Test Bank For Transcultural Nursing Assessment and Intervention, 6th Edition

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Giger & Davidhizar: Transcultural Nursing: Assessment andIntervention, 6th EditionCompetency Test1. Which of these cultural phenomena are among those considered essential and areevidenced among all cultural groups?1. Communication.2. Space.3. Social organization.4. Time.5. Environmental control.6. Biological variations.A. 1, 3, and 6 only.B. 2, 4, and 5 only.C. 1, 3, 5, and 6 only.D. 1, 2, 3, 4, 5, and 6.2. Which of these factors are among those essential in communication assessment?1. Dialect.2. Style.3. Volume.4. Touch.5. Context of speech.6. Kinesics.A. 1, 3, and 5 only.B. 2, 4, and 6 only.C. 1, 2, 3, 5, and 6 only.D. 1, 2, 3, 4, 5, and 6.3. Which of these factors associated with communication differs among cultural groupsand is usually most closely linked to geographic location?A.Volume.B. Dialect.C. Language style.D.Kinesics.*Developed by Giger and Davidhizar and refined byAnne Williams, PhD, RN; M. GailHill, PhD, CRNP;Pamela Bowen, MSN, CRNP; and D’Ann Wilson, MSN, CRNP.4. Speaking loudly usually denotes anger.A. True.B. False.5. Silence as a method of communication usually indicates nothing.A. True.B. False.6. Which of these cultural groups may commonly use touch to convey emotions?

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A. Italian Americans.B. German Americans.C. Mexican Americans.D. American Indians.7. In which of these cultural groups may touch be symbolic of “undoing” an evil spell orpreventing harm or healing?1. Mexican Americans.2. American Indians.3. Italian Americans.4. French Americans.5. Asian Americans.A. 1 and 2 only.B. 3 and 4 only.C. 1, 2, and 5 only.D. 1, 2, 3, 4, and 5.8. In which of these cultural groups is a hearty handshake NOT likely to be considered asign of good character and strength?A. Italian Americans.B. Mexican Americans.C. French Americans.D. American Indians.9. The context of speech refers to the use of emotion when communicating.A. True.B. False.10. Eye contact would probably be considered socially UNACCEPTABLE betweenpeople of differing socioeconomic levels in which of these cultures?A. Alaskan Eskimo.B. Italian American.C. Hindu American.D. German American.11. In which of these cultures is a blink likely to indicate agreement?A. Navajo Indian.B. Alaskan Eskimo.C. Chinese American.D. African-American.12. According to Giger and Davidhizar, which of these zones of interpersonal space is thepreferreddistancebetweenpeopleotherthanFrenchAmericansandAfrican-Americans in the United States?A. 0 to 18 inches.B. 18 inches to 3 feet.C. 3 to 6 feet.D. Greater than 12 feet.13. Which of these zones of interpersonal space is usually permitted by family membersand friends?A.Intimate zone.

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B. Personal zone.C. Social zone.D.Public zone.14. People from Chinese American cultures, although valuing family, are generally moreoften inclined toward individualistic behavior.A. True.B. False.15. Appalachian people are likely to have which of these time orientations?A. Past; they work to maintain tradition.B. Present; they consider the past irrelevant and the future unpredictable.C. Future; they work toward future goals.16. If people have a fatalistic attitude toward life, they are _____ likely to seek medicalattention readily.A.moreB. less17. An inverted T-wave on an electrocardiogram, normal in a Black male, is an exampleofA.a biological variation.B. a misdiagnosis.C. kinesics.D.an environmental effect.18.In assessing baseline color of skin, the abdomen can be expected to beA.least pigmented.B. most pigmented.C. unreliable for examination.D.unrelated to other areas.19. Keloids are more commonly seen inA.Asians.B. Blacks.C. American Indians.D.Europeans.20. A newborn with which of these skin colors would RARELY have Mongolian spots?A.Yellow.B. Red.C. Brown.D.White.21. Susceptibility to disease is based on cultural heritage.A. True.B. False.22. Seminole, Pima, and Papago Indians are known to have been highly susceptible todiabetes mellitus.A. True.B. False.

