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Test Bank for Cultural Diversity in Health and Illness 9th Edition by Spector
Cultural Diversity in Health and Illness, 7e (Spector)
Chapter 1 Building Cultural and Linguistic Competence
1) Which action would a hospital administrator take to meet the cultural and linguistic needs of Spanish-speaking community members?
1. Hire professional staff from different Spanish-speaking countries.
2. Ensure that all health care workers speak Spanish.
3. Ensure that all signage is posted in Spanish as well as English.
4. Ensure health services are in varying locations.
Answer: 1
Explanation: 1. Hiring professional staff from different Spanish-speaking countries would create a foundation for the variations in the language and culture of the different countries, and aid in providing cultural and linguistic competence to meet the health needs of this population.
2. Ensuring all health care workers speak Spanish would benefit this population, but does not necessarily guarantee that cultural and linguistic competence would result.
3. Spanish signage would aid with patient understanding, but this action also assumes that all of the patient population is literate.
4. Ensuring health services are in varying locations meets the needs of many populations, but is not necessarily a component of linguistic and cultural competence.
Cognitive Level: Applying
Patient Need: Psychosocial Integrity
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: LO02 - Describe the National Standards for Culturally and Linguistically Appropriate Services in Health Care.
2) On which criterion would the Human Resources manager focus when identifying interpreters to support the care of patients with limited English proficiency?
1. Proficient in health language terminology
2. Availability of family members
3. Be of the same ethnic background of the patients
4. Be on 24-hour call Answer: 1
Explanation: 1. Interpreters providing language assistance must be proficient in health language terminology in order to provide accurate information to a patient in their own language.
2. Family members are not to be used for language assistance or interpretation unless absolutely necessary, or on request by the patient, as they may not be able to provide objective impartial information.
3. While it is helpful to have the same ethnic background of the patients for whom language assistance is provided, it is not necessary.
4. An interpreter may not be able to be on 24-hour call, but back-up mechanisms should be in place to provide language assistance when a designated interpreter is not available.
Cognitive Level: Applying
Patient Need: Safe and Effective Care Environment Patient Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: LO02 - Describe the National Standards for Culturally and Linguistically Appropriate Services in Health Care.
3) A health care organization is incorporating culturally and linguistically appropriate services into the strategic plan. In which areas of the plan will these services be reflected? Select all that apply: 1. Goals
2. Policies
3. Operational plans
4. Management accountability
5. Internal audits
Answer: 1, 2, 3, 4
Explanation: 1. To support cultural and linguistically appropriate services, a health care organization needs to outline clear goals in the strategic plan.
2. To support cultural and linguistically appropriate services, a health care organization needs to outline policies within the strategic plan.
3. A health care organization needs to outline operational plans to support cultural and linguistically appropriate services within the strategic plan.
4. A health care organization needs to identify management accountability for cultural and linguistically appropriate services within the strategic plan.
5. Internal audits are used to evaluate culturally and linguistically appropriate services within a health care organization. Cognitive Level: Applying
Patient Need: Health Promotion and Maintenance
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: LO02 - Describe the National Standards for Culturally and Linguistically Appropriate Services in Health Care.
the family.
3. Health and illness can be interpreted and explained in terms of personal experience and expectations. A patient's current health status is not likely to be explained according to cost. 4. Health and illness can be interpreted and explained in terms of personal experience and expectations. A patient's current health status is not likely to be explained according to diagnosis. Cognitive Level: Analyzing
Patient Need: Health Promotion and Maintenance
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: LO01 - Discuss the underpinnings of the need for cultural and linguistic competence.
19) The nurse desires to become more culturally competent when providing care to patients from non-English- speaking cultures. Which action would the nurse take to achieve this selfexpectation?
1. Commit to a time-consuming journey.
2. Find a seminar on cultural competence.
3. Talk to people from different cultures.
4. Attend several festivals from different cultures.
Answer: 4
Explanation: 1. The reality of becoming culturally competent is a time-consuming process. 2. The development of cultural competency does not occur within a short encounter with a program on cultural diversity.
3. Developing cultural competency involves more than talking to people from different cultures.
4. Developing cultural competency involves initially attending festivals and meeting people from the given communities who are from a different culture.
