,Chapter 1 – Theoretical Foundations of Transcultural Nursing
1. Which statement best reflects the purpose of Leininger’s Culture Care
Diversity and Universality Theory?
A) To ensure all patients receive identical care regardless of background
B) To understand and integrate cultural values into nursing care for
health promotion
C) To eliminate cultural practices that may conflict with biomedical
models
D) To focus primarily on minority and immigrant populations
ANS: B ✅
Feedback: Leininger’s theory emphasizes understanding and integrating
cultural values, beliefs, and practices into care to promote health and well-
being. The goal is culturally congruent care, not identical or purely biomedical
care. While minority and immigrant populations are included, the theory
applies to all cultural contexts.
DIF: Difficult REF: Leininger’s Culture Care Theory
KEY: Integrated Process: Nursing Process BLM: Cognitive: Analyze
2. Which nursing action demonstrates application of transcultural nursing
principles to improve patient safety outcomes?
A) Using standardized discharge teaching regardless of patient
background
B) Scheduling follow-up visits without asking about transportation
resources
C) Providing written medication instructions in the patient’s primary
language
D) Assuming a patient’s family structure is the same as the nurse’s own
ANS: C ✅
Feedback: Providing medication instructions in the patient’s primary language
supports comprehension, adherence, and safety — aligning with transcultural
nursing’s goal of reducing health disparities and errors. Standardized teaching
,without adaptation can create safety risks.
DIF: Moderate REF: Cultural Competence and Safety
KEY: Nursing Process: Implementation BLM: Cognitive: Apply
3. A nurse caring for a patient from a culture with different health beliefs
uses Leininger’s theory to guide care. What is the nurse’s priority?
A) Altering the patient’s beliefs to match biomedical models
B) Identifying and integrating cultural care values into the care plan
C) Avoiding discussion of cultural beliefs to prevent conflict
D) Delegating care to a provider of the same cultural background
ANS: B ✅
Feedback: Leininger’s theory prioritizes identifying and integrating cultural
values into care for better outcomes. Altering beliefs or avoiding discussion does
not promote culturally congruent care, and delegating based on culture alone
ignores the nurse’s role in providing holistic care.
DIF: Difficult REF: Culture Care Diversity and Universality
KEY: Nursing Process: Planning BLM: Cognitive: Apply
4. Which example best demonstrates the link between cultural competence
and quality improvement?
A) Tracking readmission rates for patients receiving culturally adapted
education
B) Offering interpreters only for patients who request them
C) Documenting cultural preferences in the social history section only
D) Assigning care based on cultural stereotypes
ANS: A ✅
Feedback: Monitoring outcomes like readmission rates after implementing
culturally adapted interventions directly links cultural competence to quality
improvement metrics. Selective interpreter use and stereotypes undermine
patient safety and outcomes.
DIF: Difficult REF: Cultural Competence and Quality Outcomes
KEY: Nursing Process: Evaluation BLM: Cognitive: Analyze
, 5. Which scenario illustrates the universality component of Leininger’s
theory?
A) Recognizing that all cultures value caring for ill family members in
some way
B) Assuming every patient expresses pain the same way
C) Providing only culturally neutral interventions
D) Ignoring patient preferences when they conflict with hospital policy
ANS: A ✅
Feedback: Universality in Leininger’s theory refers to commonalities across
cultures, such as valuing care for family members, even if practices differ. The
nurse must acknowledge these shared elements while respecting diversity.
DIF: Moderate REF: Culture Care Diversity and Universality Concepts
KEY: Nursing Process: Assessment BLM: Cognitive: Understand
6. A nurse designs an intervention respecting a patient’s fasting practice
during a religious holiday while maintaining medication safety. Which
theory element is applied?
A) Cultural preservation/maintenance
B) Cultural repatterning
C) Cultural care accommodation/negotiation
D) Cultural blindness
ANS: C ✅
Feedback: Accommodation/negotiation involves adapting care to meet patient
needs and safety requirements. Preservation maintains practices without
change, while repatterning modifies harmful practices. Cultural blindness
ignores differences.
DIF: Difficult REF: Culture Care Modes of Action
KEY: Nursing Process: Implementation BLM: Cognitive: Apply
7. Which statement best describes the relationship between transcultural
nursing and patient safety?
, A) Cultural competence is optional for safe care delivery
B) Ignoring cultural needs may lead to miscommunication and errors
C) Safety depends solely on following standardized clinical protocols
D) Cultural care only affects patient satisfaction, not safety outcomes
ANS: B ✅
Feedback: Failure to address cultural needs can cause misunderstandings,
nonadherence, and unsafe care. Cultural competence is integral to both safety
and satisfaction, and goes beyond protocol compliance.
