Transcultural Nursing

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A female nurse asks an Afghan woman about her reason for
admission. The nurse should expect?
A. The patient to request a male nurse
B. The patient to allow her husband to answer the question D
C. The patient will avoid eye contact with the nurse
D. The patient to speak in story rich context, rather than providing
a brief answer
When observing an Afghan American interact with other people,
the nurse recognizes that the use of touch is based on:
A. How much they trust the person and amount of eye contact they
make A
B. Gender, race, and age
C. Social class and religion
D. Family relationships and gender
A nurse observes two Afghan women speak to each other in loud
voices. The nurse should:
A. Contact security because a fight maybe occur soon
B. Recognize that high-volume is a way that females show affec- B
tion in public
C. Tell the women to be quiet and not fight
D. Assess each woman for hearing problems
Afghan and Afghan-Americans orientation of time is considered
as...
A.Past
D
B.Present
C.Future
D.All of the above
When a nurse is caring for an Afghan or Afghan-American, it is
important to... SELECT ALL THAT APPLY
A. Not even bother with patient education, because they have no
desire to learn about health and wellness.
B. Allow the patient to continue with their spiritual rituals, such as
B,C,D
prayer 5 times daily.
C. Obtain a full patient history, paying careful attention to folk
medicinal remedies used by the patient.
D. Assess the patient for mental health issues such as depression
and suicidal thoughts.
Afghan-Americans have a high risk for developing... SELECT ALL
THAT APPLY
A.Diabetes
A, B
B.Asthma
C.Lupus
D.Crohn's
What barriers tend to keep African Americans from using health-
care services? (select all that apply)
a. Poverty
b. Discrimination A, B, C, D, E
c. Social barriers
d. Psychological barriers
e. Economic status

A Caucasian nurse is caring for a 27 year-old client and is becom-

ing frustrated due to the client pronouncing words incorrectly and
not talking grammatically correct. What action should the nurse
take?
a. Understand that Black English is different than Standard Eng- A
lish, try to understand as much as possible
b. Avoid conversing with the patient
c. Send another nurse in to speak with the patient
d. Correct the patient each time you hear him speak in a way that

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is grammatically incorrect
e. Ignore it
When working with an African American patient that is polychron-
ic, what are some important things to remember? (select all that
apply)
a. They tend to collect activities
A,C,D
b. Believe there is a specific order to getting things done
c. Very involved
d. Do not believe there is a specific order to getting things done
e. Enjoy sitting still and working on a specific activity
According to folk medicine, an African American pt. may consider
natural illness as resulting from which of the following? (select all
that apply)
a. Food
A,C,D
b. Evil spells
c. Water
d. Air
e. Dirt
The time orientation of African American individuals...
a. is always past
b. is either past or present
D.
c. can vary but is usually past
d. differs depending on personal experience
e. is almost always future but can be either past or present
A nurse caring for a 1 day-old African American baby notices
blue-green spots on the infant's sacral area. What actions should
the nurse perform? (select all that apply)
a. Accuse the parents of abusing their newborn due to the bruising
on the infant B,C
b. Recognize the spots as Mongolian Spots
c. Document the findings in the infant's chart
d. Notify the physician immediately
e. Cover the spots with moisturizing ointment
What distinctions categorize the Appalachian region from the rest
of America? (select all that apply)
A. Poverty
B. Banjos A,C,D
C. Lack of Education
D. Lack of Urbanization
E. Plentiful Jobs
Which state is not part of the Appalachian region?
A. Kentucky
B. Virginia C
C. Kansas
D. Alabama
When caring for a patient that is from Appalachia, the nurse should
consider that the patient will have:
A. No family come to visit
C
B. Only close family come to visit
C. All members of the family come to visit
D. Only the spouse come to visit
Common cuisine eaten by the Appalachian culture include: (select
all that apply)
A. Seared & Blackened Filet Mignon
B. Country Sausage Gravy
B,C,E,F
C. Biscuits
D. Garlic-Parsley Flavored Escargot
E. Mustard Greens
F. Black Eyed Peas with Bacon

