Cultural_Implications_for_Psychiatric_Mental_Health_Nursing

1. Which iWestern icultural ifeature imay iresult iin iestablishing iunrealistic ioutcomes ifor ipatients iof iother icultural igroups? a. Interdependence b. Present iorientation c. Flexible iperception iof itime d. Direct iconfrontation ito isolve iproblems ANS: D Directly iconfronting iproblems iis ia ihighly ivalued iapproach iin ithe iAmerican iculture ibut inot ipart iof imany iother icultures iin iwhich iharmony iand irestraint iare ivalued. iAmerican inurses isometimes imistakenly ithink ithat iall ipatients ishould itake idirect iaction. iPatients iwith iother ivalues iwill ibe iunable ito imeet ithis iculturally iinappropriate ioutcome. iPresent iorientation, iinterdependence, iand ia iflexible iperception iof itime iare inot ivalued iin iWestern iculture. iThese iviews iare imore ipredominant iin iother icultures. iSee irelationship ito iaudience iresponse iquestion. PTS: 1 DIF: Cognitive iLevel: iUnderstand i(Comprehension) REF: Page i88 i(Table i5-4) TOP: Nursing iProcess: iPlanning iMSC: Client iNeeds: iPsychosocial iIntegrity 2. A ipsychiatric inurse ileads ia imedication ieducation igroup ifor iHispanic ipatients. iThis inurse iholds ia iWestern iworldview iand iuses ipamphlets ias iteaching itools. iGroups iare ishort iand iconcise. iAfter ithe igroup, ithe ipatients iare imost ilikely ito ibelieve: a. the inurse iwas iuncaring. c. the iteaching iwas iefficient. b. the isession iwas ieffective. d. they iwere itreated irespectfully. ANS: A Hispanic iindividuals iusually ivalue irelationship ibehaviors. iTheir ineeds iare ifor ilearning ithrough iverbal icommunication irather ithan ireading iand ifor ihaving itime ito ichat ibefore iapproaching ithe itask. PTS: 1 DIF: Cognitive iLevel: iApply i(Application) REF: Page i85-86 i(Table i5-2) TOP: Nursing iProcess: iEvaluation iMSC: Client iNeeds: iPsychosocial iIntegrity 3. To iprovide iculturally icompetent icare, ithe inurse ishould: a. accurately iinterpret ithe ithinking iof iindividual ipatients. b. predict ihow ia ipatient imay iperceive itreatment iinterventions. c. formulate iinterventions ito ireduce ithe ipatient’s iethnocentrism. d. identify istrategies ithat ifit iwithin ithe icultural icontext iof ithe ipatient. ANS: D The icorrect ianswer iis ithe imost iglobal iresponse. iCultural icompetence irequires iongoing ieffort. iCulture iis idynamic, idiversified, iand ichanging. iThe inurse imust ibe iprepared ito igain icultural iknowledge iand idetermine inursing icare imeasures ithat ipatients ifind iacceptable iand ihelpful. iInterpreting ithe ithinking iof iindividual ipatients idoes inot iensure iculturally icompetent icare. iReducing ia ipatient’s iethnocentrism imay inot ibe ia idesired ioutcome. PTS: 1 DIF: Cognitive iLevel: iApply i(Application) REF: Page i93 TOP: Nursing iProcess: iPlanning/Outcomes iIdentification MSC: Client iNeeds: iPsychosocial iIntegrity 4. A iblack ipatient, ioriginally ifrom iHaiti, ihas ia idiagnosis iof idepression. iA icolleague itells ithe inurse, i“This ipatient ioften ilooks idown iand iis ireluctant ito ishare ifeelings. iHowever, iI’ve iobserved ithe ipatient ispontaneously iinteracting iwith iother iblack ipatients.” iSelect ithe inurse’s ibest iresponse. a. “Black ipatients idepend ion ithe ichurch ifor isupport. iHave iyou iconsulted ithe ipatient’s ipastor?” b. “Encourage ithe ipatient ito italk iin ia igroup isetting. iIt iwill ibe iless iintimidating ithan ione-to-one iinteraction.” c. “Don’t itake iit ipersonally. iBlack ipatients ioften ihave ia iresentful iattitude ithat itakes ia ilong itime ito iovercome.” d. “The ipatient imay ihave idifficulty icommunicating iin iEnglish. iHave iyou iconsidered iusing ia icultural ibroker?” ANS: D Society iexpects ia iculturally idiverse ipatient ito iaccommodate iand iuse iEnglish. iFeelings iare iabstract, iwhich irequires ia igreater icommand iof ithe ilanguage. iThis imay ibe iespecially idifficult iduring iepisodes iof ihigh istress ior imental iillness. iCultural ibrokers ican ibe ihelpful iwith ilanguage iand ihelping ithe inurse ito iunderstand ithe iHaitian iworldview iand icultural inuances. PTS: 1 DIF: Cognitive iLevel: iApply i(Application) REF: Page i88-89 TOP: Nursing iProcess: iImplementation iMSC: Client iNeeds: iPsychosocial iIntegrity 5. A iHaitian ipatient idiagnosed iwith idepression itells ithe inurse, i“There’s inothing iyou ican ido. iThis iis ia ipunishment. iThe ionly ithing iI ican ido iis isee ia ihealer.” iThe iculturally iaware inurse iassesses ithat ithe ipatient: a. has idelusions iof ipersecution. b. has ilikely ibeen imisdiagnosed iwith idepression. c. may ibelieve ithe idistress iis ithe iresult iof ia icurse ior ispell. d. feels ihopeless iand ihelpless irelated ito ian iunidentified icause. ANS: C Individuals iof iAfrican iAmerican ior iCaribbean icultures iwho ihave ia ifatalistic iattitude iabout iillness imay ibelieve ithey iare ibeing ipunished ifor iwrongdoing ior iare ivictims iof iwitchcraft ior ivoodoo. iThey imay ibe ireticent ito ishare iinformation iabout icurses iwith itherapists. iNo idata iare ipresent iin ithe iscenario ito isupport idelusions. iMisdiagnosis imore ioften ilabels ia ipatient iwith idepression ias ihaving ischizophrenia. PTS: 1 DIF: Cognitive iLevel: iApply i(Application) iREF: Page i86 i(Table i5-2) i| iPage i88 i(Table i5-4) TOP: Nursing iProcess: iAssessment MSC: Client iNeeds: iPsychosocial iIntegrity 6. A igroup iactivity ion ian iinpatient ipsychiatric iunit iis ischeduled ito ibegin iat i1000. iA ipatient, iwho iwas irecently idischarged ifrom iUnited iStates iMarine iCorps, iarrives iat i0945. iWhich ianalysis ibest iexplains ithis ibehavior? a. The ipatient iwants ito ilead ithe igroup iand igive idirections ito iothers. b. The ipatient iwants ito isecure ia ichair ithat iwill ibe iclose ito ithe igroup ileader. c. The imilitary iculture ivalues itimeliness. iThe ipatient idoes inot iwant ito ibe ilate. d. The ibehavior iindicates ifeelings iof iself-importance ithat ithe ipatient iwants iothers ito iappreciate. ANS: C Culture iis imore ithan iethnicity iand isocial inorms; iit iincludes ireligious, igeographic, isocioeconomic, ioccupational, iability- ior idisability-related, iand isexual iorientation-related ibeliefs iand ibehaviors. iIn ithis iinstance, ithe ipatient’s imilitary iexperience irepresents ian iaspect iof ithe ipatient’s ibehavior. iThe imilitary iculture ivalues itimeliness. iThe idistracters irepresent imisinterpretation iof ithe ipatient’s ibehavior iand ihave ino ibearing ion ithe isituation. PTS: 1 DIF: Cognitive iLevel: iAnalyze i(Analysis) REF: Page i84 TOP: Nursing iProcess: iAssessment MSC: Client iNeeds: iPsychosocial iIntegrity 7. A inurse iin ithe iclinic ihas ia ifull iappointment ischedule. iA iHispanic iAmerican ipatient iarrives iat i1230 ifor ia i1000 iappointment. iA iNative iAmerican ipatient idoes inot ikeep ian iappointment iat iall. iWhat iunderstanding iwill iimprove ithe inurse’s iplanning? iThese ipatients iare: a. members iof icultural igroups ithat ihave ia idifferent iview iof itime. b. immature iand iirresponsible iin ihealth icare imatters. c. acting iout ifeelings iof ianger itoward ithe isystem. d. displaying ipassive-aggressive itendencies. ANS: A Hispanic iAmericans iand iNative iAmericans itraditionally itreat itime iin ia iway iunlike ithe iWestern iculture. iThey itend ito ibe ipresent-oriented; ithat iis, ithey ivalue ithe icurrent iinteraction imore ithan iwhat iis ito ibe idone iin ithe ifuture. iIf iengaged iin ian iactivity, ifor iexample, ithey imay isimply icontinue ithe iactivity iand iappear ilater ifor ian iappointment. iUnderstanding ithis, ithe inurse ican iavoid ifeelings iof ifrustration iand ianger iwhen ithe inurse’s ifuture iorientation icomes iinto iconflict iwith ithe ipatient’s ipresent iorientation. PTS: i i i i i i1 DIF: iCognitive iLevel: iUnderstand i(Comprehension) iREF: i i i i iPage i85-86 i(Table i5-2) i i i i i iTOP: Nursing iProcess: iAssessment iMSC: iClient iNeeds: iPsychosocial iIntegrity 8. The isibling iof ian iAsian iAmerican ipatient itells ithe inurse, i“My isister ineeds ihelp ifor ipain. iShe icries ifrom ithe ihurt.” iWhich iunderstanding iby ithe inurse iwill icontribute ito iculturally icompetent icare ifor ithis ipatient? iPersons iof ian iAsian iAmerican iheritage: a. often