C HAPTER 05: C ULTURAL I MPLICATIONS
Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: 8th Edition
MULTIPLE CHOICE
1. A patient in the emergency department shows a variet y of psychiatric
s ymptoms, including restlessness and anxiet y. The patient says, I feel sad
because evil spirits have overtaken m y mind. Which worldview is most
applicable to this individu al?
a. Eastern/balance
b. Southern/holistic
c. Western/scientific
d. Indigenous/harmony
ANS: D
Persons of an indigenous worldview believe disease results from a lack
of personal, interpersonal, environmental, or spiritual harmony and that
evil spirits exist. The holism of body-mind-spirit is a key component of
this view. If one believes an evil spirit has taken control, distress
results. Western and Eastern worldviews do not embrace spirits. See
relationship to audience response question.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: 79 TOP: Nursing Process: Assessment MSC:
Client Needs: Psychosocial Integrit y
,2. A nurse prepares to teach important medication information to a patient of
Mexican heritage. How should the nurse manage the teaching
environment?
a. Stand very close to the patient while teaching.
b. Maintain direct eye contact with the patient while teaching.
c. Maintain a neutral emotional tone during the teaching session.
d. Sit 4 feet or more from the patient during the teaching session.
ANS: A
Latin American cultures use close personal space, closer than many
other minorit y groups. Standing very close to the patient frequentl y
indicates acceptance. Direct eye contact should not be prolonged with
this patient. Persons of this cultural heritage have high emotionalit y.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
REF: 81 TOP: Nursing Process: Implementation
MSC: Client Needs: Health Promotion and Maintenance
3. A Chinese American patient diagnosed with an anxiet y disorder says, My
problems began when m y energy became imbalanced. The nurse asks for
the patients ideas about how to treat the imbalance. Which comment would
the nurse expect from this patient?
a. My famil y will bring special foods to help me get well.
b. I hope m y health care provider w ill prescribe some medication to
help me.
c. I think I would benefit from talking to other patients with a similar
problem.
d. I would like to have a native healer perform a ceremony to balance
my energy.
, ANS: A
The concept of energy imbalance as a source of i llness is an
explanatory model familiar to Asian cultures. A source of healing is
dietary change to include either hot or cold foods to correct the
imbalance. Hot and cold in this case do not refer to thermal properties
of the foods. Medication would not b e a treatment suggested by a
patient with an Eastern worldview. Someone from an indigenous
culture may suggest rituals. Group discussion of mental illness would
not be appealing to a Chinese American.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
REF: 80 TOP: Nursing Process: Planning MSC:
Client Needs: Psychosocial Integrit y
4. An experienced psychiatric nurse plans to begin a new job in a
communit y-based medication clinic. The clinic sees culturall y diverse
patients. Which action should the nurse ta ke first to prepare for this
position?
a. Investigate cultural differences in patients responses to
psychotropic medications.
b. Contact the clinical nurse specialist for guidelines regarding
cultural competence.
c. Examine the literature on various health beliefs of members of
diverse cultures.
d. Complete an online continuing education offering about
psychopharmacology.
ANS: A
Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: 8th Edition
MULTIPLE CHOICE
1. A patient in the emergency department shows a variet y of psychiatric
s ymptoms, including restlessness and anxiet y. The patient says, I feel sad
because evil spirits have overtaken m y mind. Which worldview is most
applicable to this individu al?
a. Eastern/balance
b. Southern/holistic
c. Western/scientific
d. Indigenous/harmony
ANS: D
Persons of an indigenous worldview believe disease results from a lack
of personal, interpersonal, environmental, or spiritual harmony and that
evil spirits exist. The holism of body-mind-spirit is a key component of
this view. If one believes an evil spirit has taken control, distress
results. Western and Eastern worldviews do not embrace spirits. See
relationship to audience response question.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: 79 TOP: Nursing Process: Assessment MSC:
Client Needs: Psychosocial Integrit y
,2. A nurse prepares to teach important medication information to a patient of
Mexican heritage. How should the nurse manage the teaching
environment?
a. Stand very close to the patient while teaching.
b. Maintain direct eye contact with the patient while teaching.
c. Maintain a neutral emotional tone during the teaching session.
d. Sit 4 feet or more from the patient during the teaching session.
ANS: A
Latin American cultures use close personal space, closer than many
other minorit y groups. Standing very close to the patient frequentl y
indicates acceptance. Direct eye contact should not be prolonged with
this patient. Persons of this cultural heritage have high emotionalit y.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
REF: 81 TOP: Nursing Process: Implementation
MSC: Client Needs: Health Promotion and Maintenance
3. A Chinese American patient diagnosed with an anxiet y disorder says, My
problems began when m y energy became imbalanced. The nurse asks for
the patients ideas about how to treat the imbalance. Which comment would
the nurse expect from this patient?
a. My famil y will bring special foods to help me get well.
b. I hope m y health care provider w ill prescribe some medication to
help me.
c. I think I would benefit from talking to other patients with a similar
problem.
d. I would like to have a native healer perform a ceremony to balance
my energy.
, ANS: A
The concept of energy imbalance as a source of i llness is an
explanatory model familiar to Asian cultures. A source of healing is
dietary change to include either hot or cold foods to correct the
imbalance. Hot and cold in this case do not refer to thermal properties
of the foods. Medication would not b e a treatment suggested by a
patient with an Eastern worldview. Someone from an indigenous
culture may suggest rituals. Group discussion of mental illness would
not be appealing to a Chinese American.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
REF: 80 TOP: Nursing Process: Planning MSC:
Client Needs: Psychosocial Integrit y
4. An experienced psychiatric nurse plans to begin a new job in a
communit y-based medication clinic. The clinic sees culturall y diverse
patients. Which action should the nurse ta ke first to prepare for this
position?
a. Investigate cultural differences in patients responses to
psychotropic medications.
b. Contact the clinical nurse specialist for guidelines regarding
cultural competence.
c. Examine the literature on various health beliefs of members of
diverse cultures.
d. Complete an online continuing education offering about
psychopharmacology.
ANS: A