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What time orientation do the Appalachians follow?
A. Past over present
B. Future over present C
C. Present
D. Past over present
What is the disease that is caused by exposure of high levels of
cotton, flax, or hemp dust?
A. Black Lung
C
B. Red Lung
C. Brown Lung
D. Green Lung
While collecting data for an initial visit with an Eastern India
Hindu American couple, the nurse attempts to directly ask the wife
about her health. The women avoids eye contact and the husband
becomes very defensive. Why might this be?
C
A. The nurse is not a male
B. The nurse asked the wrong question regarding health
C. The nurse asked the question to the wife
D. The nurse made direct eye contact
The nurse has an Eastern India Hindu American patient and has
found it difficult to provide care because the patient typically has
5-15 guests at a time and the room gets very crowded. What is
the best nursing intervention for this patient?
A. Ask the family to guests to leave and tell the patient she can
only have 2-3 guests within a certain time frame
D
B. Add more chairs in the patient's room for the family and friends
to sit and relax
C. Clear out unneeded objects like the patients shrine and praying
area
D. While providing care politely ask the guests to step out of the
room except for father or husband
When communicating with an Eastern India Hindu American who
recently learned English as their second language, what nursing
interventions for this patient? Select all that apply.
A. Use gestures to communicate words A,B,D
B. Use visual aids
C. Speak loudly and very slow
D. Obtain a translator if necessary
Hindu culture includes many traditions. They typically inhabit a
"beings-in-becoming" mindset, and believe that present actions
have large impacts on the future. Because of this, the nurse should
recognize that Hindus are...
A. Present oriented E
B. Past oriented
C. Future oriented
D. A & C
E. All of the above
When getting report on a new Hindu patient, the nurse notes
that he bathes daily due to his religion. After breakfast, the nurse
enters with bath supplies and tells the patient it is time to get
washed up. He refuses and asks her to return at a later time. What
would be the nurse's best response?
B
A. "Every patient on this unit bathes after breakfast"
B. "We can reschedule for later today. What time would accommo-
date your needs?"
C. "Good hygiene is a very important part of health"
D. "Why don't you want to bathe now?"
Which diseases might the nurse want to be hyper-aware of when
caring for a patient with Indian Hindu descent? Select all that
apply.
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A. G-6-PD deficiency
B. Thalassemia
C. Diabetes A,B,D,E
D. Lactose intolerance
E Stroke
What do Filipino Americans value most?
A. Work
B. Family B
C. Friends
D. Money
A nurse is caring for a Filipino American patient and needs to
explain that the person's diagnosis is terminal. Who should the
nurse tell about the diagnosis first?
C
A. The patient
B. The priest
C. The family
. The nurse is caring for a Filipino American pt that is 6 months
pregnant. What meal would the patient most likely eat?
A. Pancakes with a side of prunes
D
B. Squid and a salad
C. Chicken with a piece of cake for desert
D. Soup and rice
Your patient is Filipino American and has hypertension and coro-
nary artery disease. Which food item that your patient picks shows
they understand the modifications to their condition?
A. Bread rolls and canned tomato soup C
B. Rice and bok choy with soy sauce
C. White chicken breast with broccoli
D. Cheese pizza with carrots
You are discussing treatment plans with a Filipino American Pa-
tient. What types of care are included in this culture?
A.Western medicine
B. Folk medicine
C. Eastern medicine
D. Both A and B
What specific diseases are Filipino Americans susceptible to?
SATA
A. Coronary artery disease
B. Hypertension A,B,C
C. Diabetes
D. Cushing's disease
E. Grave's disease
When speaking with Haitian-American clients, a nurse may want
to use which of the following communication techniques: (Select
all that apply)
A. Speak in direct language
A,B,E
B. Use many hand gestures
C. Avoid eye contact
D. Avoid touch
E. Use touch and eye contact
Which of the following would a nurse NOT implement when giving
care to Haitian American patients?
A. Close, personal communication
D
B. Involve family (if pt wishes) in pt's care
C. Ensure adequate health education
D. Distance when providing care
Which of the following best describes the language in Haiti?
A. Haitian Creole is only spoken by the highly elite.
B. Haitian Creole is a combination of old French and African
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languages.
C. French is spoken as the dominant language by commoners.
B
D. Haitian Creole is the spoken language, but French is the written
language.
How do Haitian Americans in the lower class view time? Select all
that apply.
A.Past and present oriented
A,C
B.Present and future oriented
C.Live day to day
D.Plan for the future
What is important to keep in mind regarding religion when taking
care of Haitian Americans?
A.Voodoo is their primary religion and believe a voodoo "reader"
can bring a spirit to cure them
B.Christianity is a dominant religion and they may want to talk to A
a pastor
C.Judaism is practiced and they need kosher meals
D.Due to their religion, the gender of health care providers has to
be the same as the patient
What are some illnesses that Haitian Americans are more prone
to contracting? Select all that apply.
A.Hypertension
B.Malaria A,B,C,E
C.Sickle cell disease
D.Chicken pox
E.AIDS
A patient is a 26 year old Irish American female. She has lower
right quadrant pain and rebound tenderness. She is told that
surgery will be needed to remove her appendix. Which response
most likely reflects the patient's concern ?

