Chapter 5: Cultural and Spiritual Concepts Relevant to Psychiatric/Mental Health Nursing Nursing School Test Banks

Chapter 5: Cultural and Spiritual Concepts Relevant to Psychiatric/Mental Health Nursing

Multiple Choice

1. An African American youth, growing up in an impoverished neighborhood, seeks affiliation with a black gang. Soon he is engaging in theft and assault. What cultural consideration should a nurse identify as playing a role in this youths choices?
1. Most African American homes are headed by strong, dominant father figures.
2. Most African Americans choose to remain within their own social organization.
3. Most African Americans are uncomfortable expressing emotions and seek out belonging.
4. Most African Americans have few religious beliefs, which contributes to criminal activity.

ANS: 2
Rationale: The nurse should identify that a tendency to remain within ones own social organization may have played a role in the youths choice to join a black gang. African Americans who have assimilated into the dominant culture are likely to be well educated and future focused. Those who have not assimilated may be unemployed or have low-paying jobs and view their future as hopeless, given their previous encounters with racism and discrimination.

Cognitive Level: Application
Integrated Process: Assessment

2. Northern European Americans value punctuality, hard work, and the acquisition of material possessions and status. A nurse should recognize that these values may contribute to which form of psychopathology?
1. Dissociative disorders
2. Alzheimers dementia
3. Stress-related disorders
4. Schizophrenia-spectrum disorders

ANS: 3
Rationale: The nurse should correlate many Northern European American values, such as punctuality, hard work, and acquisition of material possessions, with stress-related disorders. Psychopathology may occur when individuals fail to meet the expectations of the culture.

Cognitive Level: Application
Integrated Process: Assessment

3. A community health nurse is planning a health fair at a local shopping mall. Which middle-class socioeconomic cultural group should the nurse anticipate would most value preventive medicine and primary health care?
1. Northern European Americans
2. Native Americans
3. Latino Americans
4. African Americans

ANS: 1
Rationale: The community health nurse should anticipate that Northern European Americans, especially those who achieve middle-class socioeconomic status, place the most value on preventative medicine and primary health care. This value is most likely related to this groups educational level and financial capability. Many members of the Native American, Latino American, and African American subgroups value folk medicine practices.

Cognitive Level: Application
Integrated Process: Planning

4. Which rationale by a nursing instructor best explains why it is challenging to globally classify the Asian American culture?
1. Extremes of emotional expression prevent accurate assessment of this culture.
2. Suspicion of Western civilization has understandably resulted in minimal participation in cultural research.
3. The small size of this subpopulation makes research virtually impossible.
4. The Asian American culture includes individuals from Japan, China, Vietnam, Korea, and other countries.

ANS: 4
Rationale: The nursing instructors best explanation is that the Asian American culture is difficult to classify globally because of the number of countries that identify with this culture. The Asian American culture includes peoples and descendents from Japan, China, Vietnam, the Philippines, Thailand, Cambodia, Korea, Laos, India, and the Pacific Islands. Within this culture there are vast differences in values, religious practices, languages, and attitudes.

Cognitive Level: Application
Integrated Process: Assessment

5. A Latin American woman refuses to participate in an assertiveness training group. Which cultural belief should a nurse identify as most likely to affect this clients decision?
1. Future orientation causes the client to devalue assertiveness skills.
2. Decreased emotional expression makes it difficult to be assertive.
3. Assertiveness techniques may not be aligned with the clients definition of the female role.
4. Religious prohibitions prevent the clients participation in assertiveness training.

ANS: 3
Rationale: The nurse should identify that the Latin American womans refusal to participate in an assertiveness training group may be affected by the Latin American cultural definition of the female role. Latin Americans place a high value on the family, which is male dominated. The father usually possesses the ultimate authority.

Cognitive Level: Application
Integrated Process: Evaluation

6. A Latin American man refuses to acknowledge responsibility for hitting his wife, stating instead, Its the mans job to keep his wife in line. Which cultural belief should a nurse associate with this clients behavior?
1. That families are maledominated, with clear male-female role distinctions.
2. That religious tenets support the use of violence in a marital context.
3. That the nuclear family is female-dominated and the mother has ultimate authority.
4. That marriage dynamics are controlled by dominant females in the family.

ANS: 1
Rationale: The nurse should associate the cultural belief that families are maledominated, with clear male-female role distinctions with the clients abusive behavior. The father in the Latin American family usually has the ultimate authority.