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23. Nursing diagnoses offer a useful tool to assess culturally diverse patient needs.A. True.B. False.24. On which of these factors does the North American Nursing Diagnosis Association(NANDA) focus the diagnoses?A. The patient.B. The system.C. The provider.25. According to NANDA, deviations from the dominant culture are automatically andethnocentrically consideredA. normal.B. abnormal.C. irrelevant.D. nonassessable.26. A female student nurse who is caring for a dying Jordanian patient who is Muslim isannoyed when the family rewashes him after she has already bathed him. The student’sannoyance is most likely a sign ofA. confusion associated with lack of adequate cultural knowledge.B. intolerance associated with immaturity.C. anxiety due to the student nurse’s lack of organization.D. appropriate commitment to hospital procedures.27. When Muslims visit dying family members in a hospital setting, as a part of theirculture they areA.accepting of visitor limitations.B. required to visit five times a day.C. obligated to visit five consecutive days with the sick family member.D. obligated to remain until death.28. An Islamic practice of importance of dying Muslims is that the dying personA. face a picture or statue of Allah.B. face the holy city of Mecca.C. kneel on a prayer rug.D. face the door with the arms extended in prayer.29. According to the 2000 census, the largest ethnic minority group residing in the UnitedStates today is:A. Asian American.B. Black American.C. Hispanic American.D.D.American Indian.30. Mongolian spots are a common finding in which of these groups?1. Black Americans.2. White Americans.3. Asian Americans.4. American Indians.A. 1 and 4 only.B. 2 and 3 only.

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C. 1, 3, and 4 only.D. 1, 2, 3, and 4.31. In order to make a correct nursing diagnosis regarding a rash on a patient, the nurseshouldA. become familiar with the patient’s normal coloring to establish a baseline.B. assess the skin in artificial lighting, not in sunlight.C. assess darkly pigmented areas first, as it is less difficult to note color changesthere.32. The nurse assessing for jaundice in the Black patient is most likely to note the changein color in which of these areas?1. The patient’s skin.2. The mucous membrane of the buccal mucosa of the patient.3. The patient’s sclerae.4. The patient’s palmar and plantar surfaces.A. 1 and 2 only.B. 1 and 3 only.C. 2, 3, and 4 only.D. 1, 2, 3, and 4.33. Birthmarks, defined as irregularities in pigmentation, generally occur inA. 5% of American Indians.B. 10% of White Americans.C. 16% of Mexican Americans.D. 20% of Black Americans.34. Which of these statements about keloids in Blacks is accurate?A. They are rare due to an increase in melanin in Blacks.B. They are common due to susceptibility in Blacks to overgrowth of connectivetissue after injury.C. They are less common in Blacks than in White Americans, particularly after burns.D. They are temporary in Blacks, usually disappearing within a year withouttreatment.35. Religious structures fall into two different groups; one of these is the church type.Which of these statements about the church type of religious structure is accurate?A. People involved isolate themselves from the rest of society and create their ownlaws and values.B. It is a broadly based religion that generally includes people by virtue of theirmembership in society.C. It places personal commitment and experience before family and communityfunctions.36. According to kosher dietary law, Orthodox Jews areA. forbidden to eat fish that has fins or scales.B. forbidden to eat certain vegetables.C. allowed consumption of carnivorous animals.D. required to have meat that has been slaughtered and specially prepared.37. Jehovah’s Witnesses are opposed toA. blood transfusions.B. blood tests.

