,Chapter 01: Cultural Competency
x x x
Ball: Seidel’s Guide to Physical Examination, 10th Edition
x x x x x x x
MULTIPLE CHOICE x
1. Mr. L presents to the clinic with severe groin pain and a history of kidney stones. Mr. L’s sontell
x x x x x x x x x x x x x x x x x x x
s you that for religious reasons, his father wishes to keep any stone that is passed into theurine fi
x x x x x x x x x x x x x x x x x x x
lter that he has been using. What is your most appropriate response?
x x x x x x x x x x x
a. ―With your father’s permission, we will examine the stone and request that it beret
x x x x x x x x x x x x x x
urned to him.‖ x x
b. ―The stone must be sent to the lab for examination and therefore cannot be kept.‖
x x x x x x x x x x x x x x
c. ―We cannot let him keep his stone because it violates our infection control policy.‖
x x x x x x x x x x x x x
d. ―We don’t know yet if your father has another kidney stone, so we must analyzethi
x x x x x x x x x x x x x x x
s one.‖ x
ANS: A x
We should be willing to modify the delivery of health care in a manner that is respectful andin k
x x x x x x x x x x x x x x x x x x x
eeping with the patient’s cultural background. ―With your father’s permission, we will exami
x x x x x x x x x x x x
ne the stone and request that it be returned to him‖ is the most appropriate response.
x x x x x x x x x x x x x x x
―The stone must be sent to the lab for examination and therefore cannot be kept‖ and ―Wedo
x x x x x x x x x x x x x x x x x
n’t know yet if your father has another kidney stone, so we must analyze this one‖ do notsuppo
x x x x x x x x x x x x x x x x x x
rt the patient’s request. ―We cannot let him keep his stone because it violates our infection c
x x x x x x x x x x x x x x x x
ontrol policy‖ does not provide a reason that it would violate an infection controlpolicy.
x x x x x x x x x x x x x x
DIF:Cognitive Level: Analyzing (Analysis) x x x
OBJ:Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
x x x x x
2. Which statement is true regarding the relationship of physical characteristics and culture?
x x x x x x x x x x x
a. Physical characteristics should be used to identify members of cultural groups.
x x x x x x x x x x
b. There is a difference between distinguishing cultural characteristics andd
x x x x x x x x x
istinguishing physical characteristics. x x
c. To be a member of a specific culture, an individual must have certain identifiableph
x x x x x x x x x x x x x x
ysical characteristics. x
d. Gender and race are the two essential physical characteristics used to identifycu
x x x x x x x x x x x x
ltural groups. x
ANS: B x
Physical characteristics are not used to identify cultural groups; there is a difference betweenthe
x x x x x x x x x x x x x x
two, and they are considered separately. Physical characteristics should not be used to identify
x x x x x x x x x x x x x x x
members of cultural groups. To be a member of a specific culture, an individual doesnot need to
x x x x x x x x x x x x x x x x x x
have certain identifiable physical characteristics. You should not confuse physicalcharacteristic
x x x x x x x x x x
s with cultural characteristics. Gender and race are physical characteristics, not cultural charact
x x x x x x x x x x x x
eristics, and are not used to identify cultural groups.
x x x x x x x x
DIF:Cognitive Level: Understanding (Comprehension) x x x
, OBJ:Nursing process—assessment x MSC: Physiologic Integrity: Physiologic Adaptation
x x x x
3. An image of any group that rejects its potential for originality or individuality is known asa(n
x x x x x x x x x x x x x x x x
)
a. acculturation.
b. norm.
c. stereotype.
d. ethnos.
ANS: C x
A fixed image of any group that rejects its potential for originality or individuality is the definit
x x x x x x x x x x x x x x x x
ion of stereotype. Acculturation is the process of adopting another culture’s behaviors.A norm i
x x x x x x x x x x x x x x
s a standard of allowable behavior within a group. Ethnos implies the same race ornationality.