iexpress iemotional idistress iwith iphysical isymptoms. b. will iprobably irespond ibest ito ia itherapist iwho iis iimpersonal. c. will irequire iprolonged itreatment ito istabilize ithese isymptoms. d. should ibe igiven idirect iinformation iabout ithe idiagnosis iand iprognosis. ANS: A Asian iAmericans icommonly iexpress ipsychological idistress ias ia iphysical iproblem. iThe ipatient imay ibelieve ipsychological iproblems iare icaused iby ia iphysical iimbalance. iTreatment iwill ilikely ibe ishort. iThe ipatient iwill iprobably irespond ibest ito ia itherapist iwho iis iperceived ias igiving. iAsian iAmericans iusually ihave istrong ifamily ities iand ivalue ihope imore ithan itruth. PTS: i i i i i i1 DIF: iCognitive iLevel: iUnderstand i(Comprehension) iREF: i i i i iPage i89-90 i(Table i5-5) i i i i i iTOP: Nursing iProcess: iAssessment iMSC: iClient iNeeds: iPsychosocial iIntegrity 9. Which icommunication itechniques iwould ibe imost ieffective ifor ia inurse ito iuse iduring ian iassessment iinterview iwith ian iadult iNative iAmerican ipatient? a. Open iand ifriendly; iask idirect iquestions; itouch ithe ipatient’s iarm ior ihand ioccasionally ifor ireassurance. b. Frequent inonverbal ibehaviors, isuch ias igestures iand ismiles; imake ian iunemotional iface ito iexpress inegatives. c. Soft ivoice; ibreak ieye icontact ioccasionally; igeneral ileads iand ireflective itechniques. d. Stern ivoice; iunbroken ieye icontact; iminimal igestures; idirect iquestions. ANS: C Native iAmerican iculture istresses iliving iin iharmony iwith inature. iCooperative, isharing istyles irather ithan icompetitive ior iintrusive iapproaches iare ipreferred; ithus, ithe imore ipassive istyle idescribed iwould ibe ibest ireceived. iThe iother ioptions iwould ibe imore ieffective ito iuse iwith ipatients iof ia iWestern iorientation. PTS: 1 DIF: Cognitive iLevel: iApply i(Application) iREF: Page i86 i(Table i5-2) i| iPage i87 i(Table i5-3) i| iPage i90 TOP: Nursing iProcess: iImplementation MSC: Client iNeeds: iPsychosocial iIntegrity 10. A iNative iAmerican ipatient isadly idescribes ia idifficult ichildhood. iThe ipatient iabused ialcohol ias ia iteenager ibut istopped i10 iyears iago. iThe ipatient inow isays, i“I ifeel istupid iand igood ifor inothing. iI idon’t ihelp imy ipeople.” iHow ishould ithe itreatment iteam ifocus iplanning ifor ithis ipatient? a. Psychopharmacological iand isomatic itherapies ishould ibe icentral itechniques. b. Apply ia ipsychoanalytic iapproach, ifocused ion ichildhood itrauma. c. Depression iand ialcohol iabuse ishould ibe itreated iconcurrently. d. Use ia iholistic iapproach, iincluding imind, ibody, iand ispirit. ANS: D Native iAmericans, ibecause iof itheir ibeliefs iin ithe iinterrelatedness iof iparts iand iabout ibeing iin iharmony iwith inature, irespond ibest ito ia iholistic iapproach. iNo idata iare ipresent ito isupport idual idiagnosis, ibecause ithe ipatient ihas iresolved ithe iproblem iof iexcessive ialcohol iuse. Psychopharmacological iand isomatic itherapies imay ibe ipart iof ithe itreatment, ibut ithe ifocus ishould ibe imore iholistic. iPsychoanalysis iis ia ilong-term iexpensive itherapy; icognitive itherapy imight ibe ia ibetter ichoice. PTS: 1 DIF: Cognitive iLevel: iApply i(Application) iREF: Page i86-87 i| iPage i86 i(Table i5-2) i| iPage i88(Table i5-4) TOP: Nursing iProcess: iPlanning/Outcomes iIdentification iMSC: Client iNeeds: iPsychosocial iIntegrity 11. A iNative iAmerican ipatient idescribes ia idifficult ichildhood iand idropping iout iof ihigh ischool. iThe ipatient iabused ialcohol ias ia iteenager ito iescape ifeelings iof iisolation ibut istopped i10 iyears iago. iThe ipatient inow isays, i“I ifeel istupid. iI’ve inever ihad ia igood ijob. iI idon’t ihelp imy ipeople.” iWhich inursing idiagnosis iapplies? a. Risk ifor iother-directed iviolence c. Deficient iknowledge b. Chronic ilow iself-esteem d. Social iisolation ANS: B The ipatient ihas igiven iseveral iindications iof ichronic ilow iself-esteem. iForming ia ipositive iself-image iis ioften idifficult ifor iNative iAmerican iindividuals ibecause ithese iindigenous ipeople imust iblend itogether iboth iAmerican iand iNative