Health Disparities and Culturally Competent Care Nursing Quiz

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By nclexnursing

Health Disparities and Culturally Competent Care Nursing Quiz and Key Answer for your nursing exam.

Nursing Quiz Health Disparities

A 62-yr-old African American man has been diagnosed with lung cancer and has been scheduled for surgery. Does the nurse recognize what is the most likely major determinant of this patient’s health?

a. He is African American.

b. He chose to smoke all of his adult life.

c. His father died of lung cancer at about the same age.

d. His lack of experience limits his ability to understand and act on health information.

Answer Key:
b. The determinants of health are factors that influence the health of individuals and groups. The major determinant of health is behavior. Although the other factors could influence this patient’s health, smoking behavior is the most important causative factor in this situation.

A 73-yr-old white woman is brought to the emergency department by a neighbor who found the woman experiencing severe abdominal and lower back pain for 2 days and nausea and vomiting for the last 24 hours. She has always refused medical care of any kind and lives by herself “up the mountain” off a dirt road in rural West Virginia. She gave birth to two children with the help of a midwife, but both of her children left for the West Coast years ago and she rarely sees them. She was not married to the father of her children, and she has not seen him in years. She has barely made a living by sewing for a doll company and receives a small amount of public assistance. As ill as she is, she is insisting that she will return home after she sees the doctor. List at least four factors in this situation that contribute to health disparities.

a.

b.

c.

d.

Answer Key:
a. Rural setting; b. Low income; c. Gender; d. Age. Low health literacy also leads to health disparities.

Limited health literacy may be associated with which individual conditions lead to health disparities (select all that apply)?

a. Age

b. Place

c. Gender

d. Race/ethnicity

e. Language barrier

f. Income/education

Answer Key:
a, b, e, f. Health literacy is the patient's ability to obtain, process, and understand basic health information needed to make appropriate decisions. Age, language, and education influence the patient's ability to read, comprehend and analyze information to make health care decisions. The place may be associated with limited health literacy because rural populations tend to be older and have lower literacy rates. The accepted health behaviors are affected by the areas in which people grow up, work, and live. Although gender, race, ethnicity, and sexual preferences are not associated with health literacy, they may lead to health disparity.

Cultural safety describes the care that prevents cultural imposition. The nurse must be aware of and include the knowledge of which factors in providing safe cultural care for the patient (select all that apply)?

a. Values

b. Culture

c. Ethnicity

d. Stereotyping

e. Acculturation

f. Ethnocentrism

Key Answer:
a, b, c. Values, culture, and ethnicity provide the nurse with information to help plan care for the patient that ensures that cultural histories, experiences, and traditions are valued. Stereotyping, acculturation, and ethnocentrism all presuppose information about the individual because of his or her culture or ethnicity without assessing the individual.

What are the four basic characteristics of culture?

a. Ever-present, shared by all members, expected by all members, adapted to individuals

b. Dynamic, shared values, provide a baseline for judging other cultures, learned from parents

c. Ever-present, not always shared by all members, not accepted by the group, learned at school 20

d. Dynamic, not always shared by all members, adapted to specific conditions, learned by communication and imitation

Answer Key:
Culture is dynamic and ever-changing, may not be shared by all members of the same cultural group, is adapted to specific conditions such as environmental factors, and is learned through oral and written histories as well as socialization.

Identify the specific component of acquiring cultural competence that is reflected in creating a safe environment in which the collection of relevant cultural data can be obtained during the health history and physical examination.

a. Cultural skill

b. Cultural encounter

c. Cultural awareness

d. Cultural knowledge

Answer Key:
a. Cultural skill is the ability to complete a cultural assessment by collecting cultural data.

When admitting a woman experiencing a spontaneous abortion at the ambulatory care center, the nurse notes that the admission form identifies the patient’s religion as Islam. What should the nurse understand about this patient?

a. She should not receive any pork-derived products.

b. She does not believe in using contraception or abortion.

c. She probably will not have purchased any health insurance.

d. She will not be able to receive blood or blood products if an emergency develops.

Answer Key:
a. As a follower of Islam, pork or pork-derived products are prohibited (this is also true for strict followers of Judaism). Strict relationships between men and women are also characteristic of Islam. The Amish seldom purchase health insurance. Artificial contraception and abortion are prohibited in Catholicism. For Jehovah's Witnesses, the administration of blood or blood products is prohibited.

A hospitalized Native American patient tells the nurse that later in the day a medicine man from his tribe is coming to perform a healing ceremony to return his world to balance. What should the nurse recognize about this situation?

a. The patient does not adhere to organized, formal religion.

b. The patient’s spiritual needs may be met by traditional rituals.

c. The patient may be putting his health in jeopardy by relying on rituals.

d. Native American medicine cannot alter the progression of the patient’s physical illness.

