Cultural Competence
Which term describes the process where a minority group loses its unique cultural characteristics to fit into a dominant group?
A) Cultural shock B) Ethnocentrism C) Cultural assimilation
D) Cultural imposition
C) Cultural assimilation
Rationale: This is when a minority group slowly loses its own culture and starts following the dominant culture’s way of life.
What are the three universal spiritual needs common to all people, regardless of religious affiliation?
A) Prayer, fasting, and ritual B) Hope, worship, and baptism C) Meaning and purpose, love and relatedness, and forgiveness D) Guidance, sacred objects, and meditation
C) Meaning and purpose, love and relatedness, and forgiveness
Rationale: These are universal human needs that give people purpose, connection, and emotional healing.
Which factor is known to increase a patient's Basal Metabolic Rate (BMR)?
A) Prolonged fasting B) Sleep C) Infection and fever D) Aging
C) Infection and fever
Infection and fever increase BMR
Rationale: The body uses more energy during illness to fight infection.
Which device is appropriate for a patient who requires long-term enteral nutrition (typically longer than 4 weeks)?
A) Nasogastric (NG) tube B) Nasoenteric tube
C) Gastrostomy tube (PEG) D) Orogastric tube
C) Gastrostomy tube (PEG)
Rationale: PEG tubes are used for long-term feeding because they go directly into the stomach.
Gastrostomy (PEG) or jejunostomy (PEJ) devices are used for long-term nutritional support
Parenteral nutrition (TPN) is highly concentrated and hypertonic. Through which route must it be administered?
A) Nasogastric tube B) Peripheral IV line C) Central venous access device D) PEG tube
C) Central venous access device
Rationale: TPN is very concentrated and must go into a large vein to avoid damage.
TPN is a highly concentrated, hypertonic solution that must be administered via a central venous access device
A nurse believes their own ideas and practices are superior to those of others. This is an example of which barrier to diversity?
A) Stereotyping B) Ethnocentrism C) Implicit bias D) Cultural blindness
B) Ethnocentrism
Rationale: This means believing your own culture is better than others and judging others through your own cultural lens.
How is "faith" specifically defined in a spiritual context?
A) An organized system of beliefs about a higher power B) A confident belief in something for which there is no material proof C) A personal search for transcendence and peace D) A requirement to follow specific codes of conduct
B) A confident belief in something for which there is no material proof
Rationale: Faith means believing in something even when there is no physical proof.
A patient consumes 10 grams of carbohydrates. How many calories does this provide?
A) 40 calories B) 70 calories C) 90 calories D) 100 calories
A) 40 calories
Rationale: Carbohydrates provide 4 calories per gram (10 × 4 = 40).
A nurse uses a syringe to deliver 300 mL of formula over 30 minutes. Which feeding method is being used?
A) Continuous feeding B) Intermittent continuous feeding C) Bolus feeding D) Parenteral feeding
C) Bolus feeding
Rationale: Large amounts of formula are given at one time using a syringe.
A bolus involves delivering a specific volume (typically 200–400 mL) over a short window (15–60 mins) using a syringe
Which life-threatening complication of TPN is caused by overfeeding carbohydrates, resulting in a shift of electrolytes from extracellular to intracellular fluid?
A) Hyperlipidemia B) Refeeding syndrome C) Air embolism D) Liver disease
B) Refeeding syndrome
Rationale: Too much nutrition after starvation causes dangerous electrolyte shifts, especially low phosphorus.
When assessing a patient’s reaction to pain, which action is most appropriate for the nurse to take?
A) Assume the patient will openly express pain if it is severe. B) Encourage the patient to suppress emotions to maintain dignity. C) Respect the patient's right to respond to pain in their own manner. D) Use a family member as an interpreter to explain the pain level.
C) Respect the patient's right to respond to pain in their own manner.
Rationale: People express pain differently based on culture, personality, and experience. Nurses should not assume or judge how pain “should” look.
In the HOPE spiritual assessment tool, what does the "O" represent?
A) Outcomes of spiritual care B) Observations of sacred objects C) Organized religion D) Ongoing spiritual distress
C) Organized religion
Rationale: This part asks whether the patient follows a religion or spiritual system.
Which type of food is classified as an incomplete protein because it lacks one or more of the nine essential amino acids?