DIF: Moderate REF: Cultural Competence and Safety Outcomes
KEY: Nursing Process: Evaluation BLM: Cognitive: Analyze
8. A nurse integrates community health beliefs into a public health
campaign. Which theoretical basis supports this?
A) Orem’s Self-Care Deficit Theory
B) Watson’s Theory of Human Caring
C) Leininger’s Culture Care Diversity and Universality Theory
D) Roy’s Adaptation Model
ANS: C ✅
Feedback: Leininger’s theory specifically addresses the integration of cultural
beliefs into health promotion to ensure relevance and effectiveness. While
Watson’s theory values caring, it lacks the specific transcultural framework.
DIF: Moderate REF: Leininger’s Theory Applications
KEY: Nursing Process: Planning BLM: Cognitive: Apply
9. A nurse avoids assuming a patient’s dietary restrictions and instead asks
open-ended questions. Which cultural competence component is
demonstrated?
A) Cultural knowledge
B) Cultural desire
C) Cultural awareness
D) Cultural encounter
, ANS: C ✅
Feedback: Cultural awareness involves self-examination and sensitivity to
assumptions, ensuring that care is based on the patient’s input rather than
stereotypes. Knowledge is factual learning; desire is motivation; encounter is
interaction.
DIF: Moderate REF: Campinha-Bacote’s Cultural Competence Model
KEY: Nursing Process: Assessment BLM: Cognitive: Apply
10. Which nurse behavior demonstrates ethnocentrism, a barrier to
transcultural care?
A) Believing one’s own cultural practices are superior to others
B) Adapting care to accommodate traditional healing practices
C) Seeking interpreter services for complex discharge teaching
D) Documenting patient’s cultural preferences in the care plan
ANS: A ✅
Feedback: Ethnocentrism is the belief in the superiority of one’s own culture
and can hinder culturally congruent care. The other options reflect culturally
competent behaviors.
DIF: Moderate REF: Barriers to Cultural Competence
KEY: Nursing Process: Assessment BLM: Cognitive: Analyze
11. A nurse adjusts a wound care schedule to allow a patient to attend daily
religious services. This is an example of which culture care mode of
action?
A) Cultural preservation
B) Cultural care accommodation/negotiation
C) Cultural repatterning
D) Cultural imposition
ANS: B ✅
Feedback: Cultural accommodation/negotiation involves supporting patients in
maintaining cultural practices when possible while meeting healthcare needs.
Preservation maintains beneficial practices unchanged, repatterning modifies
harmful practices, and imposition forces the nurse’s values on the patient.
1. Which statement best reflects the purpose of Leininger’s Culture Care
Diversity and Universality Theory?
A) To ensure all patients receive identical care regardless of background
B) To understand and integrate cultural values into nursing care for
health promotion
C) To eliminate cultural practices that may conflict with biomedical
models
D) To focus primarily on minority and immigrant populations
ANS: B ✅
Feedback: Leininger’s theory emphasizes understanding and integrating
cultural values, beliefs, and practices into care to promote health and well-
being. The goal is culturally congruent care, not identical or purely biomedical
care. While minority and immigrant populations are included, the theory
applies to all cultural contexts.
DIF: Difficult REF: Leininger’s Culture Care Theory
KEY: Integrated Process: Nursing Process BLM: Cognitive: Analyze
2. Which nursing action demonstrates application of transcultural nursing
principles to improve patient safety outcomes?
A) Using standardized discharge teaching regardless of patient
background
B) Scheduling follow-up visits without asking about transportation
resources
C) Providing written medication instructions in the patient’s primary
language
D) Assuming a patient’s family structure is the same as the nurse’s own
ANS: C ✅
Feedback: Providing medication instructions in the patient’s primary language
supports comprehension, adherence, and safety — aligning with transcultural
nursing’s goal of reducing health disparities and errors. Standardized teaching
,without adaptation can create safety risks.
DIF: Moderate REF: Cultural Competence and Safety
KEY: Nursing Process: Implementation BLM: Cognitive: Apply
3. A nurse caring for a patient from a culture with different health beliefs
uses Leininger’s theory to guide care. What is the nurse’s priority?
A) Altering the patient’s beliefs to match biomedical models
B) Identifying and integrating cultural care values into the care plan
C) Avoiding discussion of cultural beliefs to prevent conflict
D) Delegating care to a provider of the same cultural background
ANS: B ✅
Feedback: Leininger’s theory prioritizes identifying and integrating cultural
values into care for better outcomes. Altering beliefs or avoiding discussion does
not promote culturally congruent care, and delegating based on culture alone
ignores the nurse’s role in providing holistic care.
DIF: Difficult REF: Culture Care Diversity and Universality
KEY: Nursing Process: Planning BLM: Cognitive: Apply
4. Which example best demonstrates the link between cultural competence
and quality improvement?
