Community & Public Health Nursing Promoting the Public’s Health 9th Edition by Cherie Rector – Test Bank

 

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Sample Questions Are Posted Below

 

1. After discussing the meaning of cultural diversity and its significance for community health nursing, the nursing instructor recognizes that some points need to be clarified when a student makes which of the following comments?
   1. “Dominant values are those held by the male head of the household in most American ”
   2. “The percentages of White European descent Americans are rising, while the percentages of other ethnicities are declining and this is projected to continue into the year 2050 at ”
   3. “Nurses maintain their original culture as they are socialized throughout the educational ”
   4. “America has become an amalgamation of people who have different values, ideals, and behaviors, rather than the melting pot that was once ”

Ans:  A

Feedback:

The beliefs and sanctions of the dominant or majority culture are called dominant values. The proportion of the population identified as White is projected to continue to fall below other ethnicities between 2010 and 2050. Nurses will still have the same culture as they did before they were socialized in the nursing educational process, but they may be able to see things differently. America is not the ideal melting pot once described, but rather an amalgamation of people who have different values, ideals, and behaviors.

 

 

2. The population that community health nurses serve in the United States is Because of population shifts, nurses must become sensitive to the cultural differences and language differences among new community members. Which minority group currently represents the largest group?
   1. African Americans
   2. Hispanic Americans
   3. Asian Americans
   4. American Indians Ans: B

Feedback:

Significant minorities include Hispanic Americans, numbering more than 35 million in 2000 and over 42 million in 2005 and currently representing over 14% of the population; African Americans, numbering over 37 million or approximately 12.8% of the population; Asian Americans, numbering more than 12 million or approximately 4.3% of the population; and American Indians and Alaska Natives, numbering 2.8 million or 1% of the population.

 

3. While providing care to a community group, a community health nurse provides culturally sensitive care by avoiding which of the following?
   1. Ethnocentrism
   2. Ethnorelativism
   3. Enculturation
   4. Ethnicity Ans: A Feedback:

Ethnocentrism is the belief or feeling that one’s own culture is best causing the person to believe that his or her way of doing things is right and to judge others’ methods as inferior, ignorant, or irrational. It blocks effective communication by creating biases and misconceptions. Ethnorelativism is seeing all behavior in a cultural context.

Enculturation refers to the process of each person learning his or her culture through socialization with the family or significant group. Ethnicity refers to the group of qualities that mark a person’s association with a particular ethnic group (collection of people who have common origins and a shared culture and identity).

 

 

4. As a community health nurse, you overhear a colleague say, “I don’t understand why the Yang’s take their young teenage daughters to the Hmong New Year celebration and have them play these match-making The girls meet boys every day at school and they are too young to be looking for husbands.” Which of the following would be the most appropriate response?
   1. “The Yang’s are very different from us; maybe in time we can convince them that their practices are not ”
   2. “Every culture has its differences; I think it is valuable that the Yang’s are keeping their cultural practices ”
   3. “I know what you mean, I was thinking the same You wouldn’t catch me doing something similar with my teens.”
   4. “I feel sorry for those girls; they must feel funny in those cultural Let’s talk to the parents and tell them how teens in America feel about such things.”

Ans:  B

Feedback:

Community health nurses need to develop cultural sensitivity, becoming aware of own biases and preconceived values and beliefs. This would be evidenced by the statement about every culture having differences. The celebration is a part of the family’s culture, and the nurses should not attempt to convince them that it is not right nor should they attempt to impose their views, feelings, or beliefs on the family.

 

5. What is the most serious negative effect of a nurse maintaining ethnocentric views but not recognizing or acknowledging this?
   1. The nurse fails to understand the views of other cultures because of his or her
   2. The nurse does not communicate effectively with members of other cultures because of his or her
   3. The nurse’s ethnocentrism causes damage to interpersonal relationships and interferes with the effectiveness of nursing
   4. Nurses are immune to the effects of Ans: C

Feedback:

The most negative effect of nurses maintaining ethnocentric views but not recognizing or acknowledging this is that the nurse’s ethnocentrism causes damage to interpersonal relationships and interferes with the effectiveness of nursing interventions. The nurse who is ethnocentric and doesn’t realize it will fail to understand the views of other cultures, but this is not the most serious negative effect. If the nurse is ethnocentric, he or she may not communicate effectively because of his or her ethnocentrism, and this can lead to impaired relationships and interference with the effectiveness of nursing interventions. All nurses hold ethnocentric views, but it is important for the nurse to be aware of them and acknowledge them to avoid having it damage relationships and interfere with the effectiveness of nursing interventions.

