms in a healthy person

d. None of the above.

31. A patient wants to use a complementary medicine approach for a chronic health problem. Which approaches would the nurse suggest the patient use?

a. Hypnotherapy

b. Reflexology

c. Biofeedback

d. Reiki

32. What is an advantage of using complementary medicine for treatment of an illness?

a. Complementary medicine can be used with allopathic medicine.

b. Complementary medicine replaces allopathic medicine as a primary form of treatment.

c. Complementary medicine lessens a patient's discomfort with allopathic treatments.

d. Complementary medicine is never used with allopathic medicine.

33. Which complementary treatment would the nurse suggest for a patient receiving treatment for cancer?

a. Wear a copper bracelet

b. Ingest black cohosh

c. Take gingko

d. Use ginger

34. A patient asks the nurse to help identify alternative care approaches for a newly diagnosed illness. Why would the patient want to use an alternative care approach?

a. Allopathic treatments may cause adverse effects that a person can't tolerate.

b. It has a better empirical basis than do allopathic treatments.

c. Insurance reimburses alternative care treatments at the same rate or better than allopathic treatments.

d. Training for alternative care practitioners is closely regulated and licensed.

35. For which patient would the nurse be sure to include an assessment about the use of complementary alternative medical (CAM) treatments?

a. Male patient

b. Thirty-five-year-old patient who lives in Los Angeles

c. Patient whose family believes CAM is a hoax

d. Patient with an eighth grade education

36. A patient tells the nurse that she is a member of a religion where birth control is either permitted or up to the choice of the couple. Which religions have this belief regarding the use of birth control?

a. Buddhist Church of America

b. Judaism

c. Hinduism

d. All of the above.

37. Why would a patient use a healer over a traditional allopathic physician for a health problem?

a. Willingness to be available at any time

b. Use of a unique language that is characteristic of their calling

c. Exclusive dialogue with the person who is ill

d. Formal relationship with the client

38. A patient is planning to see a spiritual healer that practices telotherapy. What is this type of healing?

a. A method that separates the physical from the spiritual

b. Spiritual healing

c. The expression of divine intervention

d. The optimal method for healing

39. A person has an illness of the spirit. What method of treatment will this person receive?

a. Laying of hands

b. Heal the memory

c. Repentance

d. Exorcism

40. A patient is planning to participate in a physical healing session. What activities will occur during this session?

a. Laying on hands

b. Submersion in water

c. Having blood drawn

d. Releasing muscle tension through massage

41. Which type of healing is most appropriate for a person who is possessed by external evil?

a. Deliverance

b. Physical healing

c. Inner healing

d. Spiritual healing

42. For which health problems would physical healing be the most appropriate with which to treat?

a. Someone afflicted with a bodily and mental evil

b. Bodily damage

c. Spiritual distress from personal sin

d. An emotional or mental illness

43. A patient of the Austrian-American Jewish tradition tells the nurse how to treat boils. What will this patient most likely explain to the nurse?

a. Apply a fried chopped onion compress to the area.

b. Press cold tea bags to the area.

c. Apply a flaxseed poultice to the area.

d. Place hot Epsom salts on the area.

44. What would a patient of Irish Catholic heritage use to treat menstrual cramps?

a. Hot milk sprinkled with ginger

b. Shot of whiskey

c. Glass of warm wine

d. All of the above.

45. What will the nurse most likely assess as a health maintenance activity for a patient of Swedish-American Protestant heritage?

a. Walking on a regular basis.

b. Starting each day with prayer.

c. Dressing appropriately for the weather.

d. Going to a physician twice a year whether needed or not.

46. Which heritage group boils a beef bone, breaks up toast in the broth, and drinks as a health restoration practice for a headache?

a. Irish-American Catholics

b. Polish-American Catholics

c. German-American Catholics

d. Canadians

47. For which heritage is applying a red scarf around the chest performed for a cold or a sore throat?

a. English Episcopal tradition

b. Norwegian Lutheran tradition

c. Polish Catholic tradition

d. Eastern European Jewish tradition

48. Which health restoration practice would a person from the Swedish-American Protestant heritage use to treat a black eye?

a. Applying ice to the affected area.

b. Placing heat on the affected area.

c. Making a poultice to draw down the swelling.

d. Applying leeches to decrease the bruising.