A) Tracking readmission rates for patients receiving culturally adapted
education
B) Offering interpreters only for patients who request them
C) Documenting cultural preferences in the social history section only
D) Assigning care based on cultural stereotypes
ANS: A ✅
Feedback: Monitoring outcomes like readmission rates after implementing
culturally adapted interventions directly links cultural competence to quality
improvement metrics. Selective interpreter use and stereotypes undermine
patient safety and outcomes.
DIF: Difficult REF: Cultural Competence and Quality Outcomes
KEY: Nursing Process: Evaluation BLM: Cognitive: Analyze
, 5. Which scenario illustrates the universality component of Leininger’s
theory?
A) Recognizing that all cultures value caring for ill family members in
some way
B) Assuming every patient expresses pain the same way
C) Providing only culturally neutral interventions
D) Ignoring patient preferences when they conflict with hospital policy
ANS: A ✅
Feedback: Universality in Leininger’s theory refers to commonalities across
cultures, such as valuing care for family members, even if practices differ. The
nurse must acknowledge these shared elements while respecting diversity.
DIF: Moderate REF: Culture Care Diversity and Universality Concepts
KEY: Nursing Process: Assessment BLM: Cognitive: Understand
6. A nurse designs an intervention respecting a patient’s fasting practice
during a religious holiday while maintaining medication safety. Which
theory element is applied?
A) Cultural preservation/maintenance
B) Cultural repatterning
C) Cultural care accommodation/negotiation
D) Cultural blindness
ANS: C ✅
Feedback: Accommodation/negotiation involves adapting care to meet patient
needs and safety requirements. Preservation maintains practices without
change, while repatterning modifies harmful practices. Cultural blindness
ignores differences.
DIF: Difficult REF: Culture Care Modes of Action
KEY: Nursing Process: Implementation BLM: Cognitive: Apply
7. Which statement best describes the relationship between transcultural
nursing and patient safety?
, A) Cultural competence is optional for safe care delivery
B) Ignoring cultural needs may lead to miscommunication and errors
C) Safety depends solely on following standardized clinical protocols
D) Cultural care only affects patient satisfaction, not safety outcomes
ANS: B ✅
Feedback: Failure to address cultural needs can cause misunderstandings,
nonadherence, and unsafe care. Cultural competence is integral to both safety
and satisfaction, and goes beyond protocol compliance.
DIF: Moderate REF: Cultural Competence and Safety Outcomes
KEY: Nursing Process: Evaluation BLM: Cognitive: Analyze
8. A nurse integrates community health beliefs into a public health
campaign. Which theoretical basis supports this?
A) Orem’s Self-Care Deficit Theory
B) Watson’s Theory of Human Caring
C) Leininger’s Culture Care Diversity and Universality Theory
D) Roy’s Adaptation Model
ANS: C ✅
Feedback: Leininger’s theory specifically addresses the integration of cultural
beliefs into health promotion to ensure relevance and effectiveness. While
Watson’s theory values caring, it lacks the specific transcultural framework.
DIF: Moderate REF: Leininger’s Theory Applications
KEY: Nursing Process: Planning BLM: Cognitive: Apply
9. A nurse avoids assuming a patient’s dietary restrictions and instead asks
open-ended questions. Which cultural competence component is
demonstrated?
A) Cultural knowledge
B) Cultural desire
C) Cultural awareness
D) Cultural encounter
, ANS: C ✅
Feedback: Cultural awareness involves self-examination and sensitivity to
assumptions, ensuring that care is based on the patient’s input rather than
stereotypes. Knowledge is factual learning; desire is motivation; encounter is
interaction.
DIF: Moderate REF: Campinha-Bacote’s Cultural Competence Model
KEY: Nursing Process: Assessment BLM: Cognitive: Apply
10. Which nurse behavior demonstrates ethnocentrism, a barrier to
transcultural care?
A) Believing one’s own cultural practices are superior to others
B) Adapting care to accommodate traditional healing practices
C) Seeking interpreter services for complex discharge teaching
D) Documenting patient’s cultural preferences in the care plan
ANS: A ✅
Feedback: Ethnocentrism is the belief in the superiority of one’s own culture
and can hinder culturally congruent care. The other options reflect culturally
competent behaviors.
DIF: Moderate REF: Barriers to Cultural Competence
KEY: Nursing Process: Assessment BLM: Cognitive: Analyze
11. A nurse adjusts a wound care schedule to allow a patient to attend daily
religious services. This is an example of which culture care mode of
action?
A) Cultural preservation
B) Cultural care accommodation/negotiation
C) Cultural repatterning
D) Cultural imposition
ANS: B ✅
Feedback: Cultural accommodation/negotiation involves supporting patients in
maintaining cultural practices when possible while meeting healthcare needs.
Preservation maintains beneficial practices unchanged, repatterning modifies
harmful practices, and imposition forces the nurse’s values on the patient.
