Chapter 27: Family, Social, Cultural, and Religious Influences on Child Health Promotion Nursing School Test Banks

Chapter 27: Family, Social, Cultural, and Religious Influences on Child Health Promotion

MULTIPLE CHOICE

1. What type of family is one in which all members are related by blood?

a.

Consanguineous

c.

Family of origin

b.

Affinal

d.

Household

ANS: A

A consanguineous family is one of the most common types and consists of members who have a blood relationship. The affinal family is one made up of marital relationships. Although the parents are married, they may each bring children from a previous relationship. The family of origin is the family unit that a person is born into. Considerable controversy has been generated about the newer concepts of families (i.e., communal, single-parent or homosexual families). To accommodate these other varieties of family styles, the descriptive term household is frequently used.

PTS: 1 DIF: Cognitive Level: Knowledge REF: 732

OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

2. The nurse is teaching a group of new parents about the experience of role transition. Which statement by a parent indicates a correct understanding of the teaching?

a.

My marital relationship can have a positive or negative effect on the role transition.

b.

If an infant has special care needs, the parents sense of confidence in their new role is strengthened.

c.

Young parents can adjust to the new role more easily than older parents.

d.

A parents previous experience with children makes the role transition more difficult.

ANS: A

If parents are supportive of each other, they can serve as positive influences on establishing satisfying parental roles. When marital tensions alter caregiving routines and interfere with the enjoyment of the infant, the marital relationship has a negative effect. Infants with special care needs can be a significant source of added stress. Older parents are usually more able to cope with the greater financial responsibilities, changes in sleeping habits, and reduced time for each other and other children. Parents who have previous experience with parenting appear more relaxed, have less conflict in disciplinary relationships, and are more aware of normal growth and development.

PTS: 1 DIF: Cognitive Level: Application REF: 732

OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

3. A 3-year-old girl was adopted immediately after birth. The parents have just asked the nurse how they should tell the child that she is adopted. Which guideline concerning adoption should the nurse use in planning her response?

a.

Telling the child is an important aspect of their parental responsibilities.

b.

The best time to tell the child is between ages 7 and 10 years.

c.

It is not necessary to tell the child who was adopted so young.

d.

It is best to wait until the child asks about it.

ANS: A

It is important for the parents not to withhold information about the adoption from the child. It is an essential component of the childs identity. There is no recommended best time to tell children. It is believed that children should be told young enough so they do not remember a time when they did not know. It should be done before the children enter school to keep third parties from telling the children before the parents have had the opportunity.

PTS: 1 DIF: Cognitive Level: Analysis REF: 734

OBJ: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance

4. The mother of a school-age child tells the school nurse that she and her spouse are going through a divorce. The child has not been doing well in school and sometimes has trouble sleeping. The nurse should recognize this as:

a.

Indicative of maladjustment.

b.

Common reaction to divorce.

c.

Suggestive of lack of adequate parenting.

d.

Unusual response that indicates need for referral.

ANS: B

Parental divorce affects school-age children in many ways. In addition to difficulties in school, they often have profound sadness, depression, fear, insecurity, frequent crying, loss of appetite, and sleep disorders. Uncommon responses to parental divorce include indications of maladjustment, the suggestion of lack of adequate parenting, and the need for referral.

PTS: 1 DIF: Cognitive Level: Application REF: 735

OBJ: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity

5. A mother brings 6-month-old Eric to the clinic for a well-baby checkup. She comments, I want to go back to work, but I dont want Eric to suffer because Ill have less time with him. The nurses most appropriate answer is:

a.

Im sure hell be fine if you get a good babysitter.

b.

You will need to stay home until Eric starts school.

c.

You should go back to work so Eric will get used to being with others.

d.

Lets talk about the child care options that will be best for Eric.

ANS: D

Lets talk about the child care options that will be best for Eric is an open-ended statement that will assist the mother in exploring her concerns about what is best for both her and Eric. Im sure hell be fine if you get a good babysitter, You will need to stay home until Eric starts school, and You should go back to work so Eric will get used to being with others are directive statements and do not address the effect of her working on Eric.

PTS: 1 DIF: Cognitive Level: Application REF: 738

OBJ: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity

6. Which term best describes a group of people who share a set of values, beliefs, practices, social relationships, law, politics, economics, and norms of behavior?

a.