x x x x x x x x x x x x x x x
DIF:Cognitive Level: Remembering (Knowledge) x x x
OBJ:Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
x x x x x
4. The motivation of the healthcare professional to ―want to‖ engage in the process of becomingcul
x x x x x x x x x x x x x x x
turally competent, not ―have to,‖ is called
x x x x x x
a. cultural knowledge. x
b. cultural awareness. x
c. cultural desire. x
d. cultural skill. x
ANS: C x
Cultural encounters are the continuous process of interacting with patients from culturally diver
x x x x x x x x x x x x
se backgrounds to validate, refine, or modify existing values, beliefs, and practices abouta cultur
x x x x x x x x x x x x x x
al group and to develop cultural desire, cultural awareness, cultural skill, and cultural knowledg
x x x x x x x x x x x x x
e. Cultural awareness is deliberate self-examination and in-
x x x x x x x
depth exploration of one’s biases, stereotypes, prejudices, assumptions, and ―-
x x x x x x x x x
isms‖ that one holds about individuals and groups who are different from them. Cultural knowle
x x x x x x x x x x x x x x
dge is the process of seeking and obtaining a sound educational base about culturally and ethnica
x x x x x x x x x x x x x x x
lly diverse groups.Cultural skill is the ability to collect culturally relevant data regarding the pati
x x x x x x x x x x x x x x x
ent’s presentingproblem, as well as accurately performing a culturally based physical assessme
x x x x x x x x x x x x
nt in a culturally sensitive manner. Cultural desire is the motivation of the healthcare profession
x x x x x x x x x x x x x x
al towant to engage in the process of becoming culturally competent, not have to.
x x x x x x x x x x x x x x
DIF:Cognitive Level: Understanding (Comprehension) x x x
OBJ:Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
x x x x x
5. Mr. Marks is a 66-year-
x x x x
old patient who presents for a physical examination to the clinic. Which question has the mo
x x x x x x x x x x x x x x x
st potential for exploring a patient’s cultural beliefs related to ahealth problem?
x x x x x x x x x x x x
, a. ―How often do you have medical examinations?‖ x x x x x x
b. ―What is your age, race, and educational level?‖ x x x x x x x
c. ―What types of symptoms have you been having?‖ x x x x x x x
d. ―Why do you think you are having these symptoms?‖
x x x x x x x x
ANS: D x
―Why do you think you are having these symptoms?‖ is an open-
x x x x x x x x x x x
ended question that avoidsstereotyping, is sensitive and respectful toward the individual, and a
x x x x x x x x x x x x x
llows for cultural data tobe exchanged. The other questions do not explore the patient’s cultura
x x x x x x x x x x x x x x x
l beliefs about health problems.
x x x x
DIF:Cognitive Level: Analyzing (Analysis) x x x
OBJ:Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
x x x x x
6. The definition of ill or sick is based on a
x x x x x x x x x
a. stereotype.
b. cultural behavior. x
c. belief system. x
d. cultural attitude. x
ANS: C x
The definition of ill or sick is based on the individual’s belief system and is determined inlar
x x x x x x x x x x x x x x x x x
ge part by his or her enculturation.
x x x x x x
DIF:Cognitive Level: Understanding (Comprehension) x x x
OBJ:Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
x x x x x
7. A 22-year-old female nurse is interviewing an 86-year-
x x x x x x x
old male patient. The patient avoids eye contact and answers questions only by saying, ―Yeah,‖
x x x x x x x x x x x x x x
―No,‖ or ―I guess so.‖ Which ofthe following is appropriate for the interviewer to say or ask?
x x x x x x x x x x x x x x x x x x
a. ―We will be able to communicate better if you look at me.‖
x x x x x x x x x x x
b. ―It’s hard for me to gather useful information because your answers are so short.‖
x x x x x x x x x x x x x
c. ―Are you uncomfortable talking with me?‖ x x x x x
d. ―Does your religion make it hard for you to answer my questions?‖ x x x x x x x x x x x
ANS: C x
It is all right to ask if the patient is uncomfortable with any aspect of your person and to talkabout i
x x x x x x x x x x x x x x x x x x x x x
t; the other choices are less respectful.
x x x x x x
DIF:Cognitive Level: Applying (Application) x x x
OBJ:Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
x x x x x
8. As you explain your patient’s condition to her husband, you notice that he is leaning toward you
x x x x x x x x x x x x x x x x
and pointedly blinking his eyes. Knowing that he is from England, your most appropriaterespon
x x x x x x x x x x x x x x x
se to this behavior is to
x x x x x
a. tell him that you understand his need to be alone.
x x x x x x x x x
b. ask whether he has any questions. x x x x x
c. ask whether he would prefer to speak to the clinician.