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C. medication.D.D.consumption of red meat.38. Seventh-Day Adventists’ practices include avoidance ofA. caffeine, alcohol, drugs, and tobacco.B. surgery on Sunday or Saturday after sundown.C. blood transfusions.D. tap water, undistilled.39. Every society has what is called the dominant value orientation. Which of thefollowing best describes the dominant value orientation of the majority culture in theUnited States?A. Belief in ancestral knowledge and reverence for aged members of the society.B. Working hard and being self-supporting and financially independent.C. Living within a communal group and rejecting personal belongings.D. Moving away from other people and living in a cabin without heat, lights, or water.40. M. Chang is a 20-year-old Chinese American. She would like to go to college but hasan aged, ill father at home. If M. Chang’s cultural value orientation regardingrelationships is collateral, she will be likely toA. stay home and take care of her father.B. go ahead with college since she is young and her needs must come first.C. find a nurse to take care of her father so that she can go to college.D. ask her minister what she should do and then take her minister’s advice.41. Dr.T.W.isfrequentlybotheredwhenpatientsarriveatthecliniclateforappointments. He is so irritated by this behavior that he often finds it hard to provideappropriate care to these individuals. What should Dr. T. W. do first in trying toovercome his difficulty?A. Identify the meaning of health to the patient.B. Allow the patients to arrive late and build this into his schedule.C. Understand that these cultural practices are helpful to the patient.D. Examine his own culturally based values, beliefs, attitudes, and practices.42. A Chinese American who is experiencing a symptom such as diarrhea (which is feltto be “yin”) is likely to try to treat it withA. high doses of medicines thought to be “cold.”B. no treatment at all, since diarrhea is an expected part of life.C. foods that are “hot” or “yang.”D. readings and Eastern medicine meditations.43. During a skin assessment, you notice that Mr. C., a Mexican American patient, hasskin that is yellowish-brown in color. However, the skin on the hard-soft palate isnormal pink color. From this finding, you could probably rule out:A. pallor.B. cyanosis.C. jaundice.D. iron deficiency.44. Mark Smith, a 35-year-old African-American male, is observed to have skin that isashen gray in color; he is oliguric and restless. You might suspect that Mr. Smith maybe experiencingA. iron deficient anemia.

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B. pernicious anemia.C. hyperglycemia.D. renal failure.45. The principle that is most important to the provision of culturally competent careis the nurse’sA. awareness of personal stereotypes based on culture.B. knowledge of specific behavior that is typical of persons in a given culture.C. sensitivity to what the physician says about persons in the cultural group of thepatient.D. awareness of actions that can be expected of persons in a given culture.46. The nurse has planned an appointment with Nancy Begay, a 25-year-old Navajo Indianclient, four times. Once she was 2 hours late, twice she was 2 hours early, and once she didnot come at all. The most important approach for a culturally competent nurse to use inscheduling appointments is toA. be more considerate of the client’s personal schedule when selecting the time foran appointment.B. assess carefully for the client’s social relationships and suggest the personclosest to her come with her to the appointment.C. work with the client to understand the importance of keeping the appointment.D. give the client a written card with the time and date of the appointment.47. Time takes on different meanings from one culture to another. To explore therelationship of time to nursing interventions, the nurse shouldA. avoid using set times to do procedures, if possible.B. be flexible in attitudes and don’t become emotionally upset when the clientdesires procedures to be done at “awkward times.”C. encourage clients to set their own times when they would like the nurse to performnursing care activities, regardless of the nurse’s schedule.D. disregard the usual adherence to time schedules for medications.48. A person is more likely to be compliant with a practice related to long-term healthpromotion if the individual isA.past and present oriented.B. present and future oriented.C. past and future oriented.D.present oriented.49. The nurse is teaching an American Indian client about the importance of taking aprescription medication at the time ordered. Which of the following shows the greatestunderstanding of the implications of social versus clock time?A. A person who is social time oriented is likely to take medication on time.B. A person who is social time oriented is more likely to have a clock.C. A person who is clock oriented is more likely to be attentive to the times thatmedication is ordered.D. A person who is clock oriented is more likely to be past time oriented.50. A Vietnamese woman was rushed to the hospital by her adult children. The ERpersonnel discovered dark red welts running up her arms, shoulders, and chest,yetheronlypresentingcomplaintwasvertigo.Whenquestioned,hersonexplained that he had rubbed her body with a quarter. What understanding aboutenvironmental control will assist the nurse in responding appropriately?A. Coin

