TEST BANK
,Chapter 01: Introduction to Medical-Surgical Nursing Practice in Canada
Lewis: Medical-Surgical Nursing in Canada, 4th Canadian Edition
MULTIPLE CHOICE
1. When caring for clients using evidence-informed practice, which of the following does the
nurse use?
a. Clinical judgement based on experience
b. Evidence from a clinical research study
c. The best available evidence to guide clinical expertise
d. Evaluation of data showing that the client outcomes are met
ANS: C
Evidence-informed nursing practice is a continuous interactive process involving the explicit,
conscientious, and judicious consideration of the best available evidence to provide care. Four
primary elements are: (a) clinical state, setting, and circumstances; (b) client preferences and
actions; (c) best research evidence; and (d) health care resources. Clinical judgement based on
the nurse’s clinical experience is part of EIP, but clinical decision making also should
incorporate current research and research-based guidelines. Evidence from one clinical
research study does not provide an adequate substantiation for interventions. Evaluation of
client outcomes is important, but interventions should be based on research from randomized
control studies with a large number of subjects.
DIF: Cognitive Level: Comprehension TOP: Nursing Process: Planning
2. Which of the following best e xp l ains t he nu r se s ’ p r i mar y use of the nursing process when
N R I G B.C M
providing care to clients? U S N T O
a. To explain nursing interventions to other health care professionals
b. As a problem-solving tool to identify and treat clients’ health care needs
c. As a scientific-based process of diagnosing the client’s health care problems
d. To establish nursing theory that incorporates the biopsychosocial nature of humans
ANS: B
The nursing process is an assertive problem-solving approach to the identification and
treatment of clients’ problems. Diagnosis is only one phase of the nursing process. The
primary use of the nursing process is in client care, not to establish nursing theory or explain
nursing interventions to other health care professionals.
DIF: Cognitive Level: Comprehension TOP: Nursing Process: Implementation
3. The nurse is caring for a critically ill client in the intensive care unit and plans an every 2-hour
turning schedule to prevent skin breakdown. Which type of nursing function is demonstrated
with this turning schedule?
a. Dependent
b. Cooperative
c. Independent
d. Collaborative
ANS: D
, When implementing collaborative nursing actions, the nurse is responsible primarily for
monitoring for complications of acute illness or providing care to prevent or treat
complications. Independent nursing actions are focused on health promotion, illness
prevention, and client advocacy. A dependent action would require a physician order to
implement. Cooperative nursing functions are not described as one of the formal nursing
functions.
DIF: Cognitive Level: Application TOP: Nursing Process: Implementation
4. The nurse is caring for a client who has been admitted to the hospital for surgery and tells the
nurse, “I do not feel right about leaving my children with my neighbour.” Which action
should the nurse take next?
a. Reassure the client that these feelings are common for parents.
b. Have the client call the children to ensure that they are doing well.
c. Call the neighbour to determine whether adequate childcare is being provided.
d. Gather more data about the client’s feelings about the childcare arrangements.
ANS: D
Since a complete assessment is necessary in order to identify a problem and choose an
appropriate intervention, the nurse’s first action should be to obtain more information. The
other actions may be appropriate, but more assessment is needed before the best intervention
can be chosen.
DIF: Cognitive Level: Application TOP: Nursing Process: Assessment
5. The nurse is caring for a client who has left-sided paralysis as the result of a stroke and
assesses a pressure injury on the client’s left hip. Which of the following is the most
appropriate nursing diagnosis fN
Uo r Rt Sh I
i s cG B.C
NlienTt? OM
a. Impaired physical mobility related to decrease in muscle control (left-sided
paralysis)
b. Risk for impaired tissue integrity as evidenced by insufficient knowledge about
protecting tissue integrity
c. Impaired skin integrity related to pressure over bony prominence (impaired
circulation)
d. Ineffective tissue perfusion related to sedentary lifestyle
ANS: C
The client’s major problem is the impaired skin integrity as demonstrated by the presence of a
pressure injury. The nurse is able to treat the cause of altered circulation and pressure by
frequently repositioning the client. Although left-sided weakness is a problem for the client,
the nurse cannot treat the weakness. The “risk for” diagnosis is not appropriate for this client,
who already has impaired tissue integrity. The client does have ineffective tissue perfusion,
but the impaired skin integrity diagnosis indicates more clearly what the health problem is.
