TEST BANKS For Family Practice Guidelines
6th Edition by Jill C. Cash; Cheryl A. Glass;
Jenny Mullen||Chapters 1 - 23
,
,Chapter 1. Health Maintenance Guidelines
Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. The nurse is preparing to teach a patient of the Asian culture to perform postoperative
dressing changes at home after discharge. Which statement made by the nurse indicates cultural
competence?
a. Tell me how you feel about your surgery.
b. Asian people are smart, so this should be easy for you to understand.
c. American surgeons are highly qualified; Im sure you will heal quickly.
d. Will you tell me about any traditional healing practices that you would like to use?
2. An unconscious victim of a house fire is brought to the emergency department by the
paramedics. Tied to the right wrist is an emblem that appears be a religious talisman. Which
action should the nurse take?
a. Tape it in place.
b. Do nothing with it.
c. Remove it and lock it up for safekeeping.
d. Place it in a clothing bag with the rest of the patients belongings.
3. A 43-year-old patient of Arab descent is admitted to the hospital. To comply with the
state laws of the organization, the nurse offers the patient a Papanicolaou smear, which she
refuses. Which action should the nurse take first?
a. Notify the physician.
b. Report the refusal to the supervisor.
c. Explain the rationale for and benefits of the test.
d. Tell her it is state law and that she does not have a choice.
4. A patient who is a Jehovahs Witness has severe gastrointestinal bleeding and a
dangerously low hemoglobin level. The patient is fully alert and competent and refuses to accept
the blood transfusion ordered by the physician. Which action by the nurse is most appropriate?
a. Obtain a court order to give the blood.
b. Administer the blood while the patient is sleeping.
c. Have the patients spouse sign the consent to have the blood administered.
,d. Ensure the patient understands possible consequences and then respect the patients wishes.
5. A patient of Mexican descent sees a curandero for asthma; the curandero has prescribed
a special tea to be taken four times a day to open the airways. How should the nurse respond to
this situation?
a. Encourage the patient to continue drinking the tea.
b. Encourage the patient to drink only one cup of the tea each day.
c. Ask the patient to bring in the tea package and have the pharmacist check the ingredients.
d. Advise the patient to stop drinking the tea because of potential interactions with other
medications.
6. The nurse is caring for a young adult male patient who refuses personal care from a
female nursing assistant. Which approach by the nurse is best?
a. Encourage the patients family to talk with him about his care.
b. Have a registered nurse (RN) help with his personal care.
c. Assign a male assistant to help with his personal care if one is available.
d. Explain to him that males and females take care of both genders in this hospital.
7. The nurse is providing medication instructions to a 45-year-old patient who does not
maintain eye contact. What should this patients behavior indicate to the nurse?
a. The patient is not interested.
b. The nurse threatens the patients ego.
c. The nurse is in a hierarchical position.
d. The patient does not intend to follow the instructions.
8. The nurse is caring for a patient of Spanish descent who is experiencing pain, but does
not speak English. An interpreter is located to help with the assessment. What should the nurse
do to facilitate communication with this patient?
a. Use hand signals to determine the cause of the pain.
b. Ensure the interpreter is not left alone with the patient.
c. Maintain eye contact with the patient and the interpreter.
d. Use only physical examination data; do not rely on verbal communication.
9. A new mother of Guatemalan descent brings her 10-day-old infant to a clinic for a well-
baby checkup. To promote healing, she has a coin taped to the infants umbilicus. What should
the nurse do about this situation?
a. Teach the mother how to clean the coin daily and reapply it.
b. Explain to the mother that the coin is not necessary for healing.
,c. Tell the mother to remove the coin, because it could cause an infection.
d. Teach the mother how to apply a dry sterile dressing in place of the coin.
10. An older patient who follows the Muslim religion is approaching death. The family
says the patients bed should be turned toward the opposite wall, so it can face Mecca to ensure
an easier passage into the next life. The wall they want the bed to face has wall suction and
oxygen, which the patient is using. Which action by the nurse is appropriate?
a. Get permission from the physician to move the bed.
b. Rearrange the furniture to accommodate the request.
c. Tell them you will move the bed when the patient is closer to death.
d. Tell them it is impossible because of the short tubing on the oxygen and suction.
11. A patient of northern European descent recovering from surgery denies postoperative
pain; however, vital signs indicate an elevated pulse and blood pressure. The patient refuses to
move in bed. Which nursing action would best ensure comfort and timely discharge?
a. Give the pain medicine as prescribed.
b. Ask the physician to prescribe the analgesics around the clock.
c. Explain that the pain medicine will help prevent complications.
d. Respect the patients denial of pain, and do not encourage the pain medicine.