 

 

6. When describing culture as shared, which of the following would be most accurate?
   1. It is acquired, not
   2. It is a product of aggregate
   3. It is interrelated and
   4. It undergoes Ans: B

Feedback:

When describing culture as shared, it means that it is a product of aggregate behavior, not an individual habit. The customs are phenomena shared by all members of the  group. Culture is learned; that is, the patterns of cultural behavior are acquired, not inherited. Culture is integrated; that is, it is a functional, integrated whole where all parts are interrelated and interdependent. Culture is dynamic; that is, it is changeable and not entirely static.

 

7. As part of a class presentation, a nursing instructor describes the characteristics shared by all Which description of culture being tacit indicates that the teaching was successful?
   1. Culture is mostly
   2. Cultures do not remain
   3. Culture is a functional and integrated
   4. Patterns of cultural behavior are Ans: A

Feedback:

Culture is tacit, that is, mostly unexpressed and at the unconscious level. Culture is dynamic, undergoing change and never entirely static. It is integrated and learned.

 

 

8. Which of the following statements is an accurate description of the characteristic shared by all cultures, culture is integrated?
   1. A person’s culture is an interrelated and interdependent web of ideas and
   2. In order to describe a person’s culture, it is necessary to describe each trait
   3. Aspects of a person’s culture are best described as unrelated to other aspects of the person’s
   4. A person’s culture is an assortment of various customs and Ans: A

Feedback:

A person’s culture is an integrated web of ideas and practices. To understand culture, single traits should not be described independently. As in any system, all parts of a culture are interrelated and interdependent.

 

 

9. A community health nurse is working with several Native American groups in Which of the following would the nurse be most likely to assess? Select all that apply.
   1. The value of competition
   2. Respect for advancing age and elders
   3. Focus of living in the future
   4. Frequent dialogue and discussion
   5. Each tribe or nation has its own distinct language, beliefs, customs, and Ans: B, C, E

Feedback:

Although there are differences among Native American tribes, most have respect for advancing age and they live in the present and not the distant future (making primary prevention activities more difficult). Each tribe or nation has its own distinct language, beliefs, customs, and rituals. Competition and frequent dialogue and discussion are not values held by Native Americans.

 

10. A community health nurse working a large metropolitan city has a large Asian American client Which of the following would the nurse be least likely to assess in this population?
    1. Belief that illness results from a body imbalance
    2. Reliance on Western medical practices
    3. Use of traditional self-care practices
    4. A focus on patriarchal family structures Ans: B

Feedback:

Asian Americans believe illness results from an imbalance of yin and yang forces. They use traditional healers and also exercise traditional self-care practices before using Western medical practices.

 

 

11. While visiting an Asian American family in their home, the community health nurse inspects the skin of the 3-year-old child and notices a bruise-like lesion on the child’s The mother states that the child has been experiencing diarrhea for 2 days. Which of the following would the nurse do next?
    1. Report the family to the local child abuse agency
    2. Recognize this as a normal skin variation
    3. Question the family about the use of cupping
    4. Obtain a blood test for clotting function Ans: C

Feedback:

The nurse needs to gather additional information about the lesion. Practicing transcultural nursing would require the nurse to perform a cultural assessment and question the family about their use of dermabrasive techniques such as cupping that would leave a bruise-like lesion on the skin and be mistaken for physical abuse. The nurse would report the family to the local child abuse agency if further investigation provides additional information to support that decision. The lesion is not a normal skin variation. Obtaining a blood test for clotting function would be warranted only if further assessment reveals additional bruising or other signs of clotting problems.

 

12. The community health nurse is working in the health department of a major city that has a large Hispanic/Latino Which of the following would the nurse need to integrate into the plan of care for this population?
    1. View of the female as superior to the male
    2. Importance of an extended, cohesive family
    3. Males as the binding force of the family
    4. Adherence to strict time schedules Ans: B

Feedback:

Hispanic people value extended, cohesive families. Families have been patriarchal, with male members perceived as superior and female members seen as a family-bonding life force. Many Latinos tend to be oriented to the present and are not as concerned as the mainstream culture about keeping time schedules or preparing for the future.

