Wong's Nursing Care Of Infants And Children, 9th Edition Test Bank

Chapter 02: Social, Cultural, and Religious Influences on Child Health Promotion Test Bank MULTIPLE CHOICE 1. Children are taught the values of their culture through observation and feedback, relative to their own behavior. In teaching a class on cultural competence, the nurse should be aware that which of the following factors may be culturally determined? a. Ethnicity b. Racial variation c. Status d. Geographic boundaries ANS: C Status is culturally determined and varies according to each culture. Some cultures ascribe higher status to age or socioeconomic position. Social roles also are influenced by the culture. Ethnicity is an affiliation of a set of persons who share a unique cultural, social, and linguistic heritage. It is one component of culture. Race and culture are two distinct attributes. Racial grouping describes transmissible traits, whereas culture is determined by the pattern of assumptions, beliefs, and practices that unconsciously frames or guides the outlook and decisions of a group of people. Cultural development may be limited by geographic boundaries, but the boundaries are not culturally determined. DIF: Cognitive Level: Analysis REF: p. 21 TOP: Integrated Process: Teaching/Learning MSC: Client Needs: Psychosocial Integrity 2. When minority groups immigrate to another country, a certain degree of cultural and ethnic blending occurs through the involuntary process of: a. acculturation. b. ethnocentrism. c. cultural shock. d. cultural sensitivity. ANS: A Acculturation is the gradual changes that are produced in a culture by the influence of another culture that cause one or both cultures to become more similar. The minority culture is forced to learn the majority culture to survive. Ethnocentrism is the belief that one’s way of living and behaving is the best way. This includes the emotional attitude that the values, beliefs, and perceptions of one’s ethnic group are superior to those of others. Cultural shock is the helpless feeling and state of disorientation felt by an outsider attempting to adapt to a different culture group. Ethnocentrism and cultural shock would limit the amount of blending that would occur. Cultural sensitivity, a component of culturally competent care, is an awareness of cultural similarities and differences. 2-2 DIF: Cognitive Level: Comprehension TOP: Nursing Process: Assessment REF: p. 23 MSC: Client Needs: Psychosocial Integrity 3. Which of the following terms best describes the emotional attitude that one’s own ethnic group is superior to others? a. Culture b. Ethnicity c. Superiority d. Ethnocentrism ANS: D Ethnocentrism is the belief that one’s way of living and behaving is the best way. This includes the emotional attitude that the values, beliefs, and perceptions of one’s ethnic group are superior to those of others. Culture is a pattern of assumptions, beliefs, and practices that unconsciously frames or guides the outlook and decisions of a group of people. A culture is composed of individuals who share a set of values, beliefs, and practices that serve as a frame of reference for individual perception and judgments. Ethnicity is an affiliation of a set of persons who share a unique cultural, social, and linguistic heritage. Superiority is the state or quality of being superior; it does not apply to ethnicity. DIF: Cognitive Level: Comprehension TOP: Nursing Process: Assessment REF: p. 24 MSC: Client Needs: Psychosocial Integrity 4. After the family, which of the following is likely to have the greatest influence on providing continuity between generations? a. Race b. Schools c. Social class d. Government ANS: B The schools convey a tremendous amount of culture from the older members to the younger members of society. They prepare children to carry out the traditional social roles that will be expected of them as adults. Race is defined as a division of mankind possessing traits that are transmissible by descent and are sufficient to characterize it as a distinct human type; although race may have an influence on childrearing practices, its role is not as significant as that of schools. Social class refers to the family’s economic and educational levels. The social class of a family may change between generations. The government establishes parameters for children, including amount of schooling, but this is usually at a local level. The school culture has the significant influence on continuity. DIF: Cognitive Level: Knowledge TOP: Nursing Process: Assessment REF: p. 25 MSC: Client Needs: Psychosocial Integrity 5. The nurse observes that families from certain minority cultural groups often miss or are late for scheduled clinic appointments. The best explanation for this is that certain cultural groups often differ from the dominant culture because they: 2-3 a. b. c. d. lack education. avoid health care. are more forgetful. view time differently. ANS: D Each cultural group has different conceptions of time and waiting. The dominant culture in the United States has a fairly rigid view of time. Persons from other cultures may be late or miss activities because other issues take precedence over the appointment. Education is not the issue, nor is avoidance of health care. The family usually believes that the appointment can be made for a later time. The family does not forget the time, but other issues take priority. DIF: Cognitive Level: Application TOP: Nursing Process: Assessment REF: p. 30 MSC: Client Needs: Psychosocial Integrity 6. The Asian parent of a child being seen in the clinic avoids eye contact with the nurse. The best explanation for this, considering cultural differences, is that the parent: a. feels inferior to nurse. b. is showing respect for nurse. c. is