Chapter 7: Cultural and Pharmacogenetic Considerations Nursing School Test Banks

Kee: Pharmacology, 7th Edition

Chapter 7: Cultural and Pharmacogenetic Considerations

Test Bank

MULTIPLE CHOICE

1. A nurse conversing with a client is aware that the majority of the message may be nonverbal in some clients from which culture?

a.

Asian

b.

African American

c.

Latino

d.

European

ANS: A

Clients of Asian cultures may be more comfortable with longer periods of silence than clients of other cultures.

DIF: Cognitive Level: Comprehension REF: pp. 118-119

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Psychosocial Integrity: Cultural Diversity

2. The nurse is caring for a client with type 1 diabetes. The nurse is aware that this illness requires scheduled meals, blood glucose monitoring, and medications. Which of the following cultural traits may provide the greatest challenge to health maintenance?

a.

Focus on health and well-being

b.

Lack of emphasis on time and routine

c.

Belief in a higher being

d.

Personal philosophy of self-care

ANS: B

Because of the time-related tasks associated with diabetes (e.g., meals, injections, and assessing blood glucose levels), it may be difficult to manage diabetes in clients who have a lack of emphasis on time and regular meals.

DIF: Cognitive Level: Application REF: p. 119

TOP: Nursing Process: Assessment

MSC: CONTENT CATEGORY: Psychosocial Integrity: Cultural Diversity

3. The client is being admitted to the hospital for a surgical procedure. He lives with his spouse and 11 children, all of whom are younger than 18 years. What should the nurse recognize may be a major concern for this client?

a.

A need for increased verbal communication from the nurse

b.

A change in the social organization of his family

c.

Insecurity because he is used to a more dense living area

d.

Lack of modesty in the semiprivate hospital room

ANS: C

The client who is accustomed to a more dense living area may feel insecure in the hospital room alone or with only one other client, as in a semiprivate room.

DIF: Cognitive Level: Analysis REF: p. 119

TOP: Nursing Process: Assessment

MSC: CONTENT CATEGORY: Psychosocial Integrity: Cultural Diversity

4. The nurse is caring for a client who is of Filipino descent. He arrived at the hospital with his entire extended family, who indicated that they intended to remain in his room to assist in his care. What should be the highest priority action on the part of the nurse?

a.

Call the physician for an order to limit the number of family members allowed in the room.

b.

Ask the client to ask his family members to limit themselves to only two in the room.

c.

Ask the nurse manager to be present when the nurse explains the situation to the family.

d.

Recognize that this is a behavior that may be part of the Filipino culture.

ANS: D

In general, the Filipino culture expects that family members will stay at a clients bedside and participate in his or her care.

DIF: Cognitive Level: Analysis REF: p. 119

TOP: Nursing Process: Assessment

MSC: CONTENT CATEGORY: Psychosocial Integrity: Cultural Diversity

5. The nurse is caring for a client who is a member of the local Hispanic community. The client asks if she can see her traditional healer while she is hospitalized. What is the most appropriate response from the nurse?

a.

Yes, we can certainly arrange for you to see the healer while youre here.

b.

Yes, but only with one of the nurses or your physician present.

c.

No, Im afraid that Security wouldnt allow that to happen.

d.

No, we cant include someone like that in your plan of care.

ANS: A

Members of some cultures may ask for a traditional healer to be included in the plan of care, and this request should be accommodated whenever possible.

DIF: Cognitive Level: Analysis REF: p. 120

TOP: Nursing Process: Assessment

MSC: CONTENT CATEGORY: Psychosocial Integrity: Cultural Diversity

6. The nurse is caring for an African-American client who is scheduled to be treated with a beta-blocker medication. The nurse should recognize that this client may:

a.

have a hyperactive response to this medication.

b.

develop a hypersensitivity reaction to this medication.

c.

respond poorly to treatment with this medication.

d.

develop multiple side effects in response to this medication.

ANS: C

African Americans may respond poorly to beta-blocker medications.

DIF: Cognitive Level: Application REF: p. 120

TOP: Nursing Process: Assessment

MSC: CONTENT CATEGORY: Psychosocial Integrity: Cultural Diversity

7. The nurse is caring for several clients. Which client is most likely to be found to have a low calcium level?

a.

56-year-old Vietnamese man

b.

38-year-old Hispanic woman

c.

25-year-old African-American man

d.

70-year-old Caucasian man

ANS: B

Hispanic clients may have lactose intolerance, thus resulting in a low calcium level.

DIF: Cognitive Level: Application REF: pp. 120-121

TOP: Nursing Process: Assessment

MSC: CONTENT CATEGORY: Psychosocial Integrity: Cultural Diversity

8. The nurse is caring for a postoperative 35-year-old Asian man. What should the nurse expect the clients pain level to be?

a.

Greater than usual, since he may not respond well to the pain medication

b.

Less than usual, since he responds exceptionally well to the pain medication

c.

Greater than usual, since he will tend to have a reaction to the pain medication

d.

Less than usual, since his stoicism will cause him to require less pain medication

ANS: A

Asian clients may have a decreased therapeutic response to codeine.

DIF: Cognitive Level: Analysis REF: pp. 120-121

TOP: Nursing Process: Assessment

MSC: CONTENT CATEGORY: Psychosocial Integrity: Cultural Diversity

9. The nurse is caring for a 62-year-old African-American woman who has been placed on Coumadin. The nurse should expect the clients response to this medication to be:

a.

greater than usual; she may respond exceptionally well to the medication.

b.

less than usual; she will probably have a decreased therapeutic effect.

c.

greater than usual; she should be monitored closely for bleeding irregularities.

d.

less than usual; she will tend to experience a hypersensitivity reaction.

ANS: B

African-American clients will tend to have a decreased therapeutic effect from Coumadin.

DIF: Cognitive Level: Analysis REF: pp. 120-121

TOP: Nursing Process: Assessment

MSC: CONTENT CATEGORY: Psychosocial Integrity: Cultural Diversity

MULTIPLE RESPONSE

1. A nurse is assessing a clients cultural background. What is part of this assessment? (Select all that apply.)

a.

Communication patterns

b.

Orientation to time

c.

Organizational skills

d.

Social organization

e.

Work ethic

f.

Biological variations

ANS: A, B, D, F

These are the components that need to be assessed. Organizational skills and work ethic are more related to personality type than to culture.

DIF: Cognitive Level: Application REF: p. 119

TOP: Nursing Process: Assessment

MSC: CONTENT CATEGORY: Psychosocial Integrity: Cultural Diversity

Copyright 2012, 2009, 2006, 2003 by Saunders, an imprint of Elsevier Inc.

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