DIF: Cognitive Level: Application TOP: Nursing Process: Diagnosis
6. The nurse caring for a client with an infection has a nursing diagnosis of deficient fluid
volume related to excessive diaphoresis. Which of the following is an appropriate client
outcome?
a. Client has a balanced intake and output.
b. Client’s bedding is changed when it becomes damp.
, c. Client understands the need for increased fluid intake.
d. Client’s skin remains cool and dry throughout hospitalization.
ANS: A
This statement gives measurable data showing resolution of the problem of deficient fluid
volume that was identified in the nursing diagnosis statement. The other statements would not
indicate that the problem of deficient fluid volume was resolved.
DIF: Cognitive Level: Application TOP: Nursing Process: Planning
7. Which of the following represents a nursing activity that is carried out during the evaluation
phase of the nursing process?
a. Determining if interventions have been effective in meeting client outcomes
b. Documenting the nursing care plan in the progress notes in the medical record
c. Deciding whether the client’s health problems have been completely resolved
d. Asking the client to evaluate whether the nursing care provided was satisfactory
ANS: A
Evaluation consists of determining whether the desired client outcomes have been met and
whether the nursing interventions were appropriate. The other responses do not describe the
evaluation phase.
DIF: Cognitive Level: Comprehension TOP: Nursing Process: Evaluation
8. Which of the following would the nurse perform during the assessment phase of the nursing
process?
a. Obtains data with which to diagnose client problems
b. Uses client data to develoN
p pR
U SIclient
r io ri t y nGursiBng.dCiagM
noses
c. Teaches interventions to relieve N Thealth problems
d. Assists the client to identify realistic outcomes to health problems
ANS: A
During the assessment phase, the nurse gathers information about the client. The other
responses are examples of the intervention, diagnosis, and planning phases of the nursing
process.
DIF: Cognitive Level: Knowledge TOP: Nursing Process: Assessment
9. Which of the following is an example of a correctly written nursing diagnosis statement?
a. Altered tissue perfusion related to heart failure
b. Risk for impaired tissue integrity related to sacral redness
c. Ineffective coping related to insufficient sense of control.
d. Altered urinary elimination related to urinary tract infection
ANS: C
This diagnosis statement includes a NANDA nursing diagnosis and an etiology that describes
a client’s response to a health problem that can be treated by nursing. The use of a medical
diagnosis (as in the responses beginning “Altered tissue perfusion” and “Altered urinary
elimination”) is not appropriate. The response beginning “Risk for impaired tissue integrity”
uses the defining characteristics as the etiology.
DIF: Cognitive Level: Comprehension TOP: Nursing Process: Diagnosis
,10. Which fof fthe ffollowing fincludes fthe fcomponents frequired ffor fa fcomplete fnursing
fdiagnosis fstatement?
a. A fproblem fand fthe fsuggested fclient fgoals for foutcomes
b. A fproblem, fits fcause, fand fobjective fdata fthat fsupport fthe fproblem
c. A fproblem fwith fall fits fpossible fcauses fand fthe fplanned finterventions
d. A fproblem fwith fits fetiology fand fthe fsigns fand fsymptoms fof fthe fproblem
ANS: f D
The fPES fformat fis fused fwhen fwriting fnursing fdiagnoses. fThe fsubjective, fas fwell fas
fobjective, fdata fshould f be f included f in fthe fdefining fcharacteristics. fInterventions fand
foutcomes fare f not fincluded f in fthe f nursing fdiagnosis fstatement.
DIF: Cognitive fLevel: fKnowledge TOP: f Nursing fProcess: fDiagnosis
11. Which fof fthe ffollowing frefers fto fa fsituation fthat fresults fin funintended fharm fto fthe
fclient fand fis frelated fto fthe fcare for fservices fprovided frather fthan fthe fclient’s f medical
fcondition?
a. Negligence
b. Adverse fevent
c. Incident freport
d. Nonmaleficence
ANS: f B
An fadverse fevent fis fan fevent fthat fresults fin funintended fharm fto fthe fclient fand fis
frelated fto fthe fcare for fservices fprovided fto fthe fclient frather fthan fto fthe fclient’s
funderlying fmedical fcondition.