embarrassed to seek health care. d. feels responsible for her child’s illness. ANS: B In some ethnic groups, eye contact is avoided. In the Vietnamese culture an individual may not look directly into the nurse’s eyes as a sign of respect. The nurse providing culturally competent care would recognize that the other answers listed are not why the parent avoids eye contact with the nurse. DIF: Cognitive Level: Analysis TOP: Nursing Process: Assessment REF: p. 32 MSC: Client Needs: Psychosocial Integrity 7. The nurse is planning care for a patient with a different ethnic background. Which of the following would be an appropriate goal? a. Adapt, as necessary, ethnic practices to health needs. b. Attempt, in a nonjudgmental way, to change ethnic beliefs. c. Encourage continuation of ethnic practices in the hospital setting. d. Strive to keep ethnic background from influencing health needs. ANS: A Whenever possible, nurses should facilitate the integration of ethnic practices into health care provision. The ethnic background is part of the individual; it would be difficult to eliminate the influence of ethnic background. The ethnic practices need to be evaluated within the context of the health care setting to determine whether they are conflicting. DIF: Cognitive Level: Application TOP: Nursing Process: Assessment REF: p. 36 MSC: Client Needs: Psychosocial Integrity 2-4 8. The nurse discovers welts on the back of a Vietnamese child during a home health visit. The child’s mother says she has rubbed the edge of a coin on her child’s oiled skin. The nurse should recognize this is which of the following? a. Child abuse b. Cultural practice to rid the body of disease c. Cultural practice to treat enuresis or temper tantrums d. Child discipline measure common in the Vietnamese culture ANS: B This is descriptive of coining. The welts are created by repeatedly rubbing a coin on the child’s oiled skin. The mother is attempting to rid the child’s body of disease. Coining is a cultural healing practice. Coining is not specific for enuresis or temper tantrums. This is not child abuse or discipline. DIF: Cognitive Level: Comprehension TOP: Nursing Process: Assessment REF: p. 35 MSC: Client Needs: Psychosocial Integrity 9. A Hispanic toddler has pneumonia. The nurse notices that the parent consistently feeds the child only the broth that comes on the clear liquid tray. Food items, such as Jell-O, Popsicles, and juices, are left. Which of the following would best explain this? a. Parent is trying to feed child only what child likes most. b. Hispanics believe the “evil eye” enters when a person gets cold. c. Parent is trying to restore normal balance through appropriate “hot” remedies. d. Hispanics believe an innate energy called chi is strengthened by eating soup. ANS: C In several cultures, including Filipino, Chinese, Arabic, and Hispanic, hot and cold describe certain properties completely unrelated to temperature. Respiratory conditions such as pneumonia are “cold” conditions and are treated with “hot” foods. The child may like broth but is unlikely to always prefer it to Jell-O, Popsicles, and juice. The evil eye applies to a state of imbalance of health, not curative actions. Chinese individuals, not Hispanic individuals, believe in chi as an innate energy. DIF: Cognitive Level: Application TOP: Nursing Process: Assessment REF: p. 34 MSC: Client Needs: Psychosocial Integrity 10. The nurse recognizes that some genetic diseases are more prevalent in certain groups and geographic areas. Which of the following disorders is more likely to be identified in individuals of Mediterranean descent? a. Phenylketonuria b. Cystic fibrosis c. G6PD deficiency d. Sickle cell anemia ANS: C Glucose-6 phosphate dehydrogenase (G6PD) deficiency is more commonly found in individuals of Mediterranean descent. Phenylketonuria is more prevalent in individuals of northern European origin. Cystic fibrosis is more prevalent in individuals from England and Scotland. Sickle cell anemia is more prevalent in individuals of African descent. 2-5 DIF: Cognitive Level: Application TOP: Nursing Process: Assessment REF: p. 40 MSC: Client Needs: Psychosocial Integrity 11. Which one of the following communicable diseases is more prevalent in certain ethnic groups, such as Vietnamese immigrants? a. Tuberculosis b. Rubeola c. Varicella d. Pertussis ANS: A Tuberculosis is a more prevalent communicable disease among certain ethnic groups such Vietnamese immigrants, Native Americans of the Southwest, and Mexican-Americans. Rubeola is a common communicable disease with a geographic constraint. Varicella and pertussis do not have ethnic prevalence. DIF: Cognitive Level: Application TOP: Nursing Process: Assessment REF: p. 39 MSC: Client Needs: Psychosocial Integrity MULTIPLE RESPONSE 1. The nurse is presenting a staff development program about cultural competency in the health care setting. Which of the following components should the nurse include in the program? Select all that apply. a. Cultural awareness b. Cultural knowledge c. Cultural skills d. Cultural research e. Cultural desire f. Cultural bias ANS: A, B, C, E Five components that should be discussed in a program about cultural competency include awareness (the nurse appreciates and is sensitive to the family’s cultural values), knowledge (formal and informal education about different cultures, beliefs, and perceptions about health and wellness), skills (the ability to include cultural data in the nursing process), and desire (the genuine motivation to work effectively with minority patients). Cultural research and cultural bias are not components of cultural competency. DIF: Cognitive Level: Analysis REF: p. 36 TOP: Integrated Process: Teaching/Learning MSC: Client Needs: Psychosocial Integrity