Race

c.

Ethnicity

b.

Culture

d.

Social group

ANS: B

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 perceptions and judgments. Race is defined as a division of humankind that possesses traits transmissible by descent and sufficient to characterize it as a distinct human type. Ethnicity is an affiliation of a set of persons who share a unique cultural, social, and linguistic heritage. A social group consists of systems of roles carried out in groups. Examples of primary social groups include the family and peer groups.

PTS: 1 DIF: Cognitive Level: Knowledge REF: 748

OBJ: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity

7. Which term best describes the emotional attitude that ones own ethnic group is superior to others?

a.

Culture

c.

Superiority

b.

Ethnicity

d.

Ethnocentrism

ANS: D

Ethnocentrism is the belief that ones way of living and behaving is the best way. This includes the emotional attitude that the values, beliefs, and perceptions of ones 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 include ethnicity.

PTS: 1 DIF: Cognitive Level: Comprehension REF: 746

OBJ: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity

8. The Vietnamese mother of a child being seen in the clinic avoids eye contact with the nurse. Considering cultural differences, the best explanation for this is that the parent:

a.

Feels responsible for her childs illness.

b.

Feels inferior to nurse.

c.

Is embarrassed to seek health care.

d.

Is showing respect for nurse.

ANS: D

In some ethnic groups eye contact is avoided. In the Vietnamese culture an individual may not look directly into the nurses eyes as a sign of respect. The nurse providing culturally competent care would recognize that the mother does not feel responsible for her childs illness, she does not feel inferior to the nurse, and she is not embarrassed to seek health care as reasons for the mother to avoid eye contact with the nurse.

PTS: 1 DIF: Cognitive Level: Analysis REF: 748

OBJ: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity

9. Health beliefs vary among the cultural groups living in the United States. The belief that health is a state of harmony with nature and the universe is common in which culture?

a.

Japanese

c.

Native American

b.

African-American

d.

Hispanic American

ANS: C

Many cultures ascribe attributes of health to natural forces. Many individuals of the Native American culture view health as a state of harmony with nature and the universe. This belief is not consistent with Japanese, African-American, or Hispanic American cultural groups.

PTS: 1 DIF: Cognitive Level: Comprehension REF: 747

OBJ: Nursing Process: Planning MSC: Client Needs: Psychosocial Integrity

10. 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. What would best explain this?

a.

The parent is trying to feed child only what child likes most.

b.

The parent is trying to restore normal balance through appropriate hot remedies.

c.

Hispanics believe that the evil eye enters when a person gets cold.

d.

Hispanics believe that an innate energy called chi is strengthened by eating soup.

ANS: B

In several groups, including Filipino, Chinese, Arabic, and Hispanic cultures, hot and cold describe certain properties completely unrelated to temperature. Respiratory conditions such as pneumonia are cold conditions and are treated with hot foods.

This may be true, but it is unlikely that a toddler would consistently prefer the broth to Jell-O, Popsicles, and juice. The evil eye applies to a state of imbalance of health, not curative actions. Chinese individuals believe in chias an innate energy.

PTS: 1 DIF: Cognitive Level: Application REF: 747

OBJ: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity

11. The nurse discovers welts on the back of a Vietnamese child during a home health visit. The childs mother says that she has rubbed the edge of a coin on her childs oiled skin. The nurse should recognize that this is:

a.

Child abuse.

b.

A cultural practice to rid the body of disease.

c.

A cultural practice to treat enuresis or temper tantrums.

d.

A child discipline measure common in the Vietnamese culture.

ANS: B

A cultural practice to rid the body of disease is descriptive of coining. The welts are created by repeatedly rubbing a coin on the childs oiled skin. The mother is attempting to rid the childs body of disease. The mother was engaged in an attempt to heal the child. This behavior is not child abuse, a cultural practice to treat enuresis or temper tantrums, or a disciplinary measure.

PTS: 1 DIF: Cognitive Level: Comprehension REF: 743

OBJ: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity

12. The father of a hospitalized child tells the nurse, He cant have meat. We are Buddhist and vegetarians. The nurses best intervention is to:

a.

Order the child a meatless tray.

b.

Ask a Buddhist priest to visit.

c.

Explain that hospital patients are exempt from dietary rules.

d.

Help the parent understand that meat provides protein needed for healing.