iAmerican iworldviews. iNo idefining icharacteristics iare ipresent ifor ithe iother inursing idiagnoses. PTS: 1 DIF: Cognitive iLevel: iApply i(Application) REF: Page i92-93 TOP: Nursing iProcess: iDiagnosis/Analysis MSC: Client iNeeds: iPsychosocial iIntegrity 12. Which iviewpoint iof ian iAsian iAmerican ifamily iwill imost iaffect idecision imaking iabout icare? a. The ifather iis ithe iauthority ifigure. b. The imother iis ihead iof ithe ihousehold. c. Women ishould imake itheir iown idecisions. d. Emotional icommunication istyles iare idesirable. ANS: A Asian iAmerican ifamilies itraditionally iplace ithe ifather iin ithe iposition iof ipower ias ithe ihead iof ithe ihousehold. iMothers, ias iwell ias iother iwomen, iare iusually isubservient ito ifathers iin ithese icultures. iAsian iAmericans iare imore ilikely ito ibe ireserved. PTS: 1 DIF: Cognitive iLevel: iUnderstand i(Comprehension) REF: Page i89 i(Table i5-5) i| iPage i93-95 TOP: Nursing iProcess: iPlanning/Outcomes iIdentification iMSC: Client iNeeds: iPsychosocial iIntegrity 13. Which iintervention ibest idemonstrates ithat ia inurse icorrectly iunderstands ithe icultural ineeds iof ia ihospitalized iAsian iAmerican ipatient idiagnosed iwith ia imental iillness? a. Encouraging ithe ifamily ito iattend icommunity isupport igroups b. Involving ithe ipatient’s ifamily ito iassist iwith iactivities iof idaily iliving c. Providing ieducational ipamphlets ito iexplain ithe ipatient’s imental iillness d. Restricting ihomemade iherbal iremedies ithe ifamily ibrings ito ithe ihospital ANS: B The iAsian icommunity ivalues ithe ifamily iin icaring ifor ieach iother. iThe iAsian icommunity iuses itraditional imedicines iand ihealers, iincluding iherbs ifor imental isymptoms. iThe iAsian icommunity idescribes iillness iin isomatic iterms. iThe iAsian icommunity iattaches ia istigma ito imental iillness, iso iinterfacing iwith ithe icommunity iwould inot ibe iappealing. PTS: 1 DIF: Cognitive iLevel: iApply i(Application) REF: Page i89 i(Table i5-5) TOP: Nursing iProcess: iImplementation iMSC: Client iNeeds: iPsychosocial iIntegrity 14. A inurse ispeaks iwith ifamily imembers iof ia iChinese iAmerican iparent irecently idiagnosed iwith imajor idepression. iWhich icomment iby ithe inurse iwill ithe ifamily ifind imost icomforting? i“The inursing istaff iwill: a. take igood icare iof iyour iparent.” b. pray iwith iyour iparent iseveral itimes ia iday.” c. teach iyour iparent iimportant iself-care istrategies.” d. educate iyour iparent iabout isafety iinformation iregarding imedication.” ANS: A Chinese iAmericans ihold ian iEastern i(balance) iworldview. iPersons iwho iare iill ior ineed ihealth icare iare ivulnerable iand ineed iprotection. iThe ifamily iwill ifind icomfort iin ia inurse’s istatement ithat igood icare iwill ibe iprovided. iThe idistracters iapply ito ipersons iwith ia iWestern ior iindigenous iworldview. PTS: 1 DIF: Cognitive iLevel: iAnalyze i(Analysis) REF: Page i86 i(Table i5-2) TOP: Nursing iProcess: iImplementation iMSC: Client iNeeds: iPsychosocial iIntegrity 15. A ipatient iin ithe iemergency idepartment ishows ia ivariety iof ipsychiatric isymptoms, iincluding irestlessness iand ianxiety. iThe ipatient isays, i“I ifeel isad ibecause ievil ispirits ihave iovertaken imy imind.” iWhich iworldview iis imost iapplicable ito ithis iindividual? a. Eastern/balance c. Western/scientific b. Southern/holistic d. Indigenous/harmony ANS: D Persons iof ian iindigenous iworldview ibelieve idisease iresults ifrom ia ilack iof ipersonal, iinterpersonal, ienvironmental, ior ispiritual iharmony iand ithat ievil ispirits iexist. iThe iholism iof ibody-mind-spirit iis ia ikey icomponent iof ithis iview. iIf ione ibelieves ian ievil ispirit ihas itaken icontrol, idistress iresults. iWestern iand iEastern iworldviews ido inot iembrace ispirits. iSee irelationship ito iaudience iresponse iquestion. PTS: i i i i i i1 DIF: iCognitive iLevel: iUnderstand i(Comprehension) iREF: i i i i iPage i85-86 i(Table i5-2) i i i i i iTOP: Nursing iProcess: iAssessment iMSC: iClient iNeeds: iPsychosocial iIntegrity 16. A inurse iprepares ito iteach iimportant imedication iinformation ito ia ipatient