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rubbing is a belief in external control.B. Coin rubbing is a belief in internal control.C. Beliefs of internal control are generally helpful.D. Beliefs in the power of external control are generally harmful.51. An individual’s feelings of environmental control will affect beliefs about compliancewith a medical regimen. Which of the following is most likely to be true?A. A person with internal locus of control will be more likely to feel personalactions can influence future health.B. A person with external locus of control will be more likely to feel personal actionscan influence future health.C. A person who believes in fate and change as an important determinant of naturehas an internal locus of control.D. A belief that the natural course of nature cannot be affected by individualsindicates belief in internal locus of control.52. A Jewish American client has been back from surgery for several hours and has notasked for pain medication. The client and nurse are from different cultural groups.Being aware of cultural influences on health behaviors, the nurse willA. realize the client does not feel as much pain as some people.B. wait for the client to ask before bringing pain medication.C. look for nonverbal signs of pain, such as holding the incision or lying still.D. tell the client to be sure to call her if he is in pain.53. You are taking care of an African-American female who recently had a CVA, leavingher unable to talk. As you attempt to give her meds with her milk on her tray, sheresists. After explaining the importance of taking her meds, and on time, your clientreluctantly takes the meds with milk. Later she has a large diarrhea stool. Whatbiological variation should have been considered with this client?A.Lactose intolerance is high among African-Americans.B. Hypertension is high among African- Americans.C. Tuberculosis is high among African-Americans.D.Dietary variations may cause diarrhea in African-Americans.54. When the nurse is planning care for a client with a different cultural background, theinitial primary concern in delivering culturally competent care is for the nurse toA.assess how cultural variables may affect the client’s health-related actions.B. explain how the client can adapt to hospital routines.C. speak slowly and clearly to ensure effective communication.D. allow the family to provide care during the hospital stay.55. A nurse in a doctor’s office explains to a Vietnamese female client the medicationregimen for the prescription the client has been given. The client nods her head andsmiles as the explanation is given. However, in 2 weeks she returns. Her condition hasdeteriorated, and the nurse discovers that she has not taken any medication. Initially,the nurse shouldA. find out if she understood the instructions as they were provided in English.B. firmly explain that she needs this medication to improve.C. call in the client’s husband and explain the schedule again.D. provide her with printed directions in Vietnamese on how to take the medication.56. A nurse on a psychiatric unit is assigned to work with a Mexican American client.The nurse knows little about the Mexican American culture. Her best action is toA. plan to go to the hospital library during break to read about Mexican Americans in

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Transcultural Nursing by Giger and Davidhizar.B. indicate to the nurse making assignments that this is not a good assignment, sinceshe is not familiar with Hispanic culture.C. assess and clarify cultural values and variations with the client as the nurseand client interact during the shift.D. apply what she learned about Hispanics from a movie she recently saw that tookplace in Mexico and depicted the culture and life-style of a wealthy Spanish family.57. When developing communication skills for cultural competence, the best practicefor the nurse when talking with clients of another culture is toA. speak loudly and slowly when communicating.B. always utilize an interpreter if a culturally appropriate interpreter is available.C. use simple words, avoid use of idioms and medical terms, and assessconstantly for comprehension.D. always talk with the client and family together, since this will increase the chancesthat someone understands what is said.58. Mrs. Tran, a Vietnamese client, is to undergo cancer surgery. The nurse notes thatMrs. Tran is very frightened. The best way for the nurse to support Mrs. Tran andallay her fears is toA. give Mrs. Tran a hug and pray with her.B. ask Mrs. Tran how much she understands about the surgical procedure andwhat she believes will happen.C. tell Mrs. Tran that the outcome of the surgery should be favorable.D. Ask Mrs. Tran’s family to leave so that the nurse may talk with her.59.When interacting with a Mexican American client, Maria Gonzales, the nurse notesthat the client will not face the nurse directly and keeps stepping back duringconversation and wringing her hands. The nurse and Mrs. Gonzales are talking aboutsexually transmitted diseases and birth control. The best explanation for this behavioris that the client isA. anxious about talking with the nurse.B. uncomfortable withthe topic being discussed.C. fearful of being with a health professional.D. in need of additional personal space.60. Mr. Chan, an 81-year-old Chinese American man, has been admitted to the hospitalfor abdominal pain. His oldest son answers questions for him and expresses his needs.Mr. Chan’s wife, who does speak English although not fluently, defers to the sonwhen asked to participate in discussion. This is an example ofA.the cultural value of male-female hierarchy.B. the cultural value of giving authority for decision making to the young.C. an attempt by the son to gain control of the situation.D. the need for family members to participate in care-giving decisions.61. A 24-year-old Korean man, visiting family in the United States, became ill and washospitalized. He was diagnosed with Class IV cardiac failure and was placed on strictbed rest, because lack of cardiac reserve made him very dyspneic on any exertion.When the nurse entered the room, she found the family members had gotten him outof bed and were assisting him to squat over a bedpan on the floor. None of the KoreanAmericans in the room could speak English. What response indicates the mostcultural understanding and sensitivity on the part of the nurse?A. The culturally sensitive nurse will allow clients and their families to continuepractices that are appropriate in their culture.B. The nurse should obtain a Korean translator to teach the family and client that even