DIF: Cognitive fLevel: fKnowledge TOP: f Nursing fProcess: fEvaluation
N fR fI fG fB.CfM
12. Ufthe
When fusing fthe fFive fSteps fof S fevidence-informed
N T O fpractice f(EIP) fProcess, fwhich fof fthe
flowing felements fis fthe ffinal fstep fwhen fconstructing fa fclinical fquestion?
a. Comparison fof finterest
b. Population fof finterest
c. Outcome fof finterest
d. Timeframe fof finterest
ANS: f D
The forder fof fthe fnurse’s fstatements ffollows fthe fPICOT fformat fwith fthe ffinal fstep fbeing
fthe f “T”, for ftimeframe fof f interest.
DIF: Cognitive fLevel: fApplication TOP: f Nursing fProcess: fImplementation
,Chapter 02: Cultural Competence and Health Equity in Nursing Care
Lewis: Medical-Surgical Nursing in Canada, 4th Canadian Edition
MULTIPLE fCHOICE
1. Which fof fthe ffollowing fterms frefers fto fcharacteristics fof fa fgroup fwhose fmembers
fshare fa fcommon fsocial, fcultural, f linguistic, for freligious f heritage?
a. Diversity
b. Ethnicity
c. Ethnocentrism
d. Cultural fimposition
ANS: f B
Ethnicity fis fthe fcommon fsocial, fcultural, flinguistic, for freligious fheritage fof fa fgroup fof
fpeople. fDiversity fis fa fpresence fof fpersons fwith fdifferences f from fthe fmajority for
fdominant fgroup fthat fis fassumed fto fbe fthe fnorm. fEthnocentrism f is fa ftendency fof
f individuals fto fbelieve fthat ftheir fway fof f viewing fand fresponding fto fthe fworld f is fthe
fmost fcorrect, fnatural, fand fsuperior fone. fCultural f imposition f is f imposition fof fone
fperson's fown fcultural f beliefs fand fpractices, f intentionally for funintentionally, fon fanother
fperson for fgroup fof fpeople.
DIF: Cognitive fLevel: fComprehension TOP: f Nursing fProcess: fPlanning
2. The fnurse fis fcaring ffor fIndigenous fclients fin fa fcommunity fclinic fsetting. fWhich
fof fthe f following fwould fthe fnurse finclude fwhen fdeveloping fstrategies fto
fdecrease f health fcare fdisparities?
a. Improve fpublic ftransportation . I fG fB.CfM
N R
b. Obtain flow-cost fmedicationUs. f S fN fT O
c. Update fequipment fand fsupplies ffor fthe fclinic.
d. Educate fstaff fabout fIndigenous fhealth fbeliefs.
ANS: f D
Health fcare fdisparities fare fdue fto fstereotyping, fbiases, fand fprejudice fof fhealth fcare
fproviders; fthe f nurse fcan fdecrease fthese fthrough f staff feducation. fThe fother fstrategies
falso fmay f be faddressed f by fthe f nurse f but fwill f not fimpact fhealth fdisparities.
DIF: Cognitive fLevel: fApplication TOP: f Nursing fProcess: fPlanning
3. A ffamily fmember fof fan felderly fHispanic fclient fadmitted fto fthe fhospital ftells fthe fnurse
fthat fthe fclient fhas ftraditional f beliefs f about fhealth fand f illness. f Which fof fthe f following
factions f is f most fappropriate f for fthe f nurse f in fthis f situation?
a. Avoid fasking fany fquestions funless fthe fclient finitiates fconversation.
b. Ask fthe fclient fwhether fit fis fimportant fthat fcultural fhealers fare fcontacted.
c. Explain fthe fusual fhospital froutines ffor fmeal ftimes, fcare, fand ffamily fvisits.
d. Obtain ffurther finformation fabout fthe fclient’s fcultural fbeliefs ffrom fthe fdaughter.