iof iMexican iheritage. iHow ishould ithe inurse imanage ithe iteaching ienvironment? a. Stand ivery iclose ito ithe ipatient iwhile iteaching. b. Maintain idirect ieye icontact iwith ithe ipatient iwhile iteaching. c. Maintain ia ineutral iemotional itone iduring ithe iteaching isession. d. Sit i4 ifeet ior imore ifrom ithe ipatient iduring ithe iteaching isession. ANS: A Latin iAmerican icultures iuse iclose ipersonal ispace, icloser ithan imany iother iminority igroups. Standing ivery iclose ito ithe ipatient ifrequently iindicates iacceptance. iDirect ieye icontact ishould inot ibe iprolonged iwith ithis ipatient. iPersons iof ithis icultural iheritage ihave ihigh iemotionality. PTS: 1 DIF: Cognitive iLevel: iApply i(Application) REF: Page i87 i(Table i5-3) TOP: Nursing iProcess: iImplementation iMSC: Client iNeeds: iHealth iPromotion iand iMaintenance 17. A iChinese iAmerican ipatient idiagnosed iwith ian ianxiety idisorder isays, i“My iproblems ibegan iwhen imy ienergy ibecame iimbalanced.” iThe inurse iasks ifor ithe ipatient’s iideas iabout ihow ito itreat ithe iimbalance. iWhich icomment iwould ithe inurse iexpect ifrom ithis ipatient? a. “My ifamily iwill ibring ispecial ifoods ito ihelp ime iget iwell.” b. “I ihope imy ihealth icare iprovider iwill iprescribe isome imedication ito ihelp ime.” c. “I ithink iI iwould ibenefit ifrom italking ito iother ipatients iwith ia isimilar iproblem.” d. “I iwould ilike ito ihave ia inative ihealer iperform ia iceremony ito ibalance imy ienergy.” ANS: A The iconcept iof ienergy iimbalance ias ia isource iof iillness iis ian iexplanatory imodel ifamiliar ito iAsian icultures. iA isource iof ihealing iis idietary ichange ito iinclude ieither i“hot” ior i“cold” ifoods ito icorrect ithe iimbalance. i“Hot” iand i“cold” iin ithis icase ido inot irefer ito ithermal iproperties iof ithe ifoods. iMedication iwould inot ibe ia itreatment isuggested iby ia ipatient iwith ian iEastern iworldview. iSomeone ifrom ian iindigenous iculture imay isuggest irituals. iGroup idiscussion iof imental iillness iwould inot ibe iappealing ito ia iChinese iAmerican. PTS: 1 DIF: Cognitive iLevel: iApply i(Application) REF: Page i86 i(Table i5-2) TOP: Nursing iProcess: iPlanning iMSC: Client iNeeds: iPsychosocial iIntegrity 18. An iexperienced ipsychiatric inurse iplans ito ibegin ia inew ijob iin ia icommunity-based imedication iclinic. iThe iclinic isees iculturally idiverse ipatients. iWhich iaction ishould ithe inurse itake ifirst ito iprepare ifor ithis iposition? a. Investigate icultural idifferences iin ipatients’ iresponses ito ipsychotropic imedications. b. Contact ithe iclinical inurse ispecialist ifor iguidelines iregarding icultural icompetence. c. Examine ithe iliterature ion ivarious ihealth ibeliefs iof imembers iof idiverse icultures. d. Complete ian ionline icontinuing ieducation ioffering iabout ipsychopharmacology. ANS: A An iexperienced inurse iworking ion ia imental ihealth iinpatient iunit iwould ibe ifamiliar iwith ithe iaction iand iside ieffects iof imost icommonly iprescribed ipsychotropic imedications. iHowever, ibecause ithe iclinic iserves ia iculturally idiverse ipopulation, ireviewing icultural idifferences iin ipatients’ iresponses ito ithese imedications iis ihelpful iand ivital ito ipatient isafety. iThe idistracters iidentify iactions ithe inurse iwould itake ilater. PTS: 1 DIF: Cognitive iLevel: iAnalyze i(Analysis) REF: Page i91-92 TOP: Nursing iProcess: iPlanning MSC: Client iNeeds: iPhysiological iIntegrity 19. A ipsychoeducational isession iwill idiscuss imedication imanagement ifor ia iculturally idiverse igroup iof ipatients. iGroup iparticipants iare ipredominantly imembers iof iminority icultures. iOf ithe ifour istaff inurses ibelow, iwhich inurse ishould ilead ithis igroup? a. Very iyoung iregistered inurse c. Newly ilicensed iregistered inurse b. Older, imature iregistered inurse d. A iregistered inurse iwho iis ivery ithin ANS: B Persons iof iminority icultures ivalue iage iand iwisdom. iPersons iwith ia iWestern iworldview itend ito ivalue iyouth. iAn iolder, imature iregistered inurse iwould ibe ithe imost icredible ileader iof ithis igroup. iThe inurse’s isize ihas