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Therapeutic Communication Exam #2 All questions with correct answers

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1. ANS: A Nurses need to know about culture because it influences both nurses' and clients' health care perceptions and behaviors. Nurses should learn about the culture of diverse clients and communities. Nurses need to recognize and overcome certain attitudes basic to the American culture. To provide culturally competent care, the nurse must address issues of discrimination. Learning how to speak another language is important, but it is more important to seek understanding of cultural influences on health.: A non-Hispanic white nurse provides care to mostly Hispanic patients. It would be most important for the nurse to take which action? A. Discover cultural influences on health care perceptions and behaviors. B. Assist the patients to adapt to American culture and health beliefs. C. Avoid confrontation of underlying issues of discrimination. D. Improve communication by learning how to speak Spanish. 2. ANS: C The initial action that the nurse should take to learn about delivering care to diverse clients is to become familiar with personal health care beliefs and be-haviors. Self-awareness helps nurses recognize that their beliefs and behaviors are not necessarily common to all. Nurses' lack of knowledge about their own culture can distort their perceptions of the beliefs and behaviors of clients from diverse cultures. Transcultural frameworks have been developed to help nurses provide culturally appropriate nursing care. Ethnocentrism interferes with the appreciation of diverse cultures and their health care beliefs and behaviors.: The nurse cares for diverse clients in a community health setting. Which action should the nurse take first to learn about delivering care to diverse clients? A. Adopt a transcultural framework to develop culturally appropriate care. B. Ask clients about their personal health care beliefs. C. Develop a self-awareness of personal health

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Therapeutic Communication Exam #2 All questions with correct answers

1. ANS: A
Nurses need to know about culture because it influences both nurses' and
clients' health care perceptions and behaviors. Nurses should learn about the
culture of diverse clients and communities. Nurses need to recognize and
overcome certain attitudes basic to the American culture. To provide culturally
competent care, the nurse must address issues of discrimination. Learning
how to speak another language is important, but it is more important to seek
understanding of cultural influences on health.: A non-Hispanic white nurse provides care to
mostly Hispanic patients. It would be most important for the nurse to take which action?
A. Discover cultural influences on health care perceptions and behaviors.
B. Assist the patients to adapt to American culture and health beliefs.
C. Avoid confrontation of underlying issues of discrimination.
D. Improve communication by learning how to speak Spanish.
2. ANS: C
The initial action that the nurse should take to learn about delivering care to
diverse clients is to become familiar with personal health care beliefs and be-
haviors. Self-awareness helps nurses recognize that their beliefs and behaviors
are not necessarily common to all. Nurses' lack of knowledge about their own
culture can distort their perceptions of the beliefs and behaviors of clients from
diverse cultures. Transcultural frameworks have been developed to help nurses
provide culturally appropriate nursing care. Ethnocentrism interferes with the
appreciation of diverse cultures and their health care beliefs and behaviors.: The
nurse cares for diverse clients in a community health setting. Which action should the nurse take first to learn about
delivering care to diverse clients?
A. Adopt a transcultural framework to develop culturally appropriate care.
B. Ask clients about their personal health care beliefs.
C. Develop a self-awareness of personal health care beliefs.
D. Recognize ethnocentric beliefs of minorities in the community.
3. ANS: B
Tripp-Reimer and Afifi (1989) suggest two processes that nurses may use to
communicate with clients from diverse cultures: cultural assessment and cul-
tural negotiation. Cultural assessment refers to the appraisal of a client's health


,Therapeutic Communication Exam #2 All questions with correct answers

beliefs and behaviors. The information is then used to determine appropriate
nursing interventions. Cultural negotiation refers to the process of negotiating
with the client regarding differences in the lay and professional belief systems
concerning appropriate care. Information obtained from other sources (e.g.,
written documents, other nurses, experts, standards) is not specific to this
client's health beliefs and behaviors.: The nurse provides care to a client from Nigeria who is visiting
the United States. Which should the nurse use to communicate with this client?