A. "How long will recovery be? I can't be away from my family for A
very long. They need
me !"
B. "How much pain will I be in?"
C. "Will I need a blood transfusion?"
D. "Will the doctor be a woman?"
A 36 year old Irish female is admitted to the unit, and they have
several family members in the room. The nurse feels that the
client's family members are overbearing and disruptive to the
client. After the nurse encourages the client to set boundaries with
their family members, the client expresses that they do not wish
to do so. The nurse should respond in which way ?

A. Tell the patient their family must leave because they are disrup-
tive to their health care. B
B. Recognize that the hierarchy of the patient's family is important
to them and use cultural competence to respect the patient's
wishes.
C. Tell the patient that they do not understand what is best for
themselves and continue to explain which boundaries need to be
set.
D. Confront the patient's family members directly since the patient
will not set boundaries on their own.

A 45 year old Irish American man rates his pain at a 0 on a 0-10

scale. The nurse notices that he grimaces while he is sitting down,
and occasionally she sees him rub his right lower back and hip.
The nurse asks for clarification about the client's back and hip,
and he states "it's not really pain, it's just a throbbing and burning
that runs down my right side." The nurse recognizes that
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A. The client is not in pain because he said what he is feeling is

not pain.
B. The client is exaggerating symptoms. D
C. The client lacks the vocabulary to state that he is in pain.
D. The client is in pain, and his pain should be treated in accor-
dance with his symptoms.
In a time of mourning a loved one, many prayers are recited. What
is the beaded piece of jewelry that the Irish Americans pray with
called?
A. medal of saints C
B. guardian angel pin
C. rosary
D. engagement ring
Irish Americans have many physical biological variations but they
also have psychological characteristics. What are those psycho-
logical characteristics? SATA.
A. Alcoholism
A,C,D
B. Autism
C. Schizophrenia
D. Bipolar disorders
E. Obsessive Compulsive Disorder
Irish Americans believe that what happens to them in life happens
outside of their control. What is this thinking called?
A. Internal locus of control
C
B. Upside down locus of control
C. External locus of control
D. The Circle of Life
While working on a pediatric unit, a nurse has a Jewish patient that
is 4 years old. She realizes that the following is a normal practice
in this culture:
A. Verbally abuse their child for getting sick
B. Tell the nurse that the child has been behaving badly and that C
is why he got sick
C. Plan for someone to stay with the child at all times while he is
in the hospital
D. Plan for the child to be alone while in the hospital
A nurse is preparing to deliver a food tray to a Jewish client. The
nurse checks the food on the tray and notes that the client has
received hamburger and whole milk as a beverage. Which is the
appropriate action for the nurse?
A.Ask the dietary department to replace the hamburger with C
crabs.
B.Replace the whole milk with fat-free milk.
C.Call the dietary department ask for a new meal tray.
D.Deliver the designated food tray to the client.
Which of the following combinations should be avoided when
caring for a conservative Orthodox Jewish patient?
A.A female nurse caring for a male patient
B
B.A male nurse caring for a female patient
C.A male nurse caring for a male patient
D.A male doctor caring for a female patient
You are the nurse of a Jewish Orthodox woman in labor with her
first child. What is a value to consider with the mother?
A.Keeping the placenta
C
B.Blood transfusions
C.Modesty
D.Having the family present

