Cultural Diversity/Ethics 1
Health equity ensures that:
A. “everyone has the same income and things as everyone else.”
B. “everyone has the same goals and dreams for the future as everyone else.”
C. “everyone has access to the same food as everyone else.”
D. “everyone has access to healthcare and quality of health.”
D. “everyone has access to healthcare and quality of health.”
The nurse is providing home care for a client who traditionally drinks herbal tea to treat an illness. How should the nurse respond to a request for the herbal tea?
A. "We do not allow our clients to drink herbal tea."
B. "Why in the world would you want to drink that stuff?"
C. "Let me check with the doctor to make sure it is okay to drink the tea with your medicines."
D. "I have to fill out a lot of forms that you will have to sign before I can do that."
C. "Let me check with the doctor to make sure it is okay to drink the tea with your medicines."
A nurse is caring for an older adult from a far eastern culture. How does the nurse demonstrate awareness of culturally competent care?
A. maintaining eye contact at all times
B. trying to speak louder than usual
C. using touch when communicating
D. establishing effective communication
D. establishing effective communication
Which of the following modes of value transmission is most likely to lead to confusion and conflict?
A. Modeling
B. Moralizing
C. Laissez-faire
D. Responsible choice
C. Laissez-faire
A nurse is caring for a client who is a celebrity in the area. A person claiming to be a family member inquires about the medical details of the client. The nurse reveals the information but later comes to find out that the person was not a family member. The nurse has violated:
A. veracity.
B. fidelity.
C. confidentiality.
D. autonomy.
C. confidentiality.
A nursing instructor has assigned a student to care for a client of Asian descent. The instructor reminds the student that personal space considerations vary among cultures. What personal space preferences are important for the student to consider when caring for this client?
A. People of Asian descent prefer some distance between themselves and others.
B. People of Asian descent commonly stand close to one another when talking.
C. People of Asian descent touch one another when sitting next to a familiar person.
D. People of Asian descent prefer direct eye contact when communicating.
A. People of Asian descent prefer some distance between themselves and others.
A nurse in a large metropolitan city enjoys working in a health clinic that primarily serves Russian clients. What does this statement imply about the nurse?
A. The nurse's knowledge and skills are not adequate to care for clients with acute illnesses.
B. The nurse respects and values providing culturally competent care.
C. The nurse is attempting to overcome cultural blindness.
D. This employment makes the nurse feel superior to a minority group of people.
B. The nurse respects and values providing culturally competent care.
The nurse is admitting a new client to the unit. The nurse notes that this client would need an alternate meal choice when the menu specified pork for a meal. Members of which cultural group might request an alternative meal choice?
A. Christian
B. Protestant
C. Muslim
D. Mormon
C. Muslim
While at lunch, a nurse heard other nurses at a nearby table talking about a client they did not like. When they asked him what he thought, he politely refused to join in the conversation. What value was the nurse demonstrating?
A. the importance of food in meeting a basic human need
B. basic respect for human dignity
C. men do not gossip with women
D. a low value on collegiality and friendship
B. basic respect for human dignity
Answer
A nursing instructor is teaching a class about ethical principles to a group of nursing students. The instructor determines that the education was successful when the students give what as an example of nonmaleficence?
A. protecting clients from a chemically impaired practitioner
B. performing dressing changes to promote wound healing
C. providing emotional support to clients who are anxious
D. administering pain medications to a client in pain
A. protecting clients from a chemically impaired practitioner
Which characteristic is used to describe racial categories?
A. Language
B. Skin color
C. Music preferences
D. Food likes and dislikes
B. Skin color
A nurse is providing care for a client from Cambodia. The nurse says, "You have to get up and walk whether you want to or not." This statement is an example of:
A. culture shock.
B. stereotyping.
C. cultural imposition.
D. cultural competence.
C. cultural imposition.
Personal space and distance is a cultural perspective that can impact nurse-client interactions. What is the best way for the nurse to interact physically with a client who has a different cultural perspective on space and distance?
A. Know the client's cultural personal space preferences.
B. Realize that sitting close to the client is an indication of warmth and caring.
C. Sit 3 to 6 ft (0.90 to 1.80 m) away from the client in an attempt to not offend.
D. Remember not to intrude into the personal space of the older adult.
A. Know the client's cultural personal space preferences.
A middle-aged man is having increasing difficulty breathing. He never exercises, eats fast food regularly, and smokes two packs of cigarettes a day. He tells the nurse practitioner that he wants to change the way he lives. What is one means of helping him change behaviors?
