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Answers to Multiple Choice Questions

Chapter 41.CThe nurses priority is to respect the clients belief, thereby providing culturally competent care. Questioning the validity of the belief