Cognitive Level: Applying
Patient Need: Psychosocial Integrity
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: LO01 - Discuss the underpinnings of the need for cultural and linguistic competence.
20) The staff development educator is analyzing ways to incorporate cultural competency concepts in continuing education programs. How will the educator explain the concept of CULTURALCOMPETENCY to staff?
1. Philosophy
2. Condition
3. Theory
4. Fad
Answer: 1
Explanation: 1. CULTURALCOMPETENCY is a philosophy whereby one develops the skills to understand from where a person from a cultural background other than his or her own is coming.
2. CULTURALCOMPETENCY is not a condition. It is a philosophy whereby one develops the skills to understand where a person from where a different cultural background other than his or her own is coming.
3. CULTURALCOMPETENCY is not a theory. It is a philosophy whereby one develops the skills to understand where a person from where a different cultural background other than his or her own is coming.
4. CULTURALCOMPETENCY is not a fad. It is a philosophy whereby one develops the skills to understand where a person from where a different cultural background other than his or her own is coming.
Cognitive Level: Applying
Patient Need: Psychosocial Integrity
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: LO01 - Discuss the underpinnings of the need for cultural and linguistic competence.
21) A healthcare organization is planning continuing education for all staff on culturally and linguistically appropriate service delivery. Which category of culturally and linguistically appropriate services in healthcare will this action support?
1. Fundamentals of culturally competent care
2. Speaking of culturally competent care
3. Structuring culturally competent care
4. Manage the dynamics of difference
Answer: 1, 2, 3
Explanation: 1. Ensuring that staff receives ongoing education and training in culturally and linguistically appropriate service delivery is a part of the fundamentals of culturally competent care.
2. Ensuring that staff receives ongoing education and training in culturally and linguistically appropriate service delivery is a part of the fundamentals of culturally competent care. Speaking of culturally competent care focuses on language services and printed materials.
3. Ensuring that staff receives ongoing education and training in culturally and linguistically appropriate service delivery is a part of the fundamentals of culturally competent care. Structuring culturally competent care focuses on organizational assessments, community profiles, and conflict and grievance resolution processes.
4. Managing the dynamics of difference is a recommendation by the Joint Commission for cultural competency. Cognitive Level: Analyzing
Patient Need: Psychosocial Integrity
Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: LO02 - Describe the National Standards for Culturally and Linguistically Appropriate Services in Health Care.
22) Why would a healthcare organization maintain a current demographic, cultural, and epidemiological profile of the community?
1. Plan for services.
2. Correlate with health records.
3. Facilitate community involvement.
4. Advertise services. Answer: 1
Explanation: 1. Healthcare organizations would maintain a current demographic, cultural, and epidemiological profile of the community to accurately plan for services that respond to the cultural and linguistic characteristics of the service area.
2. Healthcare organizations would maintain a current demographic, cultural, and epidemiological profile of the community to accurately plan for services that respond to the cultural and linguistic characteristics of the service area. Health records should include patients' race, ethnicity, and language for integration into the organization's management information system.
3. Healthcare organizations would maintain a current demographic, cultural, and epidemiological profile of the community to accurately plan for services that respond to the cultural and linguistic characteristics of the service area. Partnerships facilitate community involvement.
4. Healthcare organizations would maintain a current demographic, cultural, and epidemiological profile of the community to accurately plan for services that respond to the cultural and linguistic characteristics of the service area. Public notices would be used to share information about progress and innovations when implementing culturally and linguistically appropriate services in healthcare.
Cognitive Level: Analyzing
Patient Need: Psychosocial Integrity
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: LO02 - Describe the National Standards for Culturally and Linguistically Appropriate Services in Health Care.
23) The nurse is unable to locate an interpreter to support a patient from a non-English-speaking background. The patient asks a family member to interpret for the staff. What would the nurse do to ensure culturally and linguistically appropriate services for this patient?
1. Use the family member as an interpreter until a non-family member can be located.
2. Write the questions down for the patient to answer.
3. Do nothing until an interpreter can be located.
4. Use sign language. Answer: 1
Explanation: 1. Family and friends should not be used to provide interpretation services except on request by the patient or consumer.