Cognitive Level: Application
Integrated Process: Evaluation

7. When working with clients of a particular culture, which action should a nurse avoid?
1. Making direct eye contact
2. Assuming that all individuals who share a culture or ethnic group are similar
3. Supporting the client in participating in cultural and spiritual rituals
4. Using an interpreter to clarify communication

ANS: 2
Rationale: The nurse should avoid assuming that all individuals who share a culture or ethnic group are similar. This action constitutes stereotyping and must be avoided. Within each culture, many variations and subcultures exist. Clients should be treated as individuals.

Cognitive Level: Application
Integrated Process: Implementation

8. To effectively plan care for Asian American clients, a nurse should be aware of which cultural factor?
1. Obesity and alcoholism are common problems.
2. Older people maintain positions of authority within the culture.
3. Tai and chi are the fundamental concepts of Asian health practices.
4. Asian Americans are likely to seek psychiatric help.

ANS: 2
Rationale: To effectively care for Asian American clients, the nurse should be aware that older people in this culture maintain positions of authority. Obesity and alcoholism are low among Asian Americans. The balance of yin and yang is the fundamental concept of Asian health practices. Psychiatric illness is often believed to be out-of-control behavior and would be considered shameful to individuals and families.

Cognitive Level: Application
Integrated Process: Planning

9. A Native American client is admitted to an emergency department (ED) with an ulcerated toe, secondary to uncontrolled diabetes mellitus. The client refuses to talk to a physician unless a shaman is present. Which nursing intervention is most appropriate?
1. Try to locate a shaman that will agree to come to the ED.
2. Explain to the client that voodoo medicine will not heal the ulcerated toe.
3. Ask the client to explain what the shaman can do that the physician cannot.
4. Inform the client that refusing treatment is a clients right.

ANS: 1
Rationale: The most appropriate nursing intervention would be to try to locate a shaman that will agree to come to the ED. The nurse should understand that in the Native American culture, religion, and health-care practices are often intertwined. The shaman, a medicine man, may confer with physicians regarding the care of a client. Research supports the importance of both health-care systems in the overall wellness of Native American clients.

Cognitive Level: Application
Integrated Process: Implementation

10. When planning client care, which folk belief that may affect health-care practices should a nurse identify as characteristic of the Latino American culture?
1. The root doctor is often the first contact made when illness is encountered.
2. The yin and yang practitioner is often the first contact made when illness is encountered.
3. The shaman is often the first contact made when illness is encountered.
4. The curandero is often the first contact made when illness is encountered.

ANS: 4
Rationale: The nurse should understand that it is characteristic of Latin American culture for a client to contact a curandero when illness is initially encountered. The curandero is the folk healer who is believed to have a gift from God for healing the sick. Treatments often include supernatural rituals, prayers, magic, practical advice, and indigenous herbs.

Cognitive Level: Application
Integrated Process: Planning

11. In what probable way should a nurse expect an Asian American client to view mental illness?
1. Mental illness relates to uncontrolled behaviors that bring shame to the family.
2. Mental illness is a curse from God related to immoral behaviors.
3. Mental illness is cured by home remedies based on superstitions.
4. Mental illness is cured by hot and cold herbal remedies.

ANS: 1
Rationale: The nurse should except that many Asian Americans are most likely to view mental illness as uncontrolled behavior that brings shame to the family. In addition, it is often more acceptable for mental distress to be expressed as physical ailments.

Cognitive Level: Application
Integrated Process: Assessment

12. Which cultural considerations should a nurse identify as reflective of Western European Americans?
1. They are present-time oriented and perceive the future as Gods will.
2. They value youth, and older adults are commonly placed in nursing homes.
3. They are at high risk for alcoholism, because of a genetic predisposition.
4. They are future oriented and practice preventive health care.

ANS: 1
Rationale: The nurse should identify that most Western European Americans are present oriented and perceive the future as Gods will. Older adults are held in positions of respect and are often cared for in the home instead of in nursing homes.

Cognitive Level: Application
Integrated Process: Assessment

13. A nurse should recognize that clients who have a history of missed or late medical appointments are most likely to come from which cultural group?
1. African Americans
2. Asian Americans
3. Native Americans
4. Jewish Americans

ANS: 3
Rationale: The nurse should recognize that Native American clients might have a history of missed or late medical appointments. Many Native Americans are not ruled by the clock. The concept of time is casual and focused on the present.

Cognitive Level: Application
Integrated Process: Assessment

Multiple Response

14. When interviewing a client of a different culture, which of the following questions should a nurse consider? (Select all that apply.)
1. Would using perfume products be acceptable?
2. Who may be expected to be present during the client interview?
3. Should communication patterns be modified to accommodate this client?
4. How much eye contact should be made with the client?
5. Would hand shaking be acceptable?