49. Which health protection activity would a patient of Iranian-American Islam heritage practice?

a. Keep feet from getting wet in the rain

b. Prevent evil spirits by not looking at a mirror at night

c. Eat sorghum molasses

d. Keep onions under the bed to keep nasal passages clear

50. What would be a reason why a person with sickle cell disease does not receive adequate care and pain control during a crisis?

a. The person may not explain their symptoms appropriately.

b. Physicians are not familiar with the trajectory of a pain crisis.

c. The person isn't aware that appropriate care for a pain crisis exists.

d. There may be subtle racism exhibited toward those with sickle cell disease.

51. A patient is seeking a second level of care for a health problem. What types of health care providers are found at this level?

a. Obstetricians

b. Hospitalists

c. Surgeon

d. All of the above.

52. A patient is a migrant farm worker. Which barrier would exist for this patient to access health care if needed?

a. Language

b. Homelessness

c. Racism

d. Access

53. What would be a barrier to health care for a person who lives in a rural area?

a. Education

b. Transportation

c. Insurance

d. Technology

54. Why would a patient of limited income find technology as a barrier to accessing health care?

a. Inability to afford, desire, or utilize what technology offers as tests or treatments.

b. Difficulty understanding the results obtained as a result of technology.

c. Limited benefits due to age.

d. Lack of accessing the various diagnostic technological treatments.

55. What causes medicine to be identified as an institution of social control?

a. Focusing on health issues affecting the poorer segments of society.

b. Debating the issues of who has the right to stop medical treatment.

c. Placing attention on health issues that are considered preventable diseases of the rich.

d. Limiting the use of technology .

56. Which is the philosophy of cultural care?

a. Holistic care is predicated on cultural health traditions and needs.

b. Sufficient money, technology, and science are used to cure.

c. Premature death must be avoided.

d. Disease and injury are avoided through health promotion and maintenance.

57. The nurse is obtaining a health history from a patient of the American Indian culture. Which problems would cause the nurse to be concerned about the patient's health?

a. Heart disease

b. Diabetes mellitus

c. Cancer of the prostate

d. All of the above.

58. What is a goal of the Indian Health Service?

a. Ensure that comprehensive, culturally acceptable personal care is available and accessible to all American Indian people.

b. Provide health care to the American Indian and Alaska Native.

c. Provide American Indian medical providers to deliver medical care to the American Indian and Alaska Native population.

d. Educate the American Indian and Alaska Native in preventive health care practices.

59. How does the Indian Health Service plan to raise the health of the American Indian people?

a. Having one master health guideline blueprint for consistency of care.

b. Allotting health resources based on population numbers.

c. Partnering and assisting tribes in planning the best delivery of care.

d. Following prescribed federal guidelines and procedures.

60. Even though the Indian Health Service (IHS) provides care to a wide area of the population, what is an issue with this health service?

a. Services are predominantly given in the western part of the United States.

b. Health services can only be done through IHS facilities.

c. Any American Indian or Alaska Native can demand care from the IHS.

d. There is a redundancy of services in all its facilities.

61. A patient that is of the American Indian culture is waiting to be seen in a non-Indian Health Service facility. What concern might this patient have about receiving health care through this route?

a. Easier to receive medical care through emergency departments rather than private physicians

b. Conflict between his or her perception of the illness and what the physician diagnoses

c. Receive better health care from mainstream medical services

d. Concern that medical insurance won't cover all the medical costs

62. Which action would the nurse take when assessing a patient of American Indian culture?

a. Remaining quiet and recognizing the importance of nonverbal communication to seek information

b. Asking detailed questions regarding the presenting symptoms

c. Asking indirect questions about the reason for seeking health care

d. Ensuring that no one beyond the medical provider and the client discuss what has brought the client to seek care

63. The nurse is completing a health history for a patient of the American Indian culture What activity would the nurse perform while conducting this assessment?

a. Tape-recording the responses given.

b. Encouraging free conversation by the American Indian patient.

c. Repeating back everything that is said.

d. Remembering what is being said to be recorded at a later date.

64. In acupuncture, why are the needles inserted at predetermined points or the meridians?

a. They help to restore yin and yang balance.

b. This is where the bones and muscles intersect.

c. They represent specific yin and yang points.

d. It will achieve the best anesthetic response.