2. The patient is from a non-English-speaking culture and most likely would not understand the written questions.
3. The patient's health status could be in jeopardy if nothing is done until an interpreter is located.
4. Using sign language is not an appropriate method to communicate with the patient. Hand gestures mean different things to different people.
Cognitive Level: Applying
Patient Need: Psychosocial Integrity
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: LO02 - Describe the National Standards for Culturally and Linguistically Appropriate Services in Health Care.
24) A patient from a non-English-speaking background comes into the health clinic seeking care.
The nurse is unable to determine the patient's primary language. What should the nurse do?
1. Ask for help to determine the patient's primary language.
2. Encourage the patient to seek care elsewhere.
3. Notify Security.
4. Contact a homeless shelter.
Answer: 1
Explanation: 1. To avoid discrimination based on national origin, Title VI of the Civil Rights Act of 1964 requires that reasonable steps be taken to provide meaningful access to people with limited English proficiency.
2. To avoid discrimination based on national origin, Title VI of the Civil Rights Act of 1964 requires that reasonable steps be taken to provide meaningful access to people with limited English proficiency. Therefore, services cannot be denied.
3. To avoid discrimination based on national origin, Title VI of the Civil Rights Act of 1964 requires that reasonable steps be taken to provide meaningful access to people with limited English proficiency. Therefore, services cannot be denied. There is no reason to notify Security. 4. To avoid discrimination based on national origin, Title VI of the Civil Rights Act of 1964 requires that reasonable steps be taken to provide meaningful access to people with limited English proficiency. Therefore, services cannot be denied. There is no reason to contact a homeless shelter. Cognitive Level: Applying
Patient Need: Psychosocial Integrity
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: LO03 - Describe institutional mandates regarding cultural and linguistic competence.
25) In a non-English-speaking patient's medical records, it is indicated that he has no family. However, several people arrived in the critical care unit and stated that they are the patient's family. What impact does this miscommunication have on the patient's care?
1. Poor decision-making
2. Increase the cost
3. Improve the outcomes
4. Enhance therapeutic communication
Answer: 3
Explanation: 1. Language barriers can cause poor, abbreviated, or erroneous communication and poor decision making on the part of both the provider and patient.
2. Language barriers can cause poor, abbreviated, or erroneous communication and poor decision making on the part of the provider and patient. It has not been documented that language barriers increase the cost for health care.
3. Language barriers can cause poor, abbreviated, or erroneous communication and poor decision making on the part of the provider and patient. Language barriers will improve the patient's outcomes once overcome.
4. Language barriers can cause poor, abbreviated, or erroneous communication and poor decision making on the part of the provider and patient. Language barriers do not enhance therapeutic communication.
Cognitive Level: Analyzing
Patient Need: Psychosocial Integrity
Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: LO03 - Describe institutional mandates regarding cultural and linguistic competence.
26) The nurse working in a Joint Commission—accredited organization is admitting a patient from a non-English-speaking background. Which action supports the Joint Commission principle of effective communication? 1. Assess communication needs
2. Value diversity
3. Manage the dynamics of difference
4. Adapt to diversity
Answer: 1
Explanation: 1. Assessing communication needs is a Joint Commission principle to support cultural competency in health care.
2. Valuing diversity is an organizational action to ensure cultural competence.
3. Managing the dynamics of difference is an organizational action to ensure cultural competence.
4. Adapting to diversity is an organizational action to ensure cultural competence.
Cognitive Level: Applying
Patient Need: Psychosocial Integrity
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: LO03 - Describe institutional mandates regarding cultural and linguistic competence.
27) The nurse is completing a survey that includes questions about different aspects of cultural competence. What is the purpose of this survey?
1. Assessment of cultural competence
2. Manage the dynamics of difference
3. Value diversity
4. Institutionalize cultural knowledge
Answer: 1
Explanation: 1. The Joint Commission recognizes that cultural competence requires organizations and personnel to assess themselves with regards to cultural competence.
2. The Joint Commission recognizes that cultural competence requires organizations and personnel to assess themselves with regards to cultural competence. Managing the dynamics of difference would be achieved through a different strategy.