 

 

13. A group of nursing students are studying for a test about various cultural The students demonstrate that they understand the material when they identify which cultural group as believing in predestination?
    1. Hispanic/Latinos
    2. African Americans
    3. Muslims
    4. Native Americans Ans: C

Feedback:

Muslims believe in predestination, that life is determined beforehand, and they attribute the occurrence of disease to the will of Allah. Hispanic/Latinos believe that illness may be a form of punishment for sins. Some African Americans believe that illness is evidence of disharmony possibly due to evil spirits, punishment of God, or a hex placed on a person. Native Americans believe that health reflects living in total harmony with nature.

 

14. A community health nurse is developing health promotion programs for a local community that consists predominantly of African Which of the following areas would be a priority for health promotion with this group?
    1. Cardiac health
    2. Respiratory care
    3. Mental health
    4. Skin care Ans: A Feedback:

Leading causes of death for African Americans include heart disease, cancer, and  stroke. Heart disease is also a major health problem. Thus programs emphasizing  cardiac health would be a priority. African Americans show a lower incidence in suicide and chronic obstructive pulmonary disease. They may experience skin problems such as keloids and melasma. However, all of these conditions would be of lesser importance than cardiac health.

 

 

15. A community health nurse is providing care to a family in the community who are Which of the following would be most important for the nurse to integrate when providing care for this family?
    1. Rules are stricter for boys than for
    2. Modest dressing is key for both men and
    3. Most Arabic women work outside the
    4. Most adhere to the three tenets of Ans: B

Feedback:

For Muslims, modesty in dress is a core value for both men and women, although it is expressed more evidently by women. Rules are stricter for girls than for boys and most Arabic women stay at home and are not in the workplace. All practicing Muslims adhere to the five tenets of Islam.

 

 

16. A community health nurse is providing care to an Asian American family who believes that a member’s current illness is due to an excess of The nurse integrates knowledge of this belief, expecting the family to avoid which foods?
    1. Rice
    2. Eggs
    3. Chicken
    4. Fruits Ans: D Feedback:

If the imbalance is an excess of yin, then “cold” foods, such as vegetables and fruits, are avoided, and “hot” foods, such as rice, chicken, eggs, and pork, are offered.

 

17. What is the most important reason for the nurse to conduct a cultural assessment?
    1. Because it is often assigned by nursing faculty
    2. Because usually there is some culturally based reason that causes clients to engage in or avoid certain actions
    3. To meet the nurse’s professional learning needs
    4. Because understanding the values, beliefs, and practices of a designated cultural group is critical to effective nursing action

Ans:  D

Feedback:

The most important reason for the nurse to conduct a cultural assessment is that because understanding the values, beliefs, and practices of a designated cultural group is critical to effective nursing action. There is usually some culturally based reason that causes clients to engage in or avoid certain actions but that is not the most important reason for the nurse to conduct a cultural assessment. The nurse does not necessarily collect a cultural assessment to meet his or her own needs primarily.

 

 

18. When developing an in-service program for a group of community health nurses about culture, which of the following would the presenter expect to include?
    1. All members of a cultural group are
    2. Intraethnic variations underscore a population’s cultural
    3. Ethnicity has a major impact on the effectiveness of health
    4. Ethnocentric attitudes are key to working with different Ans: B

Feedback:

Intraethnic variations, differences within microcultures, underscore the range of culturally diverse clients served by community health nurses. Subcultures and microcultures have their own distinctive characteristics even within fairly homogenous cultural groups. Culture, not ethnicity, has a major impact on the effectiveness of health care. Ethnocentric attitudes are to be avoided. All members of a cultural group are not alike. In general, individuals who are members of a specific culture are more alike than unlike but still not totally alike.