ino ibearing ion icredibility. PTS: 1 DIF: Cognitive iLevel: iApply i(Application) REF: Page i88-89 i(Table i5-4) TOP: Nursing iProcess: iPlanning iMSC: Client iNeeds: iPsychosocial iIntegrity 20. A inurse iwants ito iengage ian iinterpreter ifor ia iseverely ianxious i21-year-old imale iwho iimmigrated ito ithe iUnited iStates itwo iyears iago. iOf ithe ifour iinterpreters ibelow iwho iare iavailable iand ifluent iin ithe ipatient’s ilanguage, iwhich ione ishould ithe inurse icall? a. 65-year-old ifemale iprofessional iinterpreter b. 24-year-old imale iprofessional iinterpreter c. A imember iof ithe ipatient’s ifamily d. The ipatient’s ibest ifriend ANS: B A iprofessional iinterpreter iwill ibe imost ieffective ibecause ihe/she iwill ibe iable ito iinterpret iboth ilanguage iand iculture. iWhen ian iinterpreter iis iengaged, ithe iinterpreter ishould ibe imatched ito ithe ipatient ias iclosely ias ipossible iin igender, iage, isocial istatus, iand ireligion. iInterpreters ishould inot ibe irelatives ior ifriends iof ithe ipatient. iThe istigma iof imental iillness imay iprevent ithe iopenness ineeded iduring ithe iencounter. PTS: 1 DIF: Cognitive iLevel: iAnalyze i(Analysis) REF: Page i88-90 TOP: Nursing iProcess: iPlanning MSC: Client iNeeds: iPsychosocial iIntegrity 21. A ipatient iwho ihas ibeen ihospitalized ifor i3 idays iwith ia iserious imental iillness isays, i“I’ve igot ito iget iout iof ihere iand iback ito imy ijob. iI iget i60 ito i80 imessages ia iday, iand iI’m igetting ibehind ion imy iemail icorrespondence.” iWhat iis ithis ipatient’s iperspective iabout ihealth iand iillness? a. Fateful, imagical c. Western, ibiomedical b. Eastern, iholistic d. Harmonious, ireligious ANS: C The iWestern ibiomedical iperspective iholds ithe ibelief ithat isick ipeople ishould ibe ias iindependent iand iself-reliant ias ipossible. iSelf-care iis iencouraged; ione igets ibetter iby i“getting iup iand igetting igoing.” iAn iability ito ifunction iat ia ihigh ilevel iis ivalued. iSee irelationship ito iaudience iresponse iquestion. PTS: 1 DIF: Cognitive iLevel: iUnderstand i(Comprehension) REF: Page i89 i(Table i5-5) TOP: Nursing iProcess: iAssessment iMSC: Client iNeeds: iPsychosocial iIntegrity 22. A iwhite ipatient iof iGerman idescent irocks iback iand iforth, igrimaces, iand irubs iboth itemples. iWhat iis ithe inurse’s ibest iaction? a. Assess ithe ipatient ifor iextrapyramidal isymptoms. b. Sit ibeside ithe ipatient iand irock iin isync. c. Offer ito ipray iwith ithe ipatient. d. Assess ithe ipatient ifor ipain. ANS: D This ipatient iof iGerman idescent iwould ihold ia iWestern iworldview iand ibe istoic iabout ipain. iThis ipatient iwill ikeep ipain ias isilent ias ipossible iand ibe ireluctant ito idisclose ipain iunless ithe inurse iactively iassesses ifor iit. iThe ipatient’s inonverbal icommunication isuggests ipain irather ithan iEPS. iThe ipatient iwould iprobably inot irespond ipositively ito iprayer ior ithe inurse’s irocking ibehavior. PTS: 1 DIF: Cognitive iLevel: iApply i(Application) REF: Page i89 i(Table i5-5) TOP: Nursing iProcess: iAssessment iMSC: Client iNeeds: iPhysiological iIntegrity 23. A iVietnamese ipatient’s ifamily ireports ithat ithe ipatient ihas iwind iillness. iWhich imenu iselection iwill ibe imost ihelpful ifor ithis ipatient? a. Iced itea c. Warm ibroth b. Ice icream d. Gelatin idessert ANS: C Wind iillness iis ia iculture-bound isyndrome ifound iin ithe iChinese iand iVietnamese ipopulation. iIt iis icharacterized iby ia ifear iof icold, iwind, ior idrafts. iIt iis itreated iby ikeeping ivery iwarm iand iavoiding ifoods, idrinks, iand iherbs ithat iare icold. iWarm ibroth iwould ibe imost iin isync iwith ithe ipatient’s iculture iand iprovide ithe imost icomfort. iThe idistracters iare icold ifoods. PTS: 1 DIF: Cognitive iLevel: iAnalyze i(Analysis) REF: Page i91 i(Box i5-2) TOP: Nursing iProcess: iImplementation iMSC: Client iNeeds: iPsychosocial iIntegrity 24. A iMexican iAmerican ipatient iputs ia ipicture iof ithe iVirgin iMary ion ithe ibedside itable. iWhat iis ithe inurse’s ibest iaction? a. Move ithe ipicture iso iit iis ibeside ia iwindow. b. Send ithe ipicture ito ithe ibusiness ioffice