ANS: f B
, Because fthe fclient fhas ftraditional fhealth fcare fbeliefs, fit fis fappropriate ffor fthe fnurse fto
fask fwhether fthe fclient fwould f like fa f visit f from fa fcultural f healer. fNurses fask fkey
fquestions fwith fregard fto flanguage, fdiet, freligion, fand facculturation fand feliciting fthe
fclient’s fexplanatory f model fof fhealth fand fillness. fThere fis fno fcultural freason ffor fthe
fnurse fto favoid fasking fthe fclient fquestions, fand fquestions f may fbe f necessary fto fobtain
fnecessary fhealth f information. fThe fclient f(rather fthan fthe fdaughter) fshould f be
fconsulted fabout fpersonal fcultural f beliefs. fThe f hospital froutines f for f meals, fcare, fand
fvisits fshould f be f adapted fto fthe fclient’s fpreferences frather fthan fexpecting fthe fclient fto
fadapt fto fthe fhospital fschedule.
DIF: Cognitive fLevel: fApplication TOP: f Nursing fProcess: fImplementation
4. When fcaring ffor fan fIndigenous fclient, fwhich fof fthe ffollowing factions fis fthe fbest
finitial fapproach f in frelation fto feye fcontact ffor fthe f nurse fto ftake?
a. Avoid fall feye fcontact fwith fthe fclient.
b. Observe fthe fclient’s fuse fof feye fcontact.
c. Look fdirectly fat fthe fclient fwhen finteracting.
d. Ask fthe ffamily fabout fthe fclient’s fcultural fbeliefs.
ANS: f B
Eye fcontact fvaries fgreatly famong fand fwithin fcultures fso fthe fnurses’ finitial faction fis fto
fassess fthe fclient’s fuse fof feye fcontact. fAlthough fnurses fare foften ftaught fto fmaintain
fdirect feye fcontact, fclients fwho fare fAsian, fArab, for fIndigenous f may favoid fdirect feye
fcontact fand fconsider fdirect feye f contact fdisrespectful for faggressive. fLooking fdirectly f at
fthe fclient for favoiding feye fcontact fmay f be f appropriate, fdepending fon fthe fclient’s
f individual fcultural f beliefs. fThe f nurse fshould fassess fthe fclient, frather fthan fasking
f family f members fabout fthe fclient’s f beliefs.
DIF: Cognitive fLevel: fApplic at io n f Process: f
N R I f GTOBP:.NCursMing Implementation
U S N T O
5. A fgraduate fnurse fis fassessing fa fnewly fadmitted fnon–English-speaking fChinese fclient
fwho fcomplains fof fsevere fheadaches. fWhich fof fthe ffollowing factions fby fthe fgraduate
fnurse fwould fcause fthe fcharge f nurse fto fintervene fduring fthis fassessment f interview?
a. Sit fdown fat fthe fbedside.
b. Palpate fthe fclient’s fscalp.
c. Call ffor fa fmedical finterpreter.
d. Avoid feye fcontact fwith fthe fclient.
ANS: f B
Many fpeople fof fAsian fethnicity fbelieve fthat ftouching fa fperson’s fhead fis fdisrespectful;
fthe fnurse fshould falways fask fpermission fbefore ftouching fany fclient’s fhead. fThe fother
factions fare fappropriate.
DIF: Cognitive fLevel: fApplication TOP: f Nursing fProcess: fImplementation
6. The fnurse fis fcaring ffor fa fclient fwho fspeaks fa flanguage fdifferent ffrom fthe fnurse’s
flanguage fand fthere fis fno finterpreter favailable. fWhich fof fthe ffollowing factions fis fthe
fmost fappropriate ffor fthe fnurse fto fimplement?
a. Use fspecific fmedical fterms fin fthe fLatin fform.
b. Talk floudly fand fslowly fso fthat feach fword fis fclearly fheard.
c. Repeat fimportant fwords fso fthat fthe fclient frecognizes ftheir fimportance.
d. Use fsimple fgestures fto fdemonstrate fmeaning fwhile ftalking fto fthe fclient.