 

19. When applying the principles of transcultural nursing, which of the following must the nurse do first?
    1. Cultivate cultural sensitivity
    2. Develop cultural awareness
    3. Learn the client’s group culture
    4. Demonstrate respect for culture Ans: B

Feedback:

Applying the principles of transcultural nursing involves the following: (1) developing cultural self-awareness, (2) cultivating cultural sensitivity, (3) assessing the client group’s culture, (4) showing respect and patience while learning about other cultures, and (5) examining culturally derived health practices.

 

 

20. A community health nurse implements a plan of care that combines aromatherapy and acupuncture with medication therapy and The nurse is applying which of the following?
    1. Holistic health care
    2. Folk medicine care
    3. Herbalistic health care
    4. Integrated health care Ans: D

Feedback:

Integrated health care is defined as the combination of complementary therapies such as aromatherapy and acupuncture with biomedical or Western health care such as medication therapy and surgery. Holistic health care vies the world as being in harmonious balance in which all facets of the individual’s natures (physical, mental, emotional, and spiritual) must be in balance. Folk medicine involves treatment practices that have been handed down from generation to generation. Herbalism is the use of medicinal herbs.

 

21. A community health nurse is providing care to several cultural groups in the When providing transcultural nursing, which of the following would be the priority?
    1. Examining one’s own culture carefully and recognizing that alternative viewpoints are possible
    2. Recognizing that cultural values, beliefs, and practices influence people’s health and lifestyles
    3. Obtaining health-related information about a cultural group concerning their values, beliefs, and practices
    4. Actively and attentively listening to demonstrate respect while learning about other cultures

Ans:  A

Feedback:

The first step in providing transcultural nursing is to develop cultural self-awareness by examining one’s own culture carefully and recognizing that alternative viewpoints are possible. Next, the nurse would need to cultivate cultural sensitivity by recognizing that cultural values, beliefs, and practices influence people’s health and lifestyle. Then the nurse would assess the client group’s culture by obtaining health-related information and actively and attentively listening to demonstrate respect.

 

 

22. A community health nurse is assessing a family during a home The nurse is examining the mother who is pregnant with her second child. The nurse asks the mother to raise her arms above her head. The mother replies, “I can’t do this because it will cause the umbilical cord to strangle the baby.” The nurse interprets this statement as reflective of which of the following?
    1. Home remedy
    2. Herbalism
    3. Folk medicine
    4. Alternative therapy Ans: C

Feedback:

The mother’s statement reflects folk medicine, a body of preserved treatment practices that has been handed down verbally from generation to generation. One example is not reaching above your head if you are pregnant, because doing so will cause the umbilical cord to strangle the baby. Home remedies are caregiving practices passed down between families, for example, ice on a cold sore, baking soda paste on a bee sting. Herbalism involves the use of medicinal herbs. Alternative therapy or complementary therapy is designed to promote comfort, health, and well-being and includes, for example, aromatherapy, music therapy, acupuncture, and yoga.

 

23. When working with different cultural groups in the area of health care practices, the nurse acts as an effective advocate for the Which of the following must the nurse do first?
    1. Prepare to teach clients about the limits and benefits of cultural health practices
    2. Assess the client or family adequately to ascertain their belief system and choices
    3. Individualize caregiving for the client within his or her culture
    4. Be knowledgeable about health care practices and choices Ans: D

Feedback:

When working with different cultural groups in the area of health care practices, the community health nurse can be an effective advocate for the client. First, however, the nurse must be prepared to speak knowledgeably about health care practices and choices. The nurse also must be able to assess the client or family adequately so as to know what belief system motivates their choices. Finally, the nurse must be prepared to teach  clients about the limits and benefits of cultural health care practices. The community health nurse should always individualize assessment and caregiving for the client within his or her culture and should not generalize about the client based on cultural group norms.

 

 

24. When working with immigrant groups in community health care, which of the following would be least appropriate for the community health nurse to do?
    1. Permit ample time for interviewing to allow time to evaluate beliefs
    2. Develop educational programs to correct misconceptions
    3. Assume that the client has a basic understanding of health issues
    4. Ensure an appropriate interpreter for communication if needed Ans: C

Feedback:

When working with immigrant groups in the community, do not make assumptions  about a client’s understanding of health care issues; permit more time for interviewing; allow time to evaluate beliefs and provide appropriate interventions; provide educational programs to correct any misconceptions about health issues; provide an appropriate interpreter to improve communication with immigrants who do not speak English well.