A. Ethical change strategy
B. Values neutrality choices
C. Values transmission
D. Values clarification
D. Values clarification
Answer
A nurse is caring for a client who is a practicing Jehovah's Witness. The physician orders two units of packed cells based on his low hemoglobin and hematocrit levels. The nurse states to the surgeon that it is unethical to go against the client's beliefs even though his blood counts are very low. What is the best description of the nurse's intentions?
A. acting in the client's best interest
B. siding with the client over the surgeon
C. observing institutional policies
D. being legally responsible
A. acting in the client's best interest
A 20-year-old housekeeper, born and educated in Iraq, wears the traditional clothing and head covering. A 50-year-old client tells the nurse, "They are in our country and should dress like we do."
In 1976, American anthropologist Edward T. Hall compared ____________ to an ____________.
“social norms, ocean”
“culture, iceberg”
“culture, ocean”
“customs, iceberg”
2. “culture, iceberg”
In which way can nurses develop cultural self-awareness?
A. Ask peers and colleagues about practicing cultural competence.
B. Objectively examine one's own beliefs, values, and practices.
C. Realize nothing can be done to change one's values and beliefs.
D. Assert to others that personal biases cannot be changed.
B. Objectively examine one's own beliefs, values, and practices.
A male nurse is preparing to take the vital signs of a female client. Which ethnic group would consider this improper?
A. Native American/First Nations
B. Arab Muslim
C. White
D. Black
B. Arab Muslim
A nurse using the principle-based approach to client care seeks to avoid causing harm to clients in all situations. What is this principle known as?
A. Nonmaleficence
B. Justice
C. Fidelity
D. Autonomy
A. Nonmaleficence
Answer
A nurse is caring for a woman 28 years of age who has delivered a baby by Cesarean section. She describes her pain as a 9. The nurse medicates her for pain. This is an example of which ethical framework?
A. Justice
B. Fidelity
C. Beneficence
D. Nonmaleficence
C. Beneficence
A nurse walks by a client's room and observes a shaman performing a healing ritual. The nurse remarks to a coworker that the ritual is a waste of time and disruptive to the other clients on the floor. What feelings is this nurse displaying?
A. Culture conflict
B. Cultural blindness
C. Stereotyping
D. Cultural shock
A. Culture conflict
A male client of Asian descent is operated on for gallstones. On the postoperative night, the nurse finds that the client is not sleeping and is tossing and turning. When asked about analgesics, the client denies having pain. Which nursing action is most appropriate?
A. believing that the client has no pain
B. assessing for nonverbal expressions of pain
C. inspecting the incision site for any abnormality
D. asking the client if he is feeling hungry
B. assessing for nonverbal expressions of pain
What is the term that describes the inability of a person to recognize his own values, beliefs, and practices as well as those of others, because of strong ethnocentric tendencies?
A. Acculturation
B. Cultural blindness
C. Cultural imposition
D. Stereotyping
B. Cultural blindness
A nurse provides client care within a philosophy of ethical decision making and professional expectations. What is the nurse using as a framework for practice?
A. Code of Ethics
B. Standards of Care
C. Definition of Nursing
D. Values Clarification
A. Code of Ethics
A home care nurse visits a client who is confined to bed and is cared for by a chemically dependence adult child. The home is cluttered and unclean and the nurse notes that the client is wet with urine, has dried feces on the buttocks, and signs of dehydration are present. After caring for the client, the nurse contacts the health care provider and reports the incident to Adult Protective Services. What ethical framework does the nurse determine is occurring?
A. Justice
B. Autonomy
C. Nonmaleficence
D. Fidelity
C. Nonmaleficence
A 40-year-old nurse is taking a health history from a Hispanic man aged 20 years. The nurse notes that he looks down at the floor when he answers questions. What should the nurse understand about this behavior?
A. The client is embarrassed by the questions.
B. This is culturally appropriate behavior.
C. The client dislikes the nurse.
D. The client does not understand what is being asked.
B. This is culturally appropriate behavior.
A client of English descent reports to the primary health care facility with symptoms of fever, cough, and running nose. While interviewing the client, which point should the nurse keep in mind?
A. Do not probe into emotional issues.
B. Do not ask very personal questions.
C. Sit at the other corner of the room.
D. Maintain eye contact while talking.
D. Maintain eye contact while talking.
A nurse in a physician's office has noted on several occasions that one of the physicians frequently obtains controlled-drug prescription forms for prescription writing. The physician reports that his wife has chronic back pain and requires pain medication. One day the nurse enters the physician's office and sees him take a pill out of a bottle. The doctor mentions that he suffers from migraines and that his wife's pain medication alleviates the pain. What type of nurse-physician ethical situation is illustrated in this scenario?