,Chapter 01: Introduction to Medical-Surgical Nursing Practice in Canada
Lewis: Medical-Surgical Nursing in Canada, 4th Canadian Edition
MULTIPLE CHOICE
1. When caring for clients using evidence-informed practice, which of the following does the
nurse use?
a. Clinical judgement based on experience
b. Evidence from a clinical research study
c. The best available evidence to guide clinical expertise
d. Evaluation of data showing that the client outcomes are met
ANS: C
Evidence-informed nursing practice is a continuous interactive process involving the explicit,
conscientious, and judicious consideration of the best available evidence to provide care. Four
primary elements are: (a) clinical state, setting, and circumstances; (b) client preferences and
actions; (c) best research evidence; and (d) health care resources. Clinical judgement based on
the nurse’s clinical experience is part of EIP, but clinical decision making also should
incorporate current research and research-based guidelines. Evidence from one clinical
research study does not provide an adequate substantiation for interventions. Evaluation of
client outcomes is important, but interventions should be based on research from randomized
control studies with a large number of subjects.
DIF: Cognitive Level: Comprehension TOP: Nursing Process: Planning
2. Which of the following best e xp l ains t he nu r se s ’ p r i mar y use of the nursing process when
N R I G B.C M
providing care to clients? U S N T O
a. To explain nursing interventions to other health care professionals
b. As a problem-solving tool to identify and treat clients’ health care needs
c. As a scientific-based process of diagnosing the client’s health care problems
d. To establish nursing theory that incorporates the biopsychosocial nature of humans
ANS: B
The nursing process is an assertive problem-solving approach to the identification and
treatment of clients’ problems. Diagnosis is only one phase of the nursing process. The
primary use of the nursing process is in client care, not to establish nursing theory or explain
nursing interventions to other health care professionals.
DIF: Cognitive Level: Comprehension TOP: Nursing Process: Implementation
3. The nurse is caring for a critically ill client in the intensive care unit and plans an every 2-hour
turning schedule to prevent skin breakdown. Which type of nursing function is demonstrated
with this turning schedule?
a. Dependent
b. Cooperative
c. Independent
d. Collaborative
ANS: D
, When implementing collaborative nursing actions, the nurse is responsible primarily for
monitoring for complications of acute illness or providing care to prevent or treat
complications. Independent nursing actions are focused on health promotion, illness
prevention, and client advocacy. A dependent action would require a physician order to
implement. Cooperative nursing functions are not described as one of the formal nursing
functions.
DIF: Cognitive Level: Application TOP: Nursing Process: Implementation
4. The nurse is caring for a client who has been admitted to the hospital for surgery and tells the
nurse, “I do not feel right about leaving my children with my neighbour.” Which action
should the nurse take next?
a. Reassure the client that these feelings are common for parents.
b. Have the client call the children to ensure that they are doing well.
c. Call the neighbour to determine whether adequate childcare is being provided.
d. Gather more data about the client’s feelings about the childcare arrangements.
ANS: D
Since a complete assessment is necessary in order to identify a problem and choose an
appropriate intervention, the nurse’s first action should be to obtain more information. The
other actions may be appropriate, but more assessment is needed before the best intervention
can be chosen.
DIF: Cognitive Level: Application TOP: Nursing Process: Assessment
5. The nurse is caring for a client who has left-sided paralysis as the result of a stroke and
assesses a pressure injury on the client’s left hip. Which of the following is the most
appropriate nursing diagnosis fN
Uo r Rt Sh I
i s cG B.C
NlienTt? OM
a. Impaired physical mobility related to decrease in muscle control (left-sided
paralysis)
b. Risk for impaired tissue integrity as evidenced by insufficient knowledge about
protecting tissue integrity
c. Impaired skin integrity related to pressure over bony prominence (impaired
circulation)
d. Ineffective tissue perfusion related to sedentary lifestyle
ANS: C
The client’s major problem is the impaired skin integrity as demonstrated by the presence of a
pressure injury. The nurse is able to treat the cause of altered circulation and pressure by
frequently repositioning the client. Although left-sided weakness is a problem for the client,
the nurse cannot treat the weakness. The “risk for” diagnosis is not appropriate for this client,
who already has impaired tissue integrity. The client does have ineffective tissue perfusion,
but the impaired skin integrity diagnosis indicates more clearly what the health problem is.