ANS: 2, 3, 4, 5
Rationale: When interviewing a client from a different culture, the nurse should consider who might be with the client during the interview, modifications of communication patterns, amount of eye contact, and hand-shaking acceptability. Given that cultural influences affect human behavior, its interpretation, and another persons response, it is important for nurses to understand the effects of these cultural influences to work effectively with diverse populations.

Cognitive Level: Application
Integrated Process: Implementation

15. A female nurse is caring for an Arab American male client. When planning effective care for this client, the nurse should be aware of which of the following cultural considerations? (Select all that apply.)
1. Limited touch is acceptable only between members of the same sex.
2. Conversing individuals of this culture stand far apart and do not make eye contact.
3. Devout Muslim men may not shake hands with women.
4. The man is the head of the household, and women take on a subordinate role.
5. Men of this culture are responsible for the education of their children.

ANS: 1, 3, 4
Rationale: When planning effective care for this client, the nurse should be aware that limited touch in this culture is acceptable only between members of the same sex, that devout Muslim men may not shake hands with women, and that women are subordinate to the man, who is the head of household. Conversing individuals of this culture stand close together and maintain eye contact. Arab American women are responsible for the education of children.

Cognitive Level: Application
Integrated Process: Planning

16. In which of the following cultural groups should a nurse expect to find assessment of mood and affect most challenging, owing to the characteristics of the groups? (Select all that apply.)
1. Arab Americans
2. Native Americans
3. Latino Americans
4. Western European Americans
5. Asian Americans

ANS: 2, 5
Rationale: The nurse should expect that both Native Americans and Asian Americans may be difficult to assess for mood and affect. In both cultures, expressing emotions is difficult. Native Americans are encouraged to not communicate private thoughts. Asian Americans may have a reserved public demeanor and may be perceived as shy or uninterested.

Cognitive Level: Application
Integrated Process: Assessment

17. A nursing instructor is developing a lesson plan to teach about the Northern European American culture. Which of the following information should be included? (Select all that apply.)
1. About half of first marriages end in divorce in this cultural group.
2. This cultural group does not use preventive medicine and primary health care.
3. Punctuality and efficiency are highly valued in this cultural group.
4. This cultural group tends to be future oriented.
5. A typical diet of this cultural group includes rice, vegetables, and fish.

ANS: 1, 3, 4
Rationale: With the advent of technology and widespread mobility, less emphasis has been placed on the cohesiveness of the family in the Northern European American culture. Data on marriage, divorce, and remarriage in the United States show that about half of first marriages end in divorce. Northern European Americans, particularly those who achieve middle-class socioeconomic status, value preventive medicine and primary health care. Punctuality and efficiency are highly valued in the culture that promoted the work ethic, and most within this cultural group tend to be future oriented. A typical diet for many Northern European Americans is high in fats and cholesterol and low in fiber.

Cognitive Level: Application
Integrated Process: Assessment

18. The United States, viewed as a melting pot of multiple worldwide ethnic groups, has its own unique culture that impacts the health and care of individuals. Which of the following are characteristics common to the U.S. culture? (Select all that apply.)
1. The culture values independence, self-reliance, and determining ones life.
2. There is a strong emphasis on achievement in jobs, sports, and physical beauty.
3. Constructive criticism is considered personally offensive.
4. The culture favors structured and formal behaviors, speech, and relationships with others.
5. Overconsumption of food in this culture leads to increased obesity and decreased health.

ANS: 1, 2, 5
Rationale: Independence, self reliance, and determining ones life describes the characteristic of individuality. Strong emphasis on achievement in jobs, sports, and physical beauty describes the characteristic of perfectionism. Constructive criticism is considered helpful for others in the U.S. culture. General behaviors, speech, and relationships with others are informal. There is common use of first names when addressing others. The overconsumption of food, leading to increased obesity and decreased health relates to the characteristic of consumerism.

Cognitive Level: Application
Integrated Process: Assessment

Fill-in-the-Blank

19. ___________________ exists within each individual, regardless of belief system, and serves as a force for interconnectedness between the self and others, the environment, and a higher power.

ANS: Spirituality
Rationale: Spirituality exists within each individual, regardless of belief system, and serves as a force for interconnectedness between the self and others, the environment, and a higher power. Spirituality is the human quality that gives meaning and sense of purpose to an individuals existence.

Cognitive Level: Application
Integrated Process: Assessment

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