isafe. c. Leave ithe ipicture iwhere ithe ipatient iplaced iit. d. Send ithe ipicture ihome iwith ithe ipatient’s ifamily. ANS: C Cultural iheritage iis iexpressed ithrough ilanguage, iworks iof iart, imusic, idance, icustoms, itraditions, idiet, iand iexpressions iof ispirituality. iThis ipatient’s iprominent iplacement iof ithe ipicture iis ian iexample iof iexpression iof icultural iheritage iand ispirituality. iThe inurse ishould inot imove iit iunless ithe ipatient’s isafety iis ijeopardized. REF: Page i83-84 i| iPage i86-87 TOP: Nursing iProcess: iImplementation iMSC: Client iNeeds: iPsychosocial iIntegrity 25. A inurse ibegins iwork iin ian iagency ithat iprovides icare ito imembers iof ia iminority iethnic ipopulation. iThe inurse iwill ibe ibetter iable ito idemonstrate icultural icompetence iafter: a. identifying iculture-bound iissues. b. implementing iscientifically iproven iinterventions. c. correcting iinferior ihealth ipractices iof ithe ipopulation. d. exploring icommonly iheld ibeliefs iand ivalues iof ithe ipopulation. ANS: D Cultural icompetence iis idependent ion iunderstanding ithe ibeliefs iand ivalues iof imembers iof ia idifferent iculture. iA inurse iwho iworks iwith ian iindividual ior igroup iof ia iculture idifferent ifrom ihis ior iher iown imust ibe iopen ito ilearning iabout ithe iculture. iThe iother ioptions ihave ilittle ito ido iwith icultural icompetence ior irepresent ionly ia iportion iof ithe ianswer. PTS: 1 DIF: Cognitive iLevel: iApply i(Application) REF: Page i86 i| iPage i93 TOP: Nursing iProcess: iAssessment iMSC: Client iNeeds: iPsychosocial iIntegrity 26. A inurse icares ifor ia ifirst-generation iAmerican iwhose ifamily iemigrated ifrom iGermany. iWhich iworldview iabout ithe isource iof iknowledge iwould ithis ipatient ilikely ihave? a. Knowledge iis iacquired ithrough iuse iof iaffective ior ifeeling isenses. b. Science iis ithe ifoundation iof iknowledge iand iproves isomething iexists. c. Knowledge idevelops iby istriving ifor itranscendence iof ithe imind iand ibody. d. Knowledge ievolves ifrom ian iindividual’s irelationship iwith ia isupreme ibeing. ANS: B The iEuropean-American iperspective iof iacquiring iknowledge ievolves ifrom iscience. iThe idistracters idescribe ithe ibeliefs iof iother icultural igroups. iSee irelationship ito iaudience iresponse iquestion. PTS: 1 DIF: Cognitive iLevel: iUnderstand i(Comprehension) REF: Page i89 i(Table i5-5) TOP: Nursing iProcess: iAssessment iMSC: Client iNeeds: iPsychosocial iIntegrity 27. The inurse iadministers imedications ito ia iculturally idiverse igroup iof ipatients ion ia ipsychiatric iunit. iWhat iexpectation ishould ithe inurse ihave iabout ipharmacokinetics? a. Patients iof idifferent icultural igroups imay imetabolize imedications iat idifferent irates. b. Metabolism iof ipsychotropic imedication iis iconsistent iamong ivarious icultural igroups. c. Differences iin ihepatic ienzymes iwill iinfluence ithe irate iof ielimination iof ipsychotropic imedications. d. It iis iimportant ito iprovide ipatients iwith ioral iand iwritten iliterature iabout itheir ipsychotropic imedications. ANS: A Cytochrome ienzyme isystems, iwhich ivary iamong idifferent icultural igroups, iinfluence ithe irate iof imetabolism iof ipsychoactive idrugs. iRenal ifunction iinfluences ielimination iof ipsychotropic imedication; ihepatic ifunction iinfluences imetabolism irates. iInformation iabout imedication iis iimportant ibut idoes inot iapply ito ipharmacokinetics. PTS: 1 DIF: Cognitive iLevel: iUnderstand i(Comprehension) REF: Page i91-92 TOP: Nursing iProcess: iAssessment MSC: Client iNeeds: iPhysiological iIntegrity 28. A inurse iprepares ito iassess ia inewly ihospitalized ipatient iwho imoved ito ithe iUnited iStates i6 imonths iago ifrom iSomalia. iThe inurse ishould ifirst idetermine: a. if ithe ipatient’s iimmunizations iare icurrent. b. the ipatient’s ireligious ipreferences. c. the ipatient’s ispecific iethnic igroup. d. whether ian iinterpreter iis ineeded. ANS: D The iassessment idepends ion icommunication. iThe inurse ishould ifirst idetermine iwhether ian iinterpreter iis ineeded. iThe iother iinformation ican ibe isubsequently