A. Unprofessional, incompetent, unethical, or illegal physician practice
B. Disagreements about the proposed medical regimen
C. Conflicts regarding the scope of the nurse's role
D. Claims of loyalty
A. Unprofessional, incompetent, unethical, or illegal physician practice
student nurse is working in the library on her plan of care for a clinical assignment. The client's name is written at the top of her plan. Which ethical responsibility is the student violating?
A. Confidentiality
B. Accountability
C. Trust
D. Informed consent
A. Confidentiality
A woman age 83 years who has suffered a cerebrovascular accident and is unable to swallow refuses the insertion of a feeding tube. This is an example of what ethical principle?
A. Nonmaleficence
B. Veracity
C. Autonomy
D. Justice
C. Autonomy
An older adult woman of Chinese ancestry refuses to eat at the nursing home, stating, "I'm just not hungry." What factors should the staff assess for this problem?
A. The woman does not like to eat with other residents of the home.
B. The woman is using this as a means of going home.
C. The food served may not be culturally appropriate.
D. The food served may violate religious beliefs.
C. The food served may not be culturally appropriate.
A client who has difficulty sleeping expresses to the nurse that watching television may help him relax and get sleep. The nurse disregards the client's concern and suggests drinking warm milk before going to bed. Which cultural characteristic is the nurse demonstrating?
A. Stereotype
B. Ethnocentrism
C. Racism
D. Relativity
B. Ethnocentrism
A client with a diagnosis of colorectal cancer has been presented with her treatment options, but wishes to defer any decisions to her uncle, who acts in the role of a family patriarch within the client's culture. The client's right to self-determination is best protected by:
A. respecting the client's desire to have the uncle make choices on her behalf.
B. revisiting the decision when the uncle is not present at the bedside.
C. educating the client about her right to autonomy.
D. holding a family meeting and encouraging the client to speak on her own behalf.
A. respecting the client's desire to have the uncle make choices on her behalf.
A nurse is concerned about the practice of routinely ordering an extensive series of laboratory tests for clients who are admitted to the hospital from a long-term care facility. An appropriate source in handling this ethical dilemma would be:
A. the client's family.
B. the admitting physician.
C. the nurse in charge of the unit.
D. the institutional ethics committee.
D. the institutional ethics committee.
Answer
A nurse states to the client that she will keep her free of pain. However, her family wishes to try a treatment to prolong her life that may necessitate withholding pain medication. This factor will cause an ethical dilemma for the nurse in relation to which ethical principle?
A. Fidelity
B. Veracity
C. Justice
D. Autonomy
A. Fidelity
All of the following are factors to consider when caring for clients with limited income. Which one is the most important?
A. Basic human needs may go unmet
B. Limited access to reliable transportation
C. Decreased access to health care services
D. Risk for increased incidence of disease
A. Basic human needs may go unmet
The client in a rehabilitation unit is having a difficult time adjusting to the scheduled activities on the unit, as well as being dependent on others for meals and medications. Which word best describes what the client is experiencing?
A. Anxiety
B. Disparity
C. Resolution
D. Shock
D. Shock
A male client age 56 years is experiencing withdrawal from alcohol and is placing himself at risk for falls by repeatedly attempting to scale his bedrails. Benzodiazepines have failed to alleviate his agitation and the nurse is considering obtaining an order for physical restraints to ensure his safety. The nurse should recognize that this measure may constitute:
A. paternalism.
B. deception.
C. harm.
D. advocacy.
A. paternalism.
A client is questioning the need for surgery. The client asks the nurse, "What should I do?" What answer by the nurse is based on advocacy?
A. "If I were you, I would not have this surgical procedure."
B. "You should ask some of the more experienced nurses this question."
C. "Tell me what reason you do not want the surgery."
D. "Let me talk to your doctor and I will let you know what is said."
C. "Tell me what reason you do not want the surgery."
The nurse is leading a discussion with a group of adolescents about what to do "if a friend shows you a gun at school in his backpack." The nurse is encouraging the adolescents to explore consequences of their actions for decisions made. What value transmission is the nurse demonstrating?
A. Modeling behavior
B. Laissez-faire approach
C. Rewarding and punishing
D. Responsible choice
D. Responsible choice
A nurse in the hospital is caring for a Native American/First Nations male. Which statement should best guide the nurse's care?