3. The Joint Commission recognizes that cultural competence requires organizations and personnel to assess themselves with regards to cultural competence. Valuing diversity would be achieved through a different strategy.
4. The Joint Commission recognizes that cultural competence requires organizations and personnel to assess themselves with regards to cultural competence. Institutionalizing cultural knowledge would be achieved through a different strategy.
Cognitive Level: Analyzing
Patient Need: Psychosocial Integrity
Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: LO03 - Describe institutional mandates regarding cultural and linguistic competence.
28) The nurse is planning care to address health care needs for a non-English-speaking patient and family. What would the nurse use as a guide for this care?
1. Checklist
2. Standardized care plan
3. Nursing textbook
4. Care map Answer: 1
Explanation: 1. The Joint Commission has created checklists for activities to address patient- and family-centered care.
2. A standardized care plan may or may not address the cultural needs of the patient and family.
3. A nursing textbook may or may not address the cultural needs of the patient and family.
4. A care map may or may not address the cultural needs of the patient and family.
Cognitive Level: Applying
Patient Need: Psychosocial Integrity
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: LO03 - Describe institutional mandates regarding cultural and linguistic competence.
29) Unlicensed assistive personnel (UAP) ask the nurse to explain the difference between CULTURALCARE and other types of care. What would the nurse say in response to the UAP?
1. It is holistic.
2. It is a fad.
3. It focuses on scientific theory.
4. It is a belief system.
Answer: 1
Explanation: 1. CULTURALCARE is holistic care.
2. CULTURALCARE is not a fad.
3. CULTURALCARE does not focus on scientific theory.
4. CULTURALCARE is not a belief system.
Cognitive Level: Applying
Patient Need: Psychosocial Integrity
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: LO04 - Articulate the attributes of CULTURALCOMPETENCY and CULTURALCARE.
30) The nurse is struggling with providing culturally competent care to non-English-speaking patients because the organization does not have any resources to support the patients' care needs. What is this nurse experiencing?
1. Dissonance
2. Compromise
3. Confusion 4. Distress
Answer: 1
Explanation: 1. Dissonance is when a practitioner provides culturally and linguistically competent care that is not in harmony with the organization's beliefs and practices.
2. Dissonance is when a practitioner provides culturally and linguistically competent care that is not in harmony with the organization's beliefs and practices. Compromise is not a term used to describe culturally competent care.
3. Dissonance is when a practitioner provides culturally and linguistically competent care that is not in harmony with the organization's beliefs and practices. Confusion is not a term used to describe culturally competent care.
4. Dissonance is when a practitioner provides culturally and linguistically competent care that is not in harmony with the organization's beliefs and practices. Distress is not a term used to describe culturally competent care. Cognitive Level: Analyzing
Patient Need: Psychosocial Integrity
Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: LO04 - Articulate the attributes of CULTURALCOMPETENCY and CULTURALCARE.
31) The nurse is disappointed with not being able to provide educational materials in a nonEnglish-speaking patient's primary language. What can the nurse do to serve as an advocate when providing culturally competent care?
1. Find or create materials to meet the patients' needs.
2. Teach the patient in English.
3. Provide educational materials written in English.
4. Ask the physician to talk with the patient.
Answer: 1
Explanation: 1. Cultural competence is a learning process. Healthcare providers need to serve as patient advocates, and not advocates of the organization or modern health care.
2. Cultural competence is a learning process. Healthcare providers need to serve as patient advocates, and not advocates of the organization or modern health care. Teaching the patient in English is not providing culturally competent care.
3. Cultural competence is a learning process. Healthcare providers need to serve as patient advocates, and not advocates of the organization or modern health care. Providing educational materials written in English is not providing culturally competent care.
4. Cultural competence is a learning process. Healthcare providers need to serve as patient advocates, and not advocates of the organization or modern health care. Asking the physician to talk with the patient is not providing culturally competent care.
Cognitive Level: Applying
Patient Need: Psychosocial Integrity
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: LO04 - Articulate the attributes of CULTURALCOMPETENCY and CULTURALCARE.
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