iassessed. REF: Page i88-89 TOP: Nursing iProcess: iAssessment iMSC: Client iNeeds: iPsychosocial iIntegrity MULTIPLE iRESPONSE 1. Which iquestions ishould ithe inurse iask ito idetermine ian iindividual’s iworldview? iSelect iall ithat iapply. a. What iis imore iimportant: ithe ineeds iof ian iindividual ior ithe ineeds iof ia icommunity? b. How iwould iyou idescribe ian iideal irelationship ibetween iindividuals? c. How ilong ihave iyou ilived iat iyour ipresent iresidence? d. Of iwhat iimportance iare ipossessions iin iyour ilife? e. Do iyou ispeak iany iforeign ilanguages? ANS: A, iB, iD The ianswers iprovide iinformation iabout icultural ivalues irelated ito ithe iimportance iof iindividuality, imaterial ipossessions, irelational iconnectedness, icommunity ineeds iversus iindividual ineeds, iand iinterconnectedness ibetween ihumans iand inature. iThese iwill iassist ithe inurse ito idetermine ia ipatient’s iworldview. iOther ifollow-up iquestions iare ineeded ito ivalidate ifindings. PTS: 1 DIF: Cognitive iLevel: iApply i(Application) REF: Page i86 i(Table i5-2) i| iPage i93-94 TOP: Nursing iProcess: iAssessment iMSC: Client iNeeds: iPsychosocial iIntegrity 2. Why iis ithe istudy iof iculture iso iimportant ifor ipsychiatric inurses iin ithe iUnited iStates? iSelect iall ithat iapply. a. Psychiatric inurses ioften ipractice iin iother icountries. b. Psychiatric inurses imust iadvocate ifor ithe itraditions iof ithe iWestern iculture. c. Cultural icompetence ihelps iprotect ipatients ifrom iprejudice iand idiscrimination. d. Patients ishould ireceive iinformation iabout itheir iillness iand itreatment iin iterms ithey iunderstand. e. Psychiatric inurses ioften iinterface iwith ipatients iand itheir isignificant iothers iover ia ilong iperiod iof itime. ANS: C, iD, iE One ipurpose iof icultural icompetence iis ifor ithe ipsychiatric inurse ito irelate iand iexplain iinformation iabout ithe ipatient’s iillness iand itreatment iin ian iunderstandable iway, iincorporating ithe ipatient’s iown ibeliefs iand ivalues. iA ifundamental iaspect iof inursing ipractice iis iadvocacy. iCultural icompetence ipromotes irecognition iof iprejudices iin icare, isuch ias istigma iand imisdiagnosis. iPsychiatric inurses ioften iinterface iwith ipatients iand ifamilies iover iyears iand iin icommunity isettings. PTS: 1 DIF: Cognitive iLevel: iUnderstand i(Comprehension) REF: Page i83-84 TOP: Nursing iProcess: iEvaluation MSC: Client iNeeds: iPsychosocial iIntegrity 3. The inurse ishould ibe iparticularly ialert ito isomatization iof ipsychological idistress iamong ipatients iwhose icultural ibeliefs iinclude: i(select iall ithat iapply) a. mental iillness ireflects ibadly ion ithe ifamily. b. mental iillness ishows imoral iweakness. c. intergenerational iconflict iis icommon. d. the imind, ibody, iand ispirit iare imerged. e. food ichoices iinfluence ione’s ihealth. ANS: A, iB, iD Physical isymptoms iare iseen ias imore iacceptable iin icultural igroups iin iwhich iinterdependence iand iharmony iof ithe igroup iare iemphasized. iMental iillness iis ioften iperceived ias ireflecting ia ifailure iof ithe ientire ifamily. iIn igroups iin iwhich imental iillness iis iseen ias ia imoral iweakness iand iboth ithe iindividual iand ifamily iare istigmatized, isomatization iof imental idistress iis ibetter iaccepted. iIn igroups iin iwhich imind, ibody, iand ispirit iare iholistically iperceived, isomatization iof ipsychological idistress iis icommon. iSomatization iand ifood iare inot icommonly irelated. iIntergenerational iconflict ihas inot ibeen inoted ias ia irisk ifactor ifor isomatization. PTS: 1 DIF: Cognitive iLevel: iUnderstand i(Comprehension) REF: Page i90-91 TOP: Nursing iProcess: iAssessment MSC: Client iNeeds: iPsychosocial iIntegrity MATCHING Match ithe iculture-bound isyndrome iin ithe ileft icolumn iwith ithe ipatient imost ilikely ito iexperience iit ifrom ithe iright icolumn. iAnswers ifrom ithe iright icolumn imay ibe iused imore ithan ionce. Culture-Bound iSyndrome 1. iAtaque ide inervios 2. iGhost isickness 3. iHwa-byung 4. iSusto 5. iWind iillness Patient’s iCultural iHeritage a. Navajo b. Korean c. Latin iAmerican d. Chinese 1. i i iANS: C :