DIF: Cognitive Level: Application TOP: Nursing Process: Diagnosis
6. The nurse caring for a client with an infection has a nursing diagnosis of deficient fluid
volume related to excessive diaphoresis. Which of the following is an appropriate client
outcome?
a. Client has a balanced intake and output.
b. Client’s bedding is changed when it becomes damp.
, c. Client understands the need for increased fluid intake.
d. Client’s skin remains cool and dry throughout hospitalization.
ANS: A
This statement gives measurable data showing resolution of the problem of deficient fluid
volume that was identified in the nursing diagnosis statement. The other statements would not
indicate that the problem of deficient fluid volume was resolved.
DIF: Cognitive Level: Application TOP: Nursing Process: Planning
7. Which of the following represents a nursing activity that is carried out during the evaluation
phase of the nursing process?
a. Determining if interventions have been effective in meeting client outcomes
b. Documenting the nursing care plan in the progress notes in the medical record
c. Deciding whether the client’s health problems have been completely resolved
d. Asking the client to evaluate whether the nursing care provided was satisfactory
ANS: A
Evaluation consists of determining whether the desired client outcomes have been met and
whether the nursing interventions were appropriate. The other responses do not describe the
evaluation phase.
DIF: Cognitive Level: Comprehension TOP: Nursing Process: Evaluation
8. Which of the following would the nurse perform during the assessment phase of the nursing
process?
a. Obtains data with which to diagnose client problems
b. Uses client data to develoN
p pR
U SIclient
r io ri t y nGursiBng.dCiagM
noses
c. Teaches interventions to relieve N Thealth problems
d. Assists the client to identify realistic outcomes to health problems
ANS: A
During the assessment phase, the nurse gathers information about the client. The other
responses are examples of the intervention, diagnosis, and planning phases of the nursing
process.
DIF: Cognitive Level: Knowledge TOP: Nursing Process: Assessment
9. Which of the following is an example of a correctly written nursing diagnosis statement?
a. Altered tissue perfusion related to heart failure
b. Risk for impaired tissue integrity related to sacral redness
c. Ineffective coping related to insufficient sense of control.
d. Altered urinary elimination related to urinary tract infection
ANS: C
This diagnosis statement includes a NANDA nursing diagnosis and an etiology that describes
a client’s response to a health problem that can be treated by nursing. The use of a medical
diagnosis (as in the responses beginning “Altered tissue perfusion” and “Altered urinary
elimination”) is not appropriate. The response beginning “Risk for impaired tissue integrity”
uses the defining characteristics as the etiology.
DIF: Cognitive Level: Comprehension TOP: Nursing Process: Diagnosis
,10. Which fof fthe ffollowing fincludes fthe fcomponents frequired ffor fa fcomplete fnursing
fdiagnosis fstatement?
a. A fproblem fand fthe fsuggested fclient fgoals for foutcomes
b. A fproblem, fits fcause, fand fobjective fdata fthat fsupport fthe fproblem
c. A fproblem fwith fall fits fpossible fcauses fand fthe fplanned finterventions
d. A fproblem fwith fits fetiology fand fthe fsigns fand fsymptoms fof fthe fproblem
ANS: f D
The fPES fformat fis fused fwhen fwriting fnursing fdiagnoses. fThe fsubjective, fas fwell fas
fobjective, fdata fshould f be f included f in fthe fdefining fcharacteristics. fInterventions fand
foutcomes fare f not fincluded f in fthe f nursing fdiagnosis fstatement.
DIF: Cognitive fLevel: fKnowledge TOP: f Nursing fProcess: fDiagnosis
11. Which fof fthe ffollowing frefers fto fa fsituation fthat fresults fin funintended fharm fto fthe
fclient fand fis frelated fto fthe fcare for fservices fprovided frather fthan fthe fclient’s f medical
fcondition?
a. Negligence
b. Adverse fevent
c. Incident freport
d. Nonmaleficence
ANS: f B
An fadverse fevent fis fan fevent fthat fresults fin funintended fharm fto fthe fclient fand fis
frelated fto fthe fcare for fservices fprovided fto fthe fclient frather fthan fto fthe fclient’s
funderlying fmedical fcondition.