A. There is no concept of a nuclear family.
B. There is likely to be deep mistrust for the physician.
C. There may be a role for a tribal medicine man in the client's care.
D. The client is likely to expect immediate results of treatment
C. There may be a role for a tribal medicine man in the client's care.
When a labor and delivery nurse tells a coworker that a client of Asian decent probably did not want any pain medication because "Asian women typically are stoic," the nurse is expressing a belief known as what?
A. Stigma
B. Ethnic slur
C. Bias
D. Stereotype
D. Stereotype
A mother always thanks clerks at the grocery store. Her daughter, age 6 years, echoes her thank you. The child is demonstrating what mode of value transmission?
A. Modeling
B. Moralizing
C. Reward and punishment
D. responsible choice
A. Modeling
Answer
A client who is scheduled to have surgery for a hernia the next day is anxious about the whole procedure. The nurse assures the client that surgery for hernias is very common and that the prognosis is very good. What skills of the nurse are reflected here?
A. Imaginal skills
B. Interpersonal skills
C. Instrumental skills
D. Systems skill
B. Interpersonal skills
A nurse exemplifies the professional value of altruism. What behaviors recognized by others demonstrates this concept? (Select all that apply.)
A. The nurse arranges for an interpreter for a client that doesn't speak English.
B. The nurse notifies the health care provider that a client reports pain medication is ineffective.
C.
The nurse provides information for a client to participate in care planning.
D. The nurse reviews a client chart to determine who may be informed of the patient's condition.
E. The nurse documents client care accurately and reviews the entry to ensure there are no errors.
A. The nurse arranges for an interpreter for a client that doesn't speak English.
B. The nurse notifies the health care provider that a client reports pain medication is ineffective.
Which nurses are acting as an advocate for the client? (Select all that apply.)
A. The nurse informs the family of a terminally ill client that the client does not want further treatment and wants to go to hospice care.
B. The client is taking oxycodone/acetaminophen for pain and reports the pain is unrelieved. The nurse states, "There is nothing else we can do for your pain."
C. The postoperative client states he is unable to void in the urinal in bed. The client believes if he stands he will be able to void. The nurse assists the client to a standing position.
D. The primary care provider (PCP) informed the client about needing to have a surgical procedure performed. After the PCP left, the nurse asked the client, "What are you feeling after being told you need surgery?"
E. The stable client is hospitalized on a religious holy day and requests to talk to a minister. The nurse states to the client, "The ministers are too busy to see you today. I'll request the minister to see you tomorrow."
A. The nurse informs the family of a terminally ill client that the client does not want further treatment and wants to go to hospice care.
C. The postoperative client states he is unable to void in the urinal in bed. The client believes if he stands he will be able to void. The nurse assists the client to a standing position.
D. The primary care provider (PCP) informed the client about needing to have a surgical procedure performed. After the PCP left, the nurse asked the client, "What are you feeling after being told you need surgery?"
The new nurse is being oriented to the unit and is assigned an experienced nurse to work with during the orientation. What are positive modeling experiences for the new nurse? (Select all that apply.)
A. The nurse organizes the day by obtaining reports, completing assessments, charting the assessments, and administering 0900 medications starting at 0830.
B. The nurse does not respond to the call light of the client who frequently requests medications for unrelieved pain.
C. The nurse contacts the primary care provider to clarify a new prescription for a medication dose.
D. The nurse enters the room to administer medications and interrupts the hospice intake nurse providing information to a terminally ill client and family.
E. The experienced nurse tells the new nurse, "I do all my charting at the end of the shift. Point-of-care charting takes too much time away from my clients."
A. The nurse organizes the day by obtaining reports, completing assessments, charting the assessments, and administering 0900 medications starting at 0830.
C. The nurse contacts the primary care provider to clarify a new prescription for a medication dose.
A nurse has had, on several occasions, the opportunity to share personal prescriptions with family members when they were in need of pain medication or antibiotics. Which set of rules should govern this moral decision?
A. Ethics
B. Administrative law
C. Common law
D. Civil law
A. Ethics
Answer
A nurse working in a long-term care facility has an older adult male client who is very confused. Which ethical dilemma is posed when using restraints in a long-term care setting?
A. It limits personal safety.
B. It increases confusion.
C. It threatens autonomy.
D. It prevents self-directed care.
C. It threatens autonomy.
A nurse has a duty of nonmaleficence. Which of the following would be considered a contradiction to that duty?
A. providing comfort measures for a terminally ill client
B. assisting the client with ADLs
C. refusing to administer pain medication as ordered
D. providing all information related to procedures
C. refusing to administer pain medication as ordered