Answer Key:
b. Traditional Native American rituals may include healing ceremonies used in addition to conventional therapy to promote a balance of physical, spiritual, and emotional wholeness believed to be necessary for wellness. These rituals may or may not be part of formal religious beliefs and may positively alter the progression of physical illnesses.

In a Hispanic patient who claims to have empacho, what assessment findings would the nurse expect?

a. Abdominal pain and cramping

b. Anxiety, insomnia, anorexia, and social isolation

c. Nightmares, weakness, and a sense of suffocation

d. Headaches, stomach problems, and loss of consciousness

Answer Key:
a. Empacho causes pain and cramping from food balls forming in the stomach or intestinal tract. Susto is a culture-bound syndrome also known as “fright sickness.” Ghost sickness for Native Americans causes nightmares, weakness, and a sense of suffocation. Bilis brought on by strong anger causes headaches, stomach disturbances, and loss of consciousness.

When the nurse takes a surgical consent form to an Asian woman for a signature after the surgeon has provided the information about the recommended surgery, the patient refuses to sign the consent form. What is the best response by the nurse?

a. “Didn’t you understand what the doctor told you about the surgery?”

b. “Are there others with whom you want to talk before making this decision?”

c. “Why won’t you sign this form? Do you want to do what the doctor recommended?”

d. “I’ll have to call the surgeon and have your surgery canceled until you can make a decision.”

Answer Key:
b. In some cultural groups, especially Asian, Hispanic, and Native American, there is an emphasis on interdependence rather than independence. The nurse should be aware that in some cultures, decisions for the patient may be made by other family members or may be made collectively by the patient and his or her family. All of the other options reflect an insensitive assumption that the patient should make an autonomous decision.

A male nurse would be providing culturally competent care by requesting that a female nurse provide care for which patient?

a. Arab male

b. Latino male

c. Arab female

d. African American female

Answer Key:
c. In the Arabic culture, male and female roles are strictly observed. A woman should not be touched by a man other than her husband, nor should she be alone with another man. An Arabic woman would be very uncomfortable being cared for by a male nurse or would be put in the position of having to refuse the care.

Identify the drug class that has a different response in African Americans when compared with the usual response of European Americans (select all that apply).

a. Analgesics

b. Anticoagulants

c. Benzodiazepines

d. Antihypertensive agents

Answer Key:
d. Antihypertensives are not responded to as well by African Americans as they are by European Americans. There is no difference in the effect of analgesics, anticoagulants, or benzodiazepines.

Several cultural groups avoid direct eye contact and consider it disrespectful or aggressive. Which cultural group(s) may not return a direct gaze (select all that apply)?

a. Arab

b. Asian

c. Hispanic

d. Native American

e. African American

Answer Key:
a, b, d. Arab, Asian, and Native American individuals may not return the nurse's direct gaze because of their respect for authority. Hispanics and African American individuals are more likely to return the nurse's direct gaze.

To communicate with a patient who does not speak the dominant language, the nurse should (select all that apply)

a. pantomime words while verbalizing the specific words.

b. speak slowly and enunciate clearly in a slightly louder voice.

c. use family members rather than strangers as interpreters to increase the patient’s feeling of comfort.

d. use a website or phrase books that translate from both the nurse’s language and the patient’s language. e. avoid the use of any words known in the patient’s language because the grammar and pronunciation may be incorrect.

Answer Key:
a, d. To communicate with a patient who does not speak the dominant language the nurse should obtain an interpreter. But if one is not available, the use of pantomime with specific words and a website or phrase book with both the nurse's and patient's language may be helpful. The patient may think you are angry if you speak in a loud voice. Only use family members if there are no other choices.

Identify measures that the nurse should use to reduce health care disparities (select all that apply).

a. Use cultural competency guidelines.

b. Use a family member as the interpreter.

c. Use standardized, evidence-based care guidelines.

d. Complete the health history as rapidly as possible.

e. Include racial-cultural differences in planning care.

Answer Key:
a, c. Using cultural competency guidelines guides the nurse in practice. Using standardized evidence-based care guidelines guides care based on the patient's outcomes. Using a family member as the interpreter is not recommended because of the possibility of misunderstanding as well as potential privacy issues. Completing the health history rapidly may not allow patients from other cultures than the nurse to explain themselves well enough. Racial cultural differences cannot be assumed. The individual patient must be assessed to determine the differences to be included in the care.

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