A) Beef B) Eggs C) Plant sources (excluding soy/quinoa) D) Dairy products
C) Plant sources (excluding soy/quinoa)
Rationale: Plant proteins often lack one or more essential amino acids.
Why does the nurse measure Gastric Residual Volume (GRV) before administering an enteral feeding?
A) To check if the tube is clogged B) To monitor the patient's tolerance to the feeding C) To determine if the patient needs additional water D) To prevent nasal erosion
B) To monitor the patient's tolerance to the feeding
Rationale: Measuring gastric residual volume (GRV) helps the nurse determine if the patient is tolerating the feeding or if it is remaining in the stomach
Due to its high sugar content and invasive administration, what is a major risk for patients receiving TPN?
A) Nasal erosion B) Infection and sepsis C) Constipation D) Vitamin K deficiency
B) Infection and sepsis
Rationale: TPN requires a central line, which increases infection risk.
TPN carries a high risk of infection due to its invasive administration and high sugar content, which promotes bacterial growth
According to federal requirements, which resource must a healthcare facility provide to effectively communicate with patients who have limited English proficiency?
A) A bilingual family member B) A staff member who speaks basic phrases C) A qualified interpreter D) Written brochures in the patient's language
C) A qualified interpreter
Rationale: Federal law requires trained interpreters to ensure accurate and safe communication, not family members or untrained staff.
A nurse is caring for a patient who is a Jehovah's Witness. Which medical intervention is this patient most likely to refuse based on religious freedom?
A) Organ transplantation B) Blood products C) Palliative sedation D) Enteral feedings
B) Blood products
Rationale: Many Jehovah’s Witnesses refuse blood transfusions due to religious beliefs
Which fat-soluble vitamin is primarily found in green leafy vegetables and liver?
A) Vitamin A
B) Vitamin D
C) Vitamin E
D) Vitamin K
D) Vitamin K
Rationale: Vitamin K is found in leafy greens and supports blood clotting.
What is the most serious risk associated with enteral feedings if the patient's head of bed is not elevated?
A) Diarrhea B) Aspiration C) Hyperglycemia D) Clogged tube
B) Aspiration
Rationale: Lying flat can cause food or formula to enter the lungs.
This is a serious complication of enteral feeding; keeping the head of the bed elevated is a critical safety measure
Which group is at the highest risk for food insecurity, characterized by lack of consistent access to nutritious food?
A) Married-couple households B) Single-parent homes and the elderly C) Individuals with BMI < 25 D) Patients on a ketogenic diet
B) Single-parent homes and the elderly
Single-parent homes, the elderly, and Black or Hispanic-headed households are at significantly higher risk for food insecurity
Which AACN competency for culturally competent care involves the nurse acting on behalf of marginalized populations to ensure equal access to health resources?
A) Apply knowledge of social factors B) Promote safe, high-quality outcomes C) Advocate for social justice D) Participate in cultural development
C) Advocate for social justice
Rationale: This means the nurse speaks up and works to ensure all patients have fair access to healthcare and resources.
Which manifestation would indicate a patient is experiencing spiritual distress?
A) Expressing interest in a spiritual counselor B) Resuming personal spiritual practices C) Feeling a sense of hope and purpose D) Questioning religious beliefs and feeling bitter
D) Questioning religious beliefs and feeling bitter
Rationale: Questioning beliefs and feeling anger or bitterness shows inner spiritual struggle.
Which nutrient is considered the body's primary energy source and should make up 45% to 60% of total daily calories?
A) Proteins B) Lipids (Fats) C) Carbohydrates D) Vitamins
C) Carbohydrates
Rationale: Carbs are the body’s main energy source and should make up the largest portion of daily intake.
Which complication is a common occurrence in patients receiving enteral feedings and may require a change in formula?
A) Thromboembolism B) Pneumothorax C) Diarrhea D) Sepsis
C) Diarrhea
Rationale: Enteral formulas can upset digestion and often cause loose stools
Which laboratory result is a key indicator of a patient's long-term nutritional status?
A) Blood glucose (70–100 mg/dL) B) Serum albumin (3.4–4.8 g/dL)
C) Hemoglobin (12–18 g/dL) D) Creatinine (0.6–1.2 mg/dL)
B) Serum albumin (3.4–4.8 g/dL)
Rationale: Albumin (normal: 3.4–4.8 g/dL) is a laboratory indicator used to assess long-term nutritional status
Albumin reflects long-term protein status and nutritional health.