,Chapter01:CulturalCompetency
Ball:Seidel’sGuidetoPhysicalExamination,10thEdition
MULTIPLE CHOICE
1. WhichJstatement is trueJregarding the relationship of physical characteristics and culture?
a. Physical characteristics should be used to identify members of cultural groups.
b. ThereJis a difference betweenJdistinguishing cultural characteristics and d
istinguishing physical characteristics.
c. To be amember of a specific culture, an individual must have certainJidentifiable ph
ysical characteristics.
d. Gender and race are theJtwo essential physical characteristics used to identify cu
ltural groups.
ANS: B
Physical characteristics areJnot used to identify cultural groups; thereJisJa difference between the
two, and they are considered separately. Physical characteristics should not be used toJidentify
membersJof cultural groups. To be a member of a specific culture, an individual does notneed to
have certainJidentifiable physical characteristics. You should not confuse physical characteristic
s withJcultural characteristics. Gender and race are physical characteristics, not cultural characte
ristics, and are not used to identify cultural groups.
DIF:Cognitive Level: UnderstandingJ(Comprehension)
OBJ:NursingJ process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
2. An image of any groupJthat rejects itsJpotential for originality or individuality is known asJa(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 theJdefiniti
onJof stereotype. Acculturation is the process of adoptingJanother culture’s behaviors. A normJisJ
a standard of allowable behavior within a group. Ethnos implies the same raceJor nationality.
DIF:Cognitive Level: Remembering (Knowledge)
OBJ:NursingJ process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
3. Mr. Lpresents to theJclinic with severeJgroin pain and a history of kidney stones. Mr. L’sJson tell
s you that for religious reasons, his father wishesJto keep any stone that is passed into the urineJfi
lter thatJhe has been using. What is your mostJappropriate response?
a. ―WithJyour father’sJpermission, we willexamineJthestoneand requestthatJitbe re
turned toJhim.‖
, b. ―ThestonemustbesentJto the lab for examination and therefore cannotbe kept.‖
c. ―Wecannotlethimkeep his stoneJbecauseitviolates our infection controlpolicy.‖
d. ―Wedon’t know yetif your father hasanother kidney stone, so we mustanalyze thi
s one.‖
ANS: A
We should be willingJto modify the delivery of health care in a manner that is respectful and in k
eeping withJthe patient’s cultural background. ―With your father’sJpermission, we will examin
e theJstone and request that itJbeJreturnedJto him‖ is the mostJappropriate response.
―Thestone must beJsent to the lab for examination and thereforeJcannot be kept‖ andJ―We don’t
know yet if your father hasJanother kidney stone, so we must analyze this one‖ do not support the
patient’s request. ―We cannot let him keep his stoneJbecause it violates our infection control po
licy‖ does not provideJa reasonJthatJit would violate an infection controlJpolicy.
DIF:Cognitive Level: AnalyzingJ(Analysis)
OBJ:NursingJ process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
4. ThemotivationJof theJhealthcare professional to ―wantJto‖ engageinJtheJprocess of becoming cul
turallycompetent, notJ―have to,‖ is called
a. cultural knowledge.
b. cultural awareness.
c. cultural desire.
d. cultural skill.
ANS: C
Cultural encounters areJthe continuous process of interacting with patients from culturally divers
e backgrounds to validate, refine, or modify existing values, beliefs, andJpractices about a cultural
groupJand 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‖ thatone holds about individuals and groups who are different from them. Cultural knowled
ge is theJprocess of
seeking and obtaining a sound educational base about culturallyand ethnically diverse groups. C
ultural skillJisJthe ability to collect culturally relevant data regarding the patient’s presenting prob
lem, asJwell as accurately performing a culturally based physical assessment in a culturally sensit
ive manner. Cultural desire is the motivation of the healthcare professional to want to engage in t
he process of becoming culturally competent, not haveJto.
DIF:Cognitive Level: UnderstandingJ(Comprehension)
OBJ:NursingJ process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
5. Mr. Marks is a 66-year-
old patientJwho presents for a physical examination to the clinic. Which question hasJthe mos
t potential for exploring apatient’s cultural beliefs relatedJto a health problem?
a. ―Howoften do you haveJmedicalJexaminations?‖
b. ―What is your age, race, andeducationallevel?‖
c. ―WhatJtypesJof symptomshaveJyou beenJhaving?‖
d. ―Why doJyou think you areJhavingtheseJsymptoms?‖
, ANS: D
―Why do you thinkJyou arehaving thesesymptoms?‖ is an open-
ended questionJthat avoids stereotyping, is sensitive and respectful toward the individual, and all
ows for cultural data to be exchanged. The other questions doJnot explore the patient’s cultural b
eliefsJabout health problems.