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though some Asian countries do not have toilets and use holes in the ground forelimination purposes, that practice is not acceptable in the United States.C. The nurse should obtain a Korean translator to communicate to the family that thehealth care team will not allow this behavior to be carried out.D. The nurse should obtain a Korean translator who can discuss with the family andclient the implications of this type of physical exertion.62. Transcultural nursing is viewed as a culturally competent practice field that isA. nurse centered and research focused.B. client centered and research focused.C. spiritually centered and research focused.D. concerned with differences between but not within cultural groups.63. Which of the following is an appropriate guideline for overcoming language barriers?A.Ask often if the person understands.B. Avoid nouns and conjunctions.C. Talk slightly louder than normal.D.Use gestures with the words.64. The major purpose of culturally congruent nursing care is to enable the nurse toA. be aware of his or her own cultural beliefs and values.B. change his or her beliefs to meet the patient’s needs.C. provide care in a culturally sensitive manner.D. refrain from making judgments when patients are wrong.65. Mr. Cappelini is a 40-year-old Italian man who just arrived in the United States. HisEnglish is limited, and the nurse does not speak Italian. Which intervention would behelpful in communicating with Mr. Cappelini?A. The nurse tells him, “I have Italian friends, so I have a good idea what you mean.”B. The nurse responds, “Please explain that to me again.”C. Explain in Italian dialect, “I’ma not understandinga you.”D. The nurse greets him with, “Well, Gino, how are you today?”66. When providing care to clients with diverse cultural backgrounds, it is imperative forthe nurse to recognize thatA. cultural considerations must be put aside when the client enters the health caresystem.B. current health standards should determine the acceptability of cultural practices.C. clients with the same cultural background will respond similarly to stressfulsituations.D. generalizations about the behavior of a particular ethnic group may beinaccurate.67. Mr. Johansen, born in Sweden, is fair-skinned, blond, and blue-eyed and has littlebody hair. Mr. Stavros, born in Greece, is olive-skinned, has dark brown hair andeyes, and has thick, dark body hair. This is an example ofA.environmental control of culture.B. social organization of a culture.C.biological variations in racial groups.D.variation in space orientation of a culture.68. The nurse suspects that the client has nontraditional health beliefs and often usesnontraditional remedies to treat various illnesses. What is the best approach forobtaining this information from the client?

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A. “What are your favorite foods?”B. “Have you been taking any remedies that your family taught you to use?”C. “Would you like to keep wearing that gold cross while you are in the hospital?”D. “You haven’t been eating any of those funny herbs your people use, have you?”69. The nurse has determined that space and territoriality are very important to the client froma different culture. What is the best way for the nurse to enter the client’s space in order todeliver nursing care?A. Explain nursing care and procedures before beginning.B. Avoid touching the client during care.C. Keep the curtains pulled around the bed at all times.D.Stand at least 8 feetfrom the bed during client-nurse discussions.70. Cultural behavior, or how one acts in certain situations, isA. socially acquired.B. genetically acquired.C. stereotyping.D. institutional.71. Culture is best defined as theA. worldview and traditions transmitted by a group from generation to generation.B. classification of people according to shared biological characteristics.C. religious or racial characteristics of a group that set it apart from the larger societyof which it is a part.D. assumption of attitudes, values, and beliefs held by a particular cultural groupthat have been passed down from one generation to the next.72. Belief that one’s culture is superior to all others is calledA.discrimination.B. stereotyping.C.ethnocentrism.D.racism.73. John Youngblood, an American Indian, has been admitted to the hospital forsurgery. Mrs. Youngblood asks if their medicine man can perform a 30-minutehealing ceremony with her husband. The nurse shouldA. tell her that rituals may exhaust Mr. Youngblood.B. provide the space and privacy for the ceremony.C. explain that there is no place in modern health care for medicine men.D. insist that there must be a separation of religion and medicine.74. Which of the following interventions is helpful in communicating with a client whospeaks a language other than yours?A. Reassure the client that you have friends of his ethnic or racial background.B. Speak to the client using his ethnic dialect.C. Ask the client for clarification if you don’t understand what he is saying.D. At the initial meeting, address the client by his first name.75. To avoid cultural conflicts with a client, the nurse shouldA. assure him that he is receiving quality health care.B. provide the client with information about the dominant culture.C. ask the client about his expectations about nursing care and procedures.D. thoroughly explain necessary nursing interventions that might cause the clientembarrassment.