65. A patient is asking for cupping to be done to help treat an illness. In the Asian culture, what is the health restoration practice of cupping?

a. Bleeding in a special cup in order to decrease heat from the body

b. Massaging an acupuncture site with a cup to treat neurological conditions

c. Placing a heated glass on the skin to remove cold and damp bodily evils

d. Using moxibustion to treat conditions related to heat

66. The nurse observes an individual from the Asian culture prepare ginseng to be used for an illness. What observation does the nurse make in the preparation of this herb?

a. It is not being prepared with anything metal.

b. It is ground to a powder and rubbed on the skin.

c. It will not be given to children.

d. It is ingested several times a day.

67. In traditional Chinese medicine, which is a remedy used to heal wounds?

a. Lime calcium

b. Snake flesh

c. Deer antlers

d. Urea

68. In traditional Chinese medicine, how would a male physician diagnose a health problem in a female patient?

a. Having the primary male member of the family describe the symptoms

b. Touching a ribbon attached to the woman's wrist

c. Speaking to the woman behind a screen

d. Allowing the primary male member of the family to touch the woman's pulse

69. Why does poor health continue to occur among immigrant Asian populations?

a. Poor working environments and crowded living conditions

b. Refusal of Western medicine to treat Asian immigrants

c. Inability to tolerate Western medications

d. Low number of health care workers of Asian origin

70. While assessing the health history of a patient who is an Asian/Pacific Islander, what will the nurse identify as a leading cause of death for people from this culture?

a. Malignant neoplasms

b. Influenza and pneumonia

c. Alzheimer's disease

d. Chronic lower respiratory diseases

71. Why would a clinic nurse cautiously discuss birth control with a patient from the Black culture?

a. It would hinder the patient's socioeconomic status.

b. It may be viewed by the patient as a way to limit community growth.

c. It does not work on members of the Black community.

d. It is not recognized as a method to space children.

72. During the examination of a patient from the Black culture, how will the nurse recognize pallor?

a. Absence of underlying red tones

b. Palpate the skin

c. Check the sclera

d. Slow blood return

73. How would the nurse document scars that form at a wound site that grow beyond the normal boundaries of a wound in a patient from the Black culture?

a. Melasma

b. A pigmentary disorder

c. Pseudofolliculitis

d. Keloid

74. How often would the nurse plan to wash the hair of a patient from the Black culture?

a. As needed

b. After it has been oiled

c. Only when dry

d. Daily to maintain oiliness

75. What should be done if a patient from the Black culture practices aspects of folk medicine while also receiving Western treatment?

a. Consult the minister to give approval.

b. Discourage folk medicine practices.

c. Integrate the two treatments.

d. Choose which treatment option they prefer.

76. Which health profession has the highest percentage of Black or African Americans?

a. Nursing

b. Podiatry

c. Optometry

d. Dentistry

77. A patient of the Black American culture is diagnosed with cancer. In addition to cancer, what are other leading causes of death for patients of this culture?

a. Heart disease

b. Cerebrovascular disease

c. Diabetes mellitus

d. All of the above.

78. What would the percentage of live births to women receiving third-trimester or no prenatal care being higher for Hispanics than the general population indicate to the nurse?

a. Hispanics might have better self-care prenatal practices than the general population

b. Live birth rates would be comparable if all women received appropriate prenatal care

c. More prenatal services are needed for the general population

d. Some prenatal care is better than no prenatal care

79. What would be a barrier to effective health care delivery from Western health care practitioners to patients of the Hispanic culture?

a. Insistence of the Hispanic population on using folk healers

b. The time phenomenon causing conflicts with appointment promptness

c. The ability to pay for provided services

d. Refusal to accept that some medical treatments may be more effective than folk treatments

80. Which action would address demographic disparity in health care for the Hispanic population?

a. Increase the number of Hispanics entering the health care professions

b. Require all health care providers to learn Spanish

c. Decrease the numbers of current students in health care education programs to increase the numbers for Hispanic students

d. Provide Hispanic health care workers for Hispanic clients

81. When collecting socioeconomic data from a patient of the Hispanic culture living in the United States, which information would be consistent with 2010 census data information?

a. Most Hispanics seek employment in urban areas

b. Few Hispanics have high-paying jobs

c. A small number of Hispanics are employed in clerical and professional areas

d. All of the above.