12. A nurse who emigrated from China begins working on a medical unit. The preceptor
explains the unit routines, including the medication administration system. When the preceptor
asks if the nurse understands, the answer is always: Yes, I understand. What should the preceptor
do to measure the nurses comprehension?
a. Give the nurse a medication quiz.
b. Have the nurse repeat the instructions.
c. Have the nurse demonstrate the procedures.
d. Ask the nurse which information is hard to understand.
13. A 52-year-old from Haiti is hospitalized with heart failure and wants to have a voodoo
practitioner visit to say prayers. How should the nurse respond to this request?
a. Report the request to the physician immediately.
b. Tell the patient that this is not permitted during hospitalization.
c. Tell the patient it is okay for the voodoo practitioner to say prayers.
d. Have the patient meet with the voodoo practitioner in the hospital lobby.
14. The nurse is caring for a patient from a non-English speaking culture. While providing
care, the nurse shows an appreciation for and attention to arts, music, crafts, clothing, and foods
,belonging to the patients culture. What did the nurse demonstrate while caring for this patient?
a. Cultural beliefs
b. Cultural awareness
c. Cultural sensitivity
d. Cultural competence
15. A female Caucasian nurse, overhead discussing a patient from another culture, asks
why the patient wants to see a practitioner from his own culture, since everyone sees physicians
when they are ill. What characteristic is the nurse exhibiting?
a. Stereotyping
b. Ethnocentrism
c. Cultural sensitivity
d. Cultural generalization
16. During an assessment, the nurse determines that a patient from a non-English speaking
culture practices activities that are past-oriented. What behavior did the nurse assess in this
patient?
a. Investing time and money
b. Enjoying each day as it comes
c. Worshipping ancestors and maintaining traditions
d. Learning from the past to avoid making the same mistakes in the future
17. The nurse notes that a patient of Arab descent is not eating anything on the meal trays.
What should the nurse do about this situation?
a. Wait for the patient to ask for specific foods.
b. Ask if the patient has special food preferences.
c. Consult with a physician of Arab descent on staff.
d. Contact the dietitian to find out what patients of Arab descent patients like to eat.
18. The mother of a 6-year-old Vietnamese child admitted with pneumonia is rubbing a
coin on the childs back. The coin leaves red marks. What should the nurse do about this
observation?
a. Report the possibility of child abuse.
b. Do not allow the mother to be alone with her child.
c. Explain to the mother that she cannot do this in the hospital.
d. Add a statement to the care plan that the family practices coining.
19. The family of an older Arab-American patient does not want the patient to be informed
,of a diagnosis of cancer. What should the nurse do?
a. Call a religious counselor.
b. Respect the familys wishes.
c. Insist that the family tell the patient about the diagnosis.
d. Tell the patient anyway, because patients have a right to know.
20. A patient with diabetes mellitus who comes to the clinic for a routine examination
agrees to have a diagnostic test, but is concerned that her transportation will not wait for the test
to be performed. What should the nurse do?
a. Contact the department to have the test done now.
b. Ask the patient to schedule an appointment for the test.
c. Refer the patient to the community health nurse practitioner.
d. Schedule the test for the next time the patient comes to the clinic.
21. The nurse is assessing a patient who believes in a balance of yin and yang in the body,
has a brother with stomach cancer, and frequently uses acupuncture for headache treatment. The
nurse should validate that the patient is a member of which cultural group?
a. Hispanic/Latino
b. Asian American
c. African American
d. American Indian/Native Alaskan
22. An older patient is observed wearing a copper bracelet to relieve the pain of arthritis.
What type of practice should the nurse realize this patient is demonstrating?
a. Allopathy
b. Acupressure
c. Reflexology
d. Folk medicine
23. The nurse is preparing discharge teaching for an older patient who immigrated to the
United States a few years ago. What should the nurse remember when preparing these
instructions?
a. The patient most likely has limited financial resources.
b. The patient will prefer to follow cultural medical practices.
c. The patient will most likely live with other family members.
d. The patient will attend all follow-up appointments as needed.