ANS: A

It is essential for the nurse to respect the religious practices of the child and family. The nurse should arrange a dietary consultation to ensure that nutritionally complete vegetarian meals are prepared by the hospital kitchen. The nurse should be able to arrange for a vegetarian tray. The nurse should not encourage the child and parent to go against their religious beliefs. Nutritionally complete, acceptable vegetarian meals should be provided.

PTS: 1 DIF: Cognitive Level: Application REF: 744

OBJ: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity

13. In which cultural group is good health considered to be a balance between yin and yang?

a.

Asians

c.

Native Americans

b.

Australian aborigines

d.

African-Americans

ANS: A

In Chinese health beliefs, the forces termed yin and yang must be kept in balance to maintain health. This belief is not consistent with Australian aborigines, Native Americans, or African-Americans.

PTS: 1 DIF: Cognitive Level: Comprehension REF: 746

OBJ: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity

14. A young child from Mexico is hospitalized for a serious illness. The father tells the nurse that the child is being punished by God for being bad. The nurse should recognize this as:

a.

A health belief common in this culture.

b.

An early indication of potential child abuse.

c.

A misunderstanding of the familys common beliefs.

d.

A belief common when fortune tellers have been used.

ANS: A

A common health belief in the Mexican-American cultural group is that health is controlled by the environment, fate, and the will of God. This comment has no relation to child abuse. The father would not misunderstand the familys beliefs. This is a cultural belief. Mexicans may use the services of curanderos (healers), not fortune tellers.

PTS: 1 DIF: Cognitive Level: Application REF: 747

OBJ: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity

MULTIPLE RESPONSE

15. 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 factor(s) may be culturally determined (Select all that apply)?

a.

Degree of competition

b.

Racial variation

c.

Determination of status

d.

Social roles

e.

Geographic boundaries

ANS: A, C, D

Each of these factors is determined by the assumptions, beliefs, and practices of the members of the culture. In cultures that value individual resourcefulness, competition would be acceptable. Status is culturally determined and varies according to each culture. Some ascribe higher status to age or socioeconomic status. Social roles also are influenced by the culture. Race and culture are two distinct attributes. The racial grouping describes transmissible traits, whereas the 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. It is not the boundaries that are culturally determined.

PTS: 1 DIF: Cognitive Level: Analysis REF: 739

OBJ: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity

16. A nurse is working in a clinic that serves a culturally diverse population of children. The nurse should plan care, understanding that the following complementary and alternative practices may be used by this patient population(Select all that apply):

a.

Seeking another doctors opinion

b.

Seeking advice from a curandero or curandera

c.

Using acupuncture or acupressure as a therapy

d.

Consulting an herbalist

e.

Consulting a kahuna

ANS: B, C, D, E

The curandero (male) or curandera (female) of the Mexican-American community is believed to have healing powers that are a gift from God. The Asian family may consult an herbalist, knowledgeable in medicines, or perhaps a specialized practitioner of Asian therapies, including acupuncture (insertion of needles) or acupressure (application of pressure). Native Hawaiians consult kahunas and practice hooponopono to heal family imbalance or disputes. The nurse may encounter use of these practices. Consulting another doctor would not be a complementary or alternative practice expected in a culturally diverse population.

PTS: 1 DIF: Cognitive Level: Application REF: 747

OBJ: Nursing Process: Planning MSC: Client Needs: Psychosocial Integrity

17. A nurse is caring for an African-American child recently admitted to the hospital. The nurse should be aware of which broad cultural characteristics for this child when planning care (Select all that apply)?

a.

Silence may indicate a lack of trust.

b.

Maintaining constant eye contact may be viewed as aggressive.

c.

Self-care and folk medicine do not play a role in health care.

d.

Illness may be seen as the will of God.

e.

No importance is attached to nonverbal behavior.

ANS: A, B, D

A nurse should be aware of the African-American broad cultural characteristics, which include the following: initial eye contact shows respect; maintaining eye contact can be viewed as aggressive, silence may indicate a lack of trust, and illness may be seen as the will of God. Self-care and folk medicine are prevalent in this culture, and importance is placed on nonverbal behavior.

PTS: 1 DIF: Cognitive Level: Application REF: 746

OBJ: Nursing Process: Evaluation MSC: Client Needs: Psychosocial Integrity

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