DIF:Cognitive Level: AnalyzingJ(Analysis)
OBJ:NursingJ process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
6. The definitionJof ill or sickJisJbased onJa
a. stereotype.
b. cultural behavior.
c. belief system.
d. cultural attitude.
ANS: C
Thedefinition of ill or sick isbased onJthe individual’s belief system and is determined in large pa
rt by his or her enculturation.
DIF:Cognitive Level: UnderstandingJ(Comprehension)
OBJ:NursingJ process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
7. A 22-year-old femaleJnurse isJinterviewing an 86-year-
old male patient. TheJpatient avoids eyecontactandanswersJquestionsJonly by saying, ―Yeah,‖
―No,‖ or ―I guessJso.‖ WhichJof the following is appropriate for the interviewer to say or ask?
a. ―We will beJableJto communicatebetter if you lookJat me.‖
b. ―It’s hard for meJto gatherusefulinformation because your answersJareJso short.‖
c. ―AreJyou uncomfortabletalkingwithJme?‖
d. ―DoesJyour religion make it hardfor you toJanswer my questions?‖
ANS: C
It is all right to ask if theJpatient is uncomfortable with any aspect of your person and to talk about
it; the other choices areJless respectful.
DIF:CognitiveJLevel: ApplyingJ(Application)
OBJ:NursingJ process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
8. As you explain your patient’s condition to her husband, you notice that heJisJleaning toward you
and pointedly blinkingJhis eyes. Knowing that heJis from England, your most appropriateJrespon
seJto this behavior is to
a. tell himJthatJyou understand his need toJbe alone.
b. askJwhether he has any questions.
c. askJwhether he would prefer to speak to the clinician.
d. tell him that it isJall right to be angry.
ANS: B
The EnglishJworry about being overheardJand tend to speak inJmodulated voices so, whenJthey l
ean inJtoward you, they are probably poised to ask a question.
Ball:Seidel’sGuidetoPhysicalExamination,10thEdition
MULTIPLE CHOICE
1. WhichJstatement is trueJregarding the relationship of physical characteristics and culture?
a. Physical characteristics should be used to identify members of cultural groups.
b. ThereJis a difference betweenJdistinguishing cultural characteristics and d
istinguishing physical characteristics.
c. To be amember of a specific culture, an individual must have certainJidentifiable ph
ysical characteristics.
d. Gender and race are theJtwo essential physical characteristics used to identify cu
ltural groups.
ANS: B
Physical characteristics areJnot used to identify cultural groups; thereJisJa difference between the
two, and they are considered separately. Physical characteristics should not be used toJidentify
membersJof cultural groups. To be a member of a specific culture, an individual does notneed to
have certainJidentifiable physical characteristics. You should not confuse physical characteristic
s withJcultural characteristics. Gender and race are physical characteristics, not cultural characte
ristics, and are not used to identify cultural groups.
DIF:Cognitive Level: UnderstandingJ(Comprehension)
OBJ:NursingJ process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
2. An image of any groupJthat rejects itsJpotential for originality or individuality is known asJa(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 theJdefiniti
onJof stereotype. Acculturation is the process of adoptingJanother culture’s behaviors. A normJisJ
a standard of allowable behavior within a group. Ethnos implies the same raceJor nationality.
DIF:Cognitive Level: Remembering (Knowledge)
OBJ:NursingJ process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
3. Mr. Lpresents to theJclinic with severeJgroin pain and a history of kidney stones. Mr. L’sJson tell
s you that for religious reasons, his father wishesJto keep any stone that is passed into the urineJfi
lter thatJhe has been using. What is your mostJappropriate response?
a. ―WithJyour father’sJpermission, we willexamineJthestoneand requestthatJitbe re
turned toJhim.‖
, b. ―ThestonemustbesentJto the lab for examination and therefore cannotbe kept.‖
c. ―Wecannotlethimkeep his stoneJbecauseitviolates our infection controlpolicy.‖
d. ―Wedon’t know yetif your father hasanother kidney stone, so we mustanalyze thi
s one.‖
ANS: A
We should be willingJto modify the delivery of health care in a manner that is respectful and in k
eeping withJthe patient’s cultural background. ―With your father’sJpermission, we will examin
e theJstone and request that itJbeJreturnedJto him‖ is the mostJappropriate response.