82. What will a patient from the Mexican culture explain to the nurse as the cause of an illness?

a. Warning from God to live a better life

b. Punishment from an ancestor

c. An imbalance within the body

d. Inevitable with no method to prevent it from occurring

83. A patient from the Mexican culture tells the nurse that an illness has been caused by mal ojo or "bad eye." How did this health problem occur?

a. Excessive admiration from someone else

b. Having a spell caused by black magic

c. Being touched improperly by a health care provider

d. Lying about the amount of food one has eaten

84. Which method will a patient of the Hispanic culture use to counteract illness caused by an imbalance?

a. Eat foods that are opposite of the imbalance

b. Refrain from discussing the illness with family members

c. Seek appropriate medical care from the local healer

d. Dress appropriately

85. Which actions would a patient of Polish descent take to treat a headache?

a. Apply a cloth with vinegar to the head

b. Drink pumpkin juice tea

c. Cover the head with kerosene

d. Drink yarrow tea

86. For which health problems would the nurse assess in a patient of Italian descent because of a genetic risk for developing?

a. Rheumatoid arthritis

b. Thalassemia syndromes

c. Sickle cell anemia

d. Psoriasis

87. What would the nurse consider about the incidence of cancer when assessing a White patient?

a. Is significantly lower than other races

b. Is lower than among the overall population

c. Is equal with other races in incidence.

d. Is slightly higher than for the overall population

88. When compared to all races, which would be higher in the White population?

a. Percentage of women receiving prenatal care

b. Infant mortality rate

c. Percentage of low birth-weight infants

d. Crude birth rate

89. What would the nurse recall when assessing a male White patient regarding the rate of suicide when compared to Native Americans, Hispanics, and African Americans?

a. Not broken out specifically for population groups

b. Essentially equal

c. Higher

d. Lower

90. When comparing the leading causes of death for all persons, which problem ranks higher for the White population?

a. Chronic lower respiratory diseases

b. Influenza and pneumonia

c. Diseases of the heart

d. Septicemia

91. Which action would a patient of German descent use to protect health?

a. Dressing properly for the season

b. Always wearing a hat to protect the head

c. Eating garlic with lunch and dinner

d. Drinking orange juice every day

92. What might a patient of German descent used to treat a stomachache?

a. Stop eating for at least 24 hours

b. Drink peppermint tea

c. Take black draught

d. Eat chicken soup

93. What does the nurse assess as demographic and social disparities among the poor and non-White minorities in the United States?

a. Diet

b. Housing

c. Employment

d. b and c only

94. The health care administrator is identifying ways to improve communication with non-English-speaking patients. Which languages would the administrator target as being spoken by hospital employees?

a. Italian

b. French

c. Spanish

d. All of the above.

95. Which action would the nurse take to improve culture care?

a. Expect everyone to embrace the process

b. Learn a foreign language

c. Confront biases and stereotypes

d. Study different cultures

96. What action would a nurse take to learn more about the different cultures represented in the community?

a. Recognize hot-cold imbalances

b. Prepare a guide sheet with a list of herbs

c. Recognize folk diseases

d. Walk through the community

97. What would be a reason for the lack of various cultural groups being represented within the health care professions?

a. Early education deprivation

b. Lack of interest

c. Family structure

d. Transportation barriers

98. A health clinic in a socioeconomically depressed area that provides care to Hispanic patients is being closed. Which action should the nurse take to support the patients?

a. Create a list of comparable resources outside the community

b. Urge for increased funding

c. Write directions to the nearest hospital in the patients' native language

d. Investigate the misappropriation of funds

99. The nurse is on the journey to learn cultural competence and sees an open highway ahead. Which action should the nurse take at this time?

a. Cruise along, but not too fast

b. Go faster

c. Stop

d. Expect clear sailing ahead

100. What self-observation does the nurse make that indicates that the nurse is "on the road" to cultural competency?

a. Avoiding the use of amulets

b. Individual culture and religion

c. Adhering to ways to protect health that are consistent with the dominant culture

d. Socialized by society.