DIF: Cognitive fLevel: fKnowledge TOP: f Nursing fProcess: fEvaluation
N fR fI fG fB.CfM
12. Ufthe
When fusing fthe fFive fSteps fof S fevidence-informed
N T O fpractice f(EIP) fProcess, fwhich fof fthe
flowing felements fis fthe ffinal fstep fwhen fconstructing fa fclinical fquestion?
a. Comparison fof finterest
b. Population fof finterest
c. Outcome fof finterest
d. Timeframe fof finterest
ANS: f D
The forder fof fthe fnurse’s fstatements ffollows fthe fPICOT fformat fwith fthe ffinal fstep fbeing
fthe f “T”, for ftimeframe fof f interest.
DIF: Cognitive fLevel: fApplication TOP: f Nursing fProcess: fImplementation
,Chapter 02: Cultural Competence and Health Equity in Nursing Care
Lewis: Medical-Surgical Nursing in Canada, 4th Canadian Edition
MULTIPLE fCHOICE
1. Which fof fthe ffollowing fterms frefers fto fcharacteristics fof fa fgroup fwhose fmembers
fshare fa fcommon fsocial, fcultural, f linguistic, for freligious f heritage?
a. Diversity
b. Ethnicity
c. Ethnocentrism
d. Cultural fimposition
ANS: f B
Ethnicity fis fthe fcommon fsocial, fcultural, flinguistic, for freligious fheritage fof fa fgroup fof
fpeople. fDiversity fis fa fpresence fof fpersons fwith fdifferences f from fthe fmajority for
fdominant fgroup fthat fis fassumed fto fbe fthe fnorm. fEthnocentrism f is fa ftendency fof
f individuals fto fbelieve fthat ftheir fway fof f viewing fand fresponding fto fthe fworld f is fthe
fmost fcorrect, fnatural, fand fsuperior fone. fCultural f imposition f is f imposition fof fone
fperson's fown fcultural f beliefs fand fpractices, f intentionally for funintentionally, fon fanother
fperson for fgroup fof fpeople.
DIF: Cognitive fLevel: fComprehension TOP: f Nursing fProcess: fPlanning
2. The fnurse fis fcaring ffor fIndigenous fclients fin fa fcommunity fclinic fsetting. fWhich
fof fthe f following fwould fthe fnurse finclude fwhen fdeveloping fstrategies fto
fdecrease f health fcare fdisparities?
a. Improve fpublic ftransportation . I fG fB.CfM
N R
b. Obtain flow-cost fmedicationUs. f S fN fT O
c. Update fequipment fand fsupplies ffor fthe fclinic.
d. Educate fstaff fabout fIndigenous fhealth fbeliefs.
ANS: f D
Health fcare fdisparities fare fdue fto fstereotyping, fbiases, fand fprejudice fof fhealth fcare
fproviders; fthe f nurse fcan fdecrease fthese fthrough f staff feducation. fThe fother fstrategies
falso fmay f be faddressed f by fthe f nurse f but fwill f not fimpact fhealth fdisparities.
DIF: Cognitive fLevel: fApplication TOP: f Nursing fProcess: fPlanning
3. A ffamily fmember fof fan felderly fHispanic fclient fadmitted fto fthe fhospital ftells fthe fnurse
fthat fthe fclient fhas ftraditional f beliefs f about fhealth fand f illness. f Which fof fthe f following
factions f is f most fappropriate f for fthe f nurse f in fthis f situation?
a. Avoid fasking fany fquestions funless fthe fclient finitiates fconversation.
b. Ask fthe fclient fwhether fit fis fimportant fthat fcultural fhealers fare fcontacted.
c. Explain fthe fusual fhospital froutines ffor fmeal ftimes, fcare, fand ffamily fvisits.
d. Obtain ffurther finformation fabout fthe fclient’s fcultural fbeliefs ffrom fthe fdaughter.