―Thestone must beJsent to the lab for examination and thereforeJcannot be kept‖ andJ―We don’t
know yet if your father hasJanother kidney stone, so we must analyze this one‖ do not support the
patient’s request. ―We cannot let him keep his stoneJbecause it violates our infection control po
licy‖ does not provideJa reasonJthatJit would violate an infection controlJpolicy.
DIF:Cognitive Level: AnalyzingJ(Analysis)
OBJ:NursingJ process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
4. ThemotivationJof theJhealthcare professional to ―wantJto‖ engageinJtheJprocess of becoming cul
turallycompetent, notJ―have to,‖ is called
a. cultural knowledge.
b. cultural awareness.
c. cultural desire.
d. cultural skill.
ANS: C
Cultural encounters areJthe continuous process of interacting with patients from culturally divers
e backgrounds to validate, refine, or modify existing values, beliefs, andJpractices about a cultural
groupJand 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‖ thatone holds about individuals and groups who are different from them. Cultural knowled
ge is theJprocess of
seeking and obtaining a sound educational base about culturallyand ethnically diverse groups. C
ultural skillJisJthe ability to collect culturally relevant data regarding the patient’s presenting prob
lem, asJwell as accurately performing a culturally based physical assessment in a culturally sensit
ive manner. Cultural desire is the motivation of the healthcare professional to want to engage in t
he process of becoming culturally competent, not haveJto.
DIF:Cognitive Level: UnderstandingJ(Comprehension)
OBJ:NursingJ process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
5. Mr. Marks is a 66-year-
old patientJwho presents for a physical examination to the clinic. Which question hasJthe mos
t potential for exploring apatient’s cultural beliefs relatedJto a health problem?
a. ―Howoften do you haveJmedicalJexaminations?‖
b. ―What is your age, race, andeducationallevel?‖
c. ―WhatJtypesJof symptomshaveJyou beenJhaving?‖
d. ―Why doJyou think you areJhavingtheseJsymptoms?‖
, ANS: D
―Why do you thinkJyou arehaving thesesymptoms?‖ is an open-
ended questionJthat avoids stereotyping, is sensitive and respectful toward the individual, and all
ows for cultural data to be exchanged. The other questions doJnot explore the patient’s cultural b
eliefsJabout health problems.
DIF:Cognitive Level: AnalyzingJ(Analysis)
OBJ:NursingJ process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
6. The definitionJof ill or sickJisJbased onJa
a. stereotype.
b. cultural behavior.
c. belief system.
d. cultural attitude.
ANS: C
Thedefinition of ill or sick isbased onJthe individual’s belief system and is determined in large pa
rt by his or her enculturation.
DIF:Cognitive Level: UnderstandingJ(Comprehension)
OBJ:NursingJ process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
7. A 22-year-old femaleJnurse isJinterviewing an 86-year-
old male patient. TheJpatient avoids eyecontactandanswersJquestionsJonly by saying, ―Yeah,‖
―No,‖ or ―I guessJso.‖ WhichJof the following is appropriate for the interviewer to say or ask?
a. ―We will beJableJto communicatebetter if you lookJat me.‖
b. ―It’s hard for meJto gatherusefulinformation because your answersJareJso short.‖
c. ―AreJyou uncomfortabletalkingwithJme?‖
d. ―DoesJyour religion make it hardfor you toJanswer my questions?‖
ANS: C
It is all right to ask if theJpatient is uncomfortable with any aspect of your person and to talk about
it; the other choices areJless respectful.
DIF:CognitiveJLevel: ApplyingJ(Application)
OBJ:NursingJ process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
8. As you explain your patient’s condition to her husband, you notice that heJisJleaning toward you
and pointedly blinkingJhis eyes. Knowing that heJis from England, your most appropriateJrespon
seJto this behavior is to
a. tell himJthatJyou understand his need toJbe alone.
b. askJwhether he has any questions.
c. askJwhether he would prefer to speak to the clinician.
d. tell him that it isJall right to be angry.
ANS: B
The EnglishJworry about being overheardJand tend to speak inJmodulated voices so, whenJthey l
ean inJtoward you, they are probably poised to ask a question.