24. During a home visit to a family of a non-English speaking culture, the nurse observes
,the male parent becoming upset when the youngest child refuses to speak the native language in
the home. What should the nurse realize is occurring within the family at this time?
a. Ethnocentrism
b. Cultural shock
c. Cultural conflict
d. Cultural assimilation
25. An older male patient is admitted to the hospital for treatment of a chronic disease. The
spouse is at the bedside for most hours of the day, and the patients children come to visit every
day after work to discuss activities and ask for advice. What should the nurse realize about the
social organization of this family?
a. The male patient is the head of the household.
b. The spouse does not trust health care providers.
c. The children want to learn everything before the patient dies.
d. The children are concerned that the patient is not receiving adequate care.
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
26. The nurse is planning care for a patient from a non-English speaking culture. Which
cultural factors should the nurse be aware of in order to provide culturally competent care to this
patient? (Select all that apply.)
a. The patients nutritional habits
b. The patients communication style
c. The patients sense of personal space
d. Complementary therapies the patient is using
e. The prescribed medications the patient is taking
27. A female nurse is providing smoking cessation counseling and education during a
community health fair. The nurse should avoid physical closeness, shaking hands, or touching
during instruction with which of the following? (Select all that apply.)
a. A 35-year-old man of Asian descent
b. A 45-year-old woman of Arab descent
c. A 28-year-old man of Hispanic descent
d. A 52-year-old woman of African American descent
e. A 41-year-old woman of American Indian descent
28. The nurse is providing care in a clinic with a culturally diverse patient population.
,Which actions should the nurse take to ensure care is culturally appropriate? (Select all that
apply.)
a. Awareness of cultural bias
b. Desire to be culturally competent
c. Educational training related to world politics
d. Awareness of personal communication patterns
e. Number of face-to-face encounters with people from various cultural backgrounds
29. The staff development instructor is planning a seminar on improving cultural sensitivity
when providing patient care. What should the instructor include in this seminar? (Select all that
apply.)
a. Information about different cultural groups
b. Recognition that patient are unique and not defined by their culture
c. Ways to enhance cultural assimilation in the health care environment
d. The importance of nurses knowing information about their own cultural group
e. Strategies to incorporate patients cultural values and practices into the plan of care
30. The nurse is visiting the home of a patient who recently immigrated to the United States
from Buenos Aires. Which observations in the patients home should the nurse question to
determine the patients health beliefs? (Select all that apply.)
a. Black bracelet woven with a cross being worn on the patients left wrist
b. A lit candle burning near a picture of a saint on a side table in the living room
c. Cup of hot black liquid that the patient is sipping from periodically during the visit
d. A copy of a magazine printed in Spanish sitting on the coffee table in the living room
e. A pillow placed between the patient and the nurse after the nurse sits down on the couch
Chapter 4. Cultural Influences on Nursing Care
Answer Section
MULTIPLE CHOICE
1. ANS: D
D. Cultural sensitivity is using language and statements that do not offend another persons
cultural beliefs. Cultural competence includes the skills and knowledge required to provide
effective nursing care. The use of traditional healers and healing therapies is common for Asian
individuals, and assessing the patients desire to use such healers or therapies shows the nurse is
, culturally sensitive and competent to provide care. B. This statement represents a stereotypean
opinion or belief about a group of people which is ascribed to an individual. C. This statement
exemplifies ethnocentrism or the tendency for people to think that their ways of thinking, acting,
and believing are the only right, proper, and natural ways. A. This is an assessment designed to
elicit the patients emotional reaction to the surgery. This may be an important part of adult
learning, but it is not the best option to represent cultural competence.
PTS: 1 DIF: Moderate
KEY: Client Need: Psychosocial Integrity | Cognitive Level: Analysis
2. ANS: A
A. Often folk practices are not harmful and can be added to the patients plan of care. Tape the
emblem in place to keep it from getting lost or damaged. C. D. Removing it could be very
distressing to the patient. B. The item could get lost if nothing is done with it.
PTS: 1 DIF: Moderate
KEY: Client Need: Psychosocial Integrity | Cognitive Level: Application
3. ANS: C
C. A Pap smear can provide important health information. The patient may refuse it, because she
does not understand what it is. A. B. Teaching is a nursing action and does not need to be
approved by a physician or supervisor. D. The state law simply says the patient must be offered
the test, not that she must accept it.
PTS: 1 DIF: Moderate
KEY: Client Need: Physiological IntegrityReduction of Risk Potential | Cognitive Level:
Application
4. ANS: D
D. Patients beliefs should be respected, even when their decisions go against medical advice. The
patient needs to understand the consequences of his decision. A. B. C. Administering the blood
without the patients knowledge or consent is unethical.
PTS: 1 DIF: Moderate
KEY: Client Need: Psychosocial Integrity | Cognitive Level: Application
