Interprofessional Approach 10th Edition
by Jane W. Ball, Joyce E. Dains
Chapter 1 - 26
, TABLE OF CONTENTS
1.The History and Interviewing Process
2. Cultural Competency
3. Examination Techniques and Equipment
4. Taking the Next Steps: Clinical Reasoning
5. The Patient Record [New title / focus!]
6. Vital Signs and Pain Assessment
7. Mental Status
8. Growth, Measurement, and Nutrition ["formerly Growth and Nutrition"]
9. Skin, Hair, and Nails
10. Lymphatic System
11. Head and Neck
12. Eyes
13. Ears, Nose, and Throat
14. Chest and Lungs
15. Heart
16. Blood Vessels
17. Breasts and Axillae
18. Abdomen
19. Female Genitalia
20. Male Genitalia
21. Anus, Rectum, and Prostate
22. Musculoskeletal System
,23. Neurologic System
24. Head-to-Toe Examination [formerly Chapter 25: "Putting It All Together"]
25. Sports Participation Evaluation [formerly Chapter 24]
26. Emergency or Life-Threatening Situations
,Chapter 01: Cultural Competency
Ball: Seidel’s Guide to Physical Examination, 10th Edition
MULTIPLE CHOICE
1. Mr. L presents to the clinic with severe groin pain and a history of kidney stones. Mr. L’s sontells you
that for religious reasons, his father wishes to keep any stone that is passed into the urine filter that
he has been using. What is your most appropriate response?
a. ―With your father’s permission, we will examine the stone and request that it be
returned to him.‖
b. ―The stone must be sent to the lab for examination and therefore cannot be kept.‖
c. ―We cannot let him keep his stone because it violates our infection control policy.‖
d. ―We don’t know yet if your father has another kidney stone, so we must analyze this
one.‖
ANS: A
We should be willing to modify the delivery of health care in a manner that is respectful andin
keeping with the patient’s cultural background. ―With your father’s permission, we will examine the
stone and request that it be returned to him‖ is the most appropriate response.
―The stone must be sent to the lab for examination and therefore cannot be kept‖ and ―We don’t
know yet if your father has another kidney stone, so we must analyze this one‖ do notsupport the
patient’s request. ―We cannot let him keep his stone because it violates our infection control
policy‖ does not provide a reason that it would violate an infection control policy.
DIF:Cognitive Level: Analyzing (Analysis)
OBJ:Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
2. Which statement is true regarding the relationship of physical characteristics and culture?
a. Physical characteristics should be used to identify members of cultural groups.
b. There is a difference between distinguishing cultural characteristics and
distinguishing physical characteristics.
c. To be a member of a specific culture, an individual must have certain identifiable
physical characteristics.
d. Gender and race are the two essential physical characteristics used to identify
cultural groups.
ANS: B
Physical characteristics are not used to identify cultural groups; there is a difference between the
two, and they are considered separately. Physical characteristics should not be used to identify
members of cultural groups. To be a member of a specific culture, an individual doesnot need to
have certain identifiable physical characteristics. You should not confuse physicalcharacteristics with
cultural characteristics. Gender and race are physical characteristics, not cultural characteristics, and
are not used to identify cultural groups.
DIF:Cognitive Level: Understanding (Comprehension)
, OBJ:Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
3. An image of any group that rejects its potential for originality or individuality is known asa(n)
a. acculturation.
b. norm.
c. stereotype.
d. ethnos.
ANS: C
A fixed image of any group that rejects its potential for originality or individuality is the definition of
stereotype. Acculturation is the process of adopting another culture’s behaviors.A norm is a
standard of allowable behavior within a group. Ethnos implies the same race or nationality.
DIF:Cognitive Level: Remembering (Knowledge)
OBJ:Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
4. The motivation of the healthcare professional to ―want to‖ engage in the process of becoming
culturally competent, not ―have to,‖ is called
a. cultural knowledge.
b. cultural awareness.
c. cultural desire.
d. cultural skill.
ANS: C
Cultural encounters are the continuous process of interacting with patients from culturally diverse
backgrounds to validate, refine, or modify existing values, beliefs, and practices abouta cultural
group and to develop cultural desire, cultural awareness, cultural skill, and cultural knowledge.
Cultural awareness is deliberate self-examination and in-depth exploration of one’s biases,
stereotypes, prejudices, assumptions, and ―-isms‖ that one holds about individuals and groups who
are different from them. Cultural knowledge is the process of
seeking and obtaining a sound educational base about culturally and ethnically diverse groups.
Cultural skill is the ability to collect culturally relevant data regarding the patient’s presenting
problem, as well as accurately performing a culturally based physical assessment in a culturally
sensitive manner. Cultural desire is the motivation of the healthcare professional to want to engage
in the process of becoming culturally competent, not have to.
DIF:Cognitive Level: Understanding (Comprehension)
OBJ:Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
5. Mr. Marks is a 66-year-old patient who presents for a physical examination to the clinic. Which
question has the most potential for exploring a patient’s cultural beliefs related to ahealth
problem?
, a. ―How often do you have medical examinations?‖
b. ―What is your age, race, and educational level?‖
c. ―What types of symptoms have you been having?‖
d. ―Why do you think you are having these symptoms?‖
ANS: D
―Why do you think you are having these symptoms?‖ is an open-ended question that avoids
stereotyping, is sensitive and respectful toward the individual, and allows for cultural data tobe
exchanged. The other questions do not explore the patient’s cultural beliefs about health problems.
DIF:Cognitive Level: Analyzing (Analysis)
OBJ:Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
6. The definition of ill or sick is based on a
a. stereotype.
b. cultural behavior.
c. belief system.
d. cultural attitude.
ANS: C
The definition of ill or sick is based on the individual’s belief system and is determined inlarge part
by his or her enculturation.
DIF:Cognitive Level: Understanding (Comprehension)
OBJ:Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
7. A 22-year-old female nurse is interviewing an 86-year-old male patient. The patient avoids eye
contact and answers questions only by saying, ―Yeah,‖ ―No,‖ or ―I guess so.‖ Which of the
following is appropriate for the interviewer to say or ask?
a. ―We will be able to communicate better if you look at me.‖
b. ―It’s hard for me to gather useful information because your answers are so short.‖
c. ―Are you uncomfortable talking with me?‖
d. ―Does your religion make it hard for you to answer my questions?‖
ANS: C
It is all right to ask if the patient is uncomfortable with any aspect of your person and to talkabout
it; the other choices are less respectful.
DIF:Cognitive Level: Applying (Application)
OBJ:Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
8. As you explain your patient’s condition to her husband, you notice that he is leaning toward you and
pointedly blinking his eyes. Knowing that he is from England, your most appropriateresponse to this
behavior is to
a. tell him that you understand his need to be alone.
b. ask whether he has any questions.
c. ask whether he would prefer to speak to the clinician.