x x x x x x x x x
x x x
Ball: Seidel’s Guide to Physical Examination, 10th Edition
x x x x x x x
MULTIPLE CHOICE x
1. Mr. L presents to the clinic with severe groin pain and a history of kidney stones. Mr. L’s sontell
x x x x x x x x x x x x x x x x x x x
s you that for religious reasons, his father wishes to keep any stone that is passed into theurine fi
x x x x x x x x x x x x x x x x x x x
lter that he has been using. What is your most appropriate response?
x x x x x x x x x x x
a. ―With your father’s permission, we will examine the stone and request that it beret
x x x x x x x x x x x x x x
urned to him.‖ x x
b. ―The stone must be sent to the lab for examination and therefore cannot be kept.‖
x x x x x x x x x x x x x x
c. ―We cannot let him keep his stone because it violates our infection control policy.‖
x x x x x x x x x x x x x
d. ―We don’t know yet if your father has another kidney stone, so we must analyzethi
x x x x x x x x x x x x x x x
s one.‖ x
ANS: A x
We should be willing to modify the delivery of health care in a manner that is respectful andin k
x x x x x x x x x x x x x x x x x x x
eeping with the patient’s cultural background. ―With your father’s permission, we will exami
x x x x x x x x x x x x
ne the stone and request that it be returned to him‖ is the most appropriate response.
x x x x x x x x x x x x x x x
―The stone must be sent to the lab for examination and therefore cannot be kept‖ and ―Wedo
x x x x x x x x x x x x x x x x x
n’t know yet if your father has another kidney stone, so we must analyze this one‖ do notsuppo
x x x x x x x x x x x x x x x x x x
rt the patient’s request. ―We cannot let him keep his stone because it violates our infection c
x x x x x x x x x x x x x x x x
ontrol policy‖ does not provide a reason that it would violate an infection controlpolicy.
x x x x x x x x x x x x x x
DIF:Cognitive Level: Analyzing (Analysis) x x x
OBJ:Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
x x x x x
2. Which statement is true regarding the relationship of physical characteristics and culture?
x x x x x x x x x x x
a. Physical characteristics should be used to identify members of cultural groups.
x x x x x x x x x x
b. There is a difference between distinguishing cultural characteristics andd
x x x x x x x x x
istinguishing physical characteristics. x x
c. To be a member of a specific culture, an individual must have certain identifiableph
x x x x x x x x x x x x x x
ysical characteristics. x
d. Gender and race are the two essential physical characteristics used to identifycu
x x x x x x x x x x x x
ltural groups. x
ANS: B x
Physical characteristics are not used to identify cultural groups; there is a difference betweenthe
x x x x x x x x x x x x x x
two, and they are considered separately. Physical characteristics should not be used to identify
x x x x x x x x x x x x x x x
members of cultural groups. To be a member of a specific culture, an individual doesnot need to
x x x x x x x x x x x x x x x x x x
have certain identifiable physical characteristics. You should not confuse physicalcharacteristic
x x x x x x x x x x
s with cultural characteristics. Gender and race are physical characteristics, not cultural charact
x x x x x x x x x x x x
eristics, and are not used to identify cultural groups.
x x x x x x x x
DIF:Cognitive Level: Understanding (Comprehension) x x x
, OBJ:Nursing process—assessment x MSC: Physiologic Integrity: Physiologic Adaptation
x x x x
3. An image of any group that rejects its potential for originality or individuality is known asa(n
x x x x x x x x x x x x x x x x
)
a. acculturation.
b. norm.
c. stereotype.
d. ethnos.
ANS: C x
A fixed image of any group that rejects its potential for originality or individuality is the definit
x x x x x x x x x x x x x x x x
ion of stereotype. Acculturation is the process of adopting another culture’s behaviors.A norm i
x x x x x x x x x x x x x x
s a standard of allowable behavior within a group. Ethnos implies the same race ornationality.