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76. When planning nursing care for a client with a different cultural background, thenurse shouldA. identify how cultural variables affect the health problem.B. try to explain how the client can adapt to hospital routines.C. speak slowly and clearly to ensure effective communication.D. allow the family to provide care during the hospital stay.77. Cultural groups vary greatly. Which of the following is false concerning thesedifferences?A. Environmental control refers to the ability of a group to plan activities that controlnature.B. Social organization refers to the differences that exist within the family unit ina culture.C. Verbal communication differences exist among cultures, and nonverbalcommunication differences exist between cultures.D. The personal space and its meaning vary from one culture to another.78. Time takes on different meanings from one culture to another. To explore therelationship of time to nursing interventions, the nurse shouldA. avoid using set times to do procedures, if possible.B. be flexible in attitudes and not become emotionally upset when the clientdesires procedures to be done at “awkward times.”C. encourage clients to set their own times when they would like the nurse to performnursing care activities, regardless of the nurse’s schedule.D. disregard the usual adherence to time schedules for medications.

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Giger: Transcultural Nursing, 6thEditionGiger & Davidhizar's Culturally Competent Test Bank: NCLEX-RN ReviewChapter 1: Introduction to Transcultural NursingMULTIPLE CHOICE1.The use of transcultural nursing knowledge is founded on the goal of:A.Increasing client compliance to the Western medical model.B.Delivering culturally sensitive care that is free of inherent biases.C.Eliminating cultural differences.D.Establishing system-centered health policy.ANS:BDIF:Cognitive Level: KnowledgeKEY:Nursing Process: AssessmentMSC:NCLEX Category: Safe, Effective Care Environment2.The major purpose of culturally congruent nursing care is to enable the nurse to:A.Be aware of his or her own cultural beliefs and values.B.Change his or her beliefs to meet the patient’s needs.C.Provide care in a culturally sensitive manner.D.Refrain from making judgments when patients are wrong.ANS:CDIF:Cognitive Level: KnowledgeKEY:Nursing Process: AssessmentMSC:NCLEX Category: Health Promotion and Maintenance3.Transcultural nursing is viewed as a culturally competent practice field that is:A.Nurse centered and research focused.B.Client centered and research focused.C.Spiritually centered and research focused.D.Concerned with differences between but not within cultural groups.

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ANS:BDIF:Cognitive Level: KnowledgeKEY:Nursing Process: AssessmentMSC:NCLEX Category: Safe, Effective Care Environment4.The principle that is most important to the provision of culturally competent care is thenurse’s:A.Awareness of personal stereotypes based on culture.B.Knowledge of specific behavior that is typical of persons in a given culture.C.Sensitivity to what the physician says about persons in the cultural group of thepatient.D.Awareness of actions that can be expected of persons in a given culture.ANS:ADIF:Cognitive Level: KnowledgeKEY:Nursing Process: AssessmentMSC:NCLEX Category: Psychosocial Integrity5.Which of these cultural phenomena are among those considered essential and areevidenced among all cultural groups? Mark all that apply.A.CommunicationB.SpaceC.Social organizationD.TimeE.Environmental controlF.Biological variationsANS:FDIF:Cognitive Level: KnowledgeKEY:Nursing Process: AssessmentMSC:NCLEX Category: Psychosocial Integrity6.The nurse responding to patients from diverse cultures with interpersonal awareness,knowledge, skill, and sensitivity is known as having:A.Enculturation.B.Culture care preservation.

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C.Cultural competence.D.Culture care accommodation.ANS:CDIF:Cognitive Level: KnowledgeKEY:Nursing Process: ImplementationMSC:NCLEX Category: Health Promotion and Maintenance7.The nurse is preparing a healthy diet plan for Mrs. O. In doing so, she takes the time toinclude the Polish foods that Mrs. O. favors. This is an example of the nurse’s demonstrat-ing:A.Cultural competence.B.Bicultural values.C.Ethnocentrism.D.Assimilation.ANS:ADIF:Cognitive Level: ApplicationKEY:Nursing Process: PlanningMSC:NCLEX Category: Health Promotion and Maintenance

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