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Jewish people are known to identify with which sense of time?
A.Past
B.Present D
C.Present & Future
D.Past, Present, & Future
What is true of Jewish American culture?
A. Feel emotions intensely
B. May openly complain of pain or discomfort D
C. Generally on time to appointments
D. All of the above
When gathering information from a Japanese American, it is
important to do what?
A. Greet them through touch
B.
B. Build a personal relationship
C. Ask direct questions
D. Maintain eye contact
You are taking care of a Japanese American child with the mother
in the room. The mother begins aggressively coughing, but when
asked if she is okay, she replies that she's more concerned about
her child's health. What should you do?
A
A. Remind her that her health is important too
B. Continue assessing the child
C. Acknowledge that something is wrong, but don't press it
D. Ask her again more firmly
Your Japanese American patient is at greater risk for which of
these conditions? Choose all that apply.
A. Glaucoma
A,B,C,D
B. HTN
C. Type 2 DM
D. Colorectal cancer
What do Japanese American believe cause disease or illness?
Select all that apply.
A. Contact with polluting agents such as blood, corpses, and skin
diseases A,B,D
B. Disharmony with family or society
C. Certain foods such as soft boiled rice and miso soup
D. Imbalance such as a lack of sleep or exercise
You are caring for a Japanese American patient. Which of the
following forms of communication should you expect your patient
to use?
A. Direct eye contact C
B. Frequent touch
C. Subtle gestures and facial expressions
D. Constant verbal communication
Which of the following does NOT describe the family system of a
Japanese American?
A. Frequent expression of emotions among family members
B. Father or male figure makes all decisions A
C. Family obligations take precedence over personal desires
D. Achievements and accomplishments of an individual member
are a reflection of the entire family
When a Mexican American pt is admitted on your floor, you should
expect:
A. No visitors, privacy is important
D
B. Visitors of the same sex
C. Only close relatives
D. Friends and family of the patient
How should you greet someone who is Mexican-American?
A. Say hello
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B. Don't greet them at all
C. Shake their hand A
D. Do not make eye contact and introduce yourself
What should you do if your patient is embarrassed to be naked in
front of you? SATA
A. Assure them that you will only uncover what is necessary
B. Tell them that their opinion is invalid A,B,D,E
C. Say it is normal to be embarrassed
D. Ask them how they would be comfortable
E. Make sure they have a nurse that is the same sex
In regards to death and dying, the Mexican American culture
believes that dying is a result of:
A. Being a bad person
C
B. Natural Causes
C. God's will
D. Not honoring your family
When scheduling an appointment for a Mexican American pt who
is present oriented, you can expect which of the following? SATA
A. They may be late to the appointment
B. They won't come to the appointment because they simply don't
care about their health A,C,D
C. They will need frequent reminders
D. They may need education on why follow up appointments are
so important
E. They will be 10 minutes early
In regards to social organization of the Mexican American Family,
which of the following is NOT true?
A. Male is the head of the household
B. Extended families live together in one house C
C. The elderly are primarily taken care of by members outside of
the family
D. Behavior in children is a direct reflection of family
A Mexican American Adolescent states to the nurse, "I have
cancer because it is God's will. It will make me stronger." The
MOST appropriate response by the nurse is:
A. "You're too young to think that way. You still have many years to
live." B
B. "Tell me how you feel about the treatment plan."
C. "I'll move your family into the waiting area to give you some
quiet time."
D. "I'll contact the hospital chaplain for you."
A nurse who is caring for a patient with an external locus of control
can anticipate which of the following?
A. The pt will desire help to control health and illness outcomes.
B. The patient is more likely to feel in control of events that affect
him or her D
C. The patient will expect to be able to modify behaviors to reach
health goals
D. The patient will be more likely to be fatalistic about nature and
illness
Mexican Americans tend to subscribe to which of the following
beliefs?
A. Hot and cold/wet and dry
A
B. Yin and yang/light and dark
C. Smooth and dark
D. Black and white

A nurse preparing patient teaching for hypertensive medication to

a Nigerian man can expect which of the following outcomes?
a. The client will always take medication on time