x x x x x x x x x x x x x x x
DIF:Cognitive Level: Remembering (Knowledge) x x x
OBJ:Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
x x x x x
4. The motivation of the healthcare professional to ―want to‖ engage in the process of becomingcul
x x x x x x x x x x x x x x x
turally competent, not ―have to,‖ is called
x x x x x x
a. cultural knowledge. x
b. cultural awareness. x
c. cultural desire. x
d. cultural skill. x
ANS: C x
Cultural encounters are the continuous process of interacting with patients from culturally diver
x x x x x x x x x x x x
se backgrounds to validate, refine, or modify existing values, beliefs, and practices abouta cultur
x x x x x x x x x x x x x x
al group and to develop cultural desire, cultural awareness, cultural skill, and cultural knowledg
x x x x x x x x x x x x x
e. Cultural awareness is deliberate self-examination and in-
x x x x x x x
depth exploration of one’s biases, stereotypes, prejudices, assumptions, and ―-
x x x x x x x x x
isms‖ that one holds about individuals and groups who are different from them. Cultural knowle
x x x x x x x x x x x x x x
dge is the process of seeking and obtaining a sound educational base about culturally and ethnica
x x x x x x x x x x x x x x x
lly diverse groups.Cultural skill is the ability to collect culturally relevant data regarding the pati
x x x x x x x x x x x x x x x
ent’s presentingproblem, as well as accurately performing a culturally based physical assessme
x x x x x x x x x x x x
nt in a culturally sensitive manner. Cultural desire is the motivation of the healthcare profession
x x x x x x x x x x x x x x
al towant to engage in the process of becoming culturally competent, not have to.
x x x x x x x x x x x x x x
DIF:Cognitive Level: Understanding (Comprehension) x x x
OBJ:Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
x x x x x
5. Mr. Marks is a 66-year-
x x x x
old patient who presents for a physical examination to the clinic. Which question has the mo
x x x x x x x x x x x x x x x
st potential for exploring a patient’s cultural beliefs related to ahealth problem?
x x x x x x x x x x x x
, a. ―How often do you have medical examinations?‖ x x x x x x
b. ―What is your age, race, and educational level?‖ x x x x x x x
c. ―What types of symptoms have you been having?‖ x x x x x x x
d. ―Why do you think you are having these symptoms?‖
x x x x x x x x
ANS: D x
―Why do you think you are having these symptoms?‖ is an open-
x x x x x x x x x x x
ended question that avoidsstereotyping, is sensitive and respectful toward the individual, and a
x x x x x x x x x x x x x
llows for cultural data tobe exchanged. The other questions do not explore the patient’s cultura
x x x x x x x x x x x x x x x
l beliefs about health problems.
x x x x
DIF:Cognitive Level: Analyzing (Analysis) x x x
OBJ:Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
x x x x x
6. The definition of ill or sick is based on a
x x x x x x x x x
a. stereotype.
b. cultural behavior. x
c. belief system. x
d. cultural attitude. x
ANS: C x
The definition of ill or sick is based on the individual’s belief system and is determined inlar
x x x x x x x x x x x x x x x x x
ge part by his or her enculturation.
x x x x x x
DIF:Cognitive Level: Understanding (Comprehension) x x x
OBJ:Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
x x x x x
7. A 22-year-old female nurse is interviewing an 86-year-
x x x x x x x
old male patient. The patient avoids eye contact and answers questions only by saying, ―Yeah,‖
x x x x x x x x x x x x x x
―No,‖ or ―I guess so.‖ Which ofthe following is appropriate for the interviewer to say or ask?
x x x x x x x x x x x x x x x x x x
a. ―We will be able to communicate better if you look at me.‖
x x x x x x x x x x x
b. ―It’s hard for me to gather useful information because your answers are so short.‖
x x x x x x x x x x x x x
c. ―Are you uncomfortable talking with me?‖ x x x x x
d. ―Does your religion make it hard for you to answer my questions?‖ x x x x x x x x x x x
ANS: C x
It is all right to ask if the patient is uncomfortable with any aspect of your person and to talkabout i
x x x x x x x x x x x x x x x x x x x x x
t; the other choices are less respectful.
x x x x x x
DIF:Cognitive Level: Applying (Application) x x x
OBJ:Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
x x x x x
8. As you explain your patient’s condition to her husband, you notice that he is leaning toward you
x x x x x x x x x x x x x x x x
and pointedly blinking his eyes. Knowing that he is from England, your most appropriaterespon
x x x x x x x x x x x x x x x
se to this behavior is to
x x x x x
a. tell him that you understand his need to be alone.
x x x x x x x x x
b. ask whether he has any questions. x x x x x
c. ask whether he would prefer to speak to the clinician.
x x x x x x x x x