A. Review the predominant health beliefs of the Nigerian population.
B. Appraise the client's health beliefs and behaviors with a cultural assessment.
C. Consult with other nurses who have taken care of clients from other countries.
D. Use standard communication techniques to establish a helping relationship.
4. ANS: C
Professional interpreters are able to communicate medical terms and can be
of assistance in reducing the risks of breaches in patient privacy and confiden-
tiality. Also, information can be directly obtained from the patient. When family
members or volunteers serve as the interpreter, patients are often uncomfort-
able sharing sensitive information. Family members in a stressful situation may
have difficulty being the interpreter. Although nonverbal communication is
important, this method should only be used if an interpreter is not available.: The
nurse needs to obtain a health history from a Spanish-speaking patient. Which action by the nurse is best?
A. Ask a bilingual friend of the patient to interpret.
B. Use nonverbal communication and draw pictures.
C. Request a Spanish-speaking medical interpreter.
D. Interview the patient's English-speaking daughter.
5. ANS: B
Eye contact is often cultural; some Native Americans believe that prolonged eye
contact is rude and intrusive. However, it is important to assess each individual
patient for preferences and comfort with eye contact.: The nurse is interviewing a Native
American client. It is most important for the nurse to take which action?
A. Maintain eye contact to show respect and interest.
B. Assess whether the client is comfortable with eye contact.


,Therapeutic Communication Exam #2 All questions with correct answers

C. Avoid prolonged eye contact with this client.
D. Sit next to the patient to avoid any eye contact.
6. ANS: B
It is important to call the patient by the name he or she prefers. The nurse
should ask a person how he or she prefers to be addressed, because consid-
erable cultural variation exists. Most Americans are comfortable with calling
people by their first names. This is perceived by some, however, as a failure to
show respect.: The nurse provides care for a male patient. When the nurse addresses the patient, which would
be most appropriate?
A. Use both first and last name with each encounter.
B. Ask the patient how he prefers to be addressed.
C. Call the patient by his first name.
D. Address the patient by his last name.
7. ANS: D
The elderly should not be addressed using disrespectful terms such as "honey,"
"sweetheart," "gramps," and "granny" and other patronizing forms of speech.
Short term memory may decline with age; health care providers may assist
patients as needed. The elderly may express their spirituality through prayer
and reading the Bible. Sharing stories helps an elderly patient to review life
and establish meaning.: The nurse observes a nursing assistant interacting with an elderly patient. Which
statement by the nursing assistant requires an immediate intervention by the nurse?
A. "I will help you remember where your room is located."
B. "Would you like me to read from your Bible today?"
C. "Tell me a story about when you were young."
D. "Sweetie, I will bring your cottee in a few minutes."
8. ANS: B
Simplicity of speech is recommended; use direct communication with few
words. The nurse should not assume a subservient role to the physician;
there needs to be a connection between communication, collaboration, and
teamwork in the nurse-physician relationship to provide quality care. The nurse
should be assertive, expect professional respect, and exude expertise.: A female
nurse discusses a concern related to client care with a male physician. Which communication strategy, if used by the


,Therapeutic Communication Exam #2 All questions with correct answers

nurse, is most ettective?
A. Assume a subservient role to the physician.
B. Use a direct approach with succinct sentences.
C. Ask questions instead of making recommendations.
D. Be polite and expect politeness from the physician.
9. ANS: A
Different cultures prefer different degrees of closeness in personal space.
Optimal distance for a therapeutic conversation is usually 3 to 4 feet. Generally,
middle-class Americans feel uncomfortable when standing close to people they
do not know well. Latin Americans, African Americans, and the French welcome
physical closeness. In most cultures, men need more space than women do.
Usually people will tolerate a person standing close to them at their side more
readily than directly in front of them. Direct eye contact usually requires more
space. Placing oneself at the same level (e.g., sitting while the client is sitting,
or standing at eye level when the client is standing) is usually perceived as less
threatening. Nurses should sit at eye level with bedridden clients.: Which patient
would most likely be uncomfortable with close personal space during an interaction with the nurse?
A. 19-year-old white female patient who is standing two feet in front of the nurse.
B. 40-year-old African-American male patient who is sitting next to the nurse.
C. 60-year-old Latin-American female patient who is seated across from the nurse.
D. 82-year-old patient from France who is lying in bed with the nurse sitting next to the bed.
10. ANS: A, D, E
Culture is the learned and shared beliefs, values, and lifeways of a particular
group that are generally transmitted intergenerationally and influence one's
thinking and actions. Ethnicity refers to the social identity and origins of a social
group due largely to language, religion, and national origin. Ethnocentrism is
the universal tendency of people to believe that one's own race or ethnic group
is the most important and/or that some or all aspects of its culture are superior
to those of other groups.: Which characteristic would the nurse use to define culture? Select all that apply.
A. Learned and shared lifeways of a particular group.
B. Social identity influenced by language and religion.
C. Belief in superiority of one's own ethnic group.

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