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b. The client may be non-compliant in taking medications on time
c. The client will avoid folk medicine that may interfere with pre-
scription B
d.The client will not include family members in reminding them to
take medication
Illness in the Nigerian culture is often treated first by which of the
following?
a. Clinics and doctors
B
b. Herbalists and traditional healers
c. Surgeons
d. Physical therapy
Nigerians believe that illness is: (Select all that apply)
a. A natural occurrence from disharmony in an area of one's life
b. A crisis that affects the whole family A,B,D
c. Only related to physical health
d. An imbalance in spiritual life as a result of witchcraft/voodoo
The nurse is providing discharge instructions to a Nigerian Amer-
ican client regarding prescribed dietary modifications. The nurse
is knowledgeable the patient of this cultural might do what?
a. Often turn away from the nurse and remain quiet/shy.
C
b. Sit as far away possible from the nurse.
c. Have a number of family members present with them when
health care is provided.
d. Maintain eye contact the entire time.
When doing a skin assessment on a Nigerian American, the nurse
should be aware of the following.
a. A black-skinned person appears ashen gray
b. Erythema and inflammation are assessed by palpating for in-
creased warmth of skin, edema, tightness, or induration of skin.
A,B,C
c. Jaundice should be observed in the sclerae of their eyes, oral
mucous membrane, palms of the hands, and soles of the feet for
yellow discoloration
d. There are no differences between light and dark-skinned peo-
ple.
The nurse interacting with a Nigerian American should follow
which guidelines for communicating in a culturally competent
manner? (Select all that apply.)
a. Establish primary languages first and assess need for qualified
interpreters.
b. Will need to get an interpreter, because their official language A,C,D,E
is not English.
c. Adapt the physical examination to meet privacy and modesty
needs.
d. Allow enough time for storytelling and long histories.
e. Avoid a hurried, impatient, or distracted demeanor
The nurse knows the biological variations makes Nigerian Amer-
ican more susceptible to which diseases? (select all that apply.)
a. Diabetes
b. Lactose Intolerance B,C,D,E
c. Alzheimer's Disease
d. AIDS (HIV)
e. Hypertension
What is the typical occupation of an Amish male?
A. Stays at home while wife is bread winner of family
B. Works in a factory C
C. Is a farmer
D. Baker

Among the Amish population, what disease/health conditions are

most prominent? SATA

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A. Obesity
B. Asthma
C. Hypertension A,C,D
D. Diabetes
E. Anemia
Based on what you know of the Amish culture, which statement is
correct?
A. The Amish culture uses birth control
B
B. They believe that death is God's will
C. They want to be apart of the world
D. They believe that divorce is okay
Where do the Amish people originate from?
A. Lancaster County, PA
B. Switzerland B
C. France
D. Germany
What is the Ordnung?
A. What the call their Bible
B. A set of written rules that is specific for every community
C. A set of rules that is the same for all Amish people in every D
settlement
D. A set of unwritten rules made by the community and Bishop,
specific to each community
How can a nurse provide good care for Amish pts? SATA
A. Introducing her/himself with a firm handshake when s/he enters
the room for the first time
B. Describing the medical options for the pt, the pros and cons A,B,D
C. Talking primarily to the mother about the health care decisions
that need to be made
D. Explaining costs before doing the procedure.
What are three common foods in Russian culture?
A. Salmon, deviled eggs, and potatoes
B. Meat pies, beef stew, and pickled foods D
C. Potatoes, bread and fish
D. borscht, beef stroganoff and pelmeni
As the nurse, what should you keep in mind when caring for a
Russian American patient? (Select all that apply)
A. Warm and inviting
B. Open posture A,B,D,E
C. Avoid eye contact
D. Avoid chattiness
E. Evaluate pt for understanding
What spacial zone do Russian Americans use for friends?
a. Intimate
b. Personal B
c. Work
d. social/public
When discussing care options with a Russian American while
family is present, who should the nurse expect to talk to?
a. The patient
C
b. The father of the patient
c. The family and the patient together
d. The mother of the patient

Which problems are common among Russians? (Select all that

apply)
a. Type II Diabetes A,B,D,E
b. Obesity
c. Cushing's Syndrome

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d. Tuberculosis
e. Alcoholism
What methods of care would a Russian American be most likely
to accept? (Select all that apply)
a. Massages for aching muscles
b. Metoprolol for hypertension A,C,D
c. Dry heat for back pain
d. Gargling salt and baking soda for a sore throat
e. Breathing treatments for pneumonia

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