ANS: f B
, Because fthe fclient fhas ftraditional fhealth fcare fbeliefs, fit fis fappropriate ffor fthe fnurse fto
fask fwhether fthe fclient fwould f like fa f visit f from fa fcultural f healer. fNurses fask fkey
fquestions fwith fregard fto flanguage, fdiet, freligion, fand facculturation fand feliciting fthe
fclient’s fexplanatory f model fof fhealth fand fillness. fThere fis fno fcultural freason ffor fthe
fnurse fto favoid fasking fthe fclient fquestions, fand fquestions f may fbe f necessary fto fobtain
fnecessary fhealth f information. fThe fclient f(rather fthan fthe fdaughter) fshould f be
fconsulted fabout fpersonal fcultural f beliefs. fThe f hospital froutines f for f meals, fcare, fand
fvisits fshould f be f adapted fto fthe fclient’s fpreferences frather fthan fexpecting fthe fclient fto
fadapt fto fthe fhospital fschedule.
DIF: Cognitive fLevel: fApplication TOP: f Nursing fProcess: fImplementation
4. When fcaring ffor fan fIndigenous fclient, fwhich fof fthe ffollowing factions fis fthe fbest
finitial fapproach f in frelation fto feye fcontact ffor fthe f nurse fto ftake?
a. Avoid fall feye fcontact fwith fthe fclient.
b. Observe fthe fclient’s fuse fof feye fcontact.
c. Look fdirectly fat fthe fclient fwhen finteracting.
d. Ask fthe ffamily fabout fthe fclient’s fcultural fbeliefs.
ANS: f B
Eye fcontact fvaries fgreatly famong fand fwithin fcultures fso fthe fnurses’ finitial faction fis fto
fassess fthe fclient’s fuse fof feye fcontact. fAlthough fnurses fare foften ftaught fto fmaintain
fdirect feye fcontact, fclients fwho fare fAsian, fArab, for fIndigenous f may favoid fdirect feye
fcontact fand fconsider fdirect feye f contact fdisrespectful for faggressive. fLooking fdirectly f at
fthe fclient for favoiding feye fcontact fmay f be f appropriate, fdepending fon fthe fclient’s
f individual fcultural f beliefs. fThe f nurse fshould fassess fthe fclient, frather fthan fasking
f family f members fabout fthe fclient’s f beliefs.
DIF: Cognitive fLevel: fApplic at io n f Process: f
N R I f GTOBP:.NCursMing Implementation
U S N T O
5. A fgraduate fnurse fis fassessing fa fnewly fadmitted fnon–English-speaking fChinese fclient
fwho fcomplains fof fsevere fheadaches. fWhich fof fthe ffollowing factions fby fthe fgraduate
fnurse fwould fcause fthe fcharge f nurse fto fintervene fduring fthis fassessment f interview?
a. Sit fdown fat fthe fbedside.
b. Palpate fthe fclient’s fscalp.
c. Call ffor fa fmedical finterpreter.
d. Avoid feye fcontact fwith fthe fclient.
ANS: f B
Many fpeople fof fAsian fethnicity fbelieve fthat ftouching fa fperson’s fhead fis fdisrespectful;
fthe fnurse fshould falways fask fpermission fbefore ftouching fany fclient’s fhead. fThe fother
factions fare fappropriate.
DIF: Cognitive fLevel: fApplication TOP: f Nursing fProcess: fImplementation
6. The fnurse fis fcaring ffor fa fclient fwho fspeaks fa flanguage fdifferent ffrom fthe fnurse’s
flanguage fand fthere fis fno finterpreter favailable. fWhich fof fthe ffollowing factions fis fthe
fmost fappropriate ffor fthe fnurse fto fimplement?
a. Use fspecific fmedical fterms fin fthe fLatin fform.
b. Talk floudly fand fslowly fso fthat feach fword fis fclearly fheard.
c. Repeat fimportant fwords fso fthat fthe fclient frecognizes ftheir fimportance.
d. Use fsimple fgestures fto fdemonstrate fmeaning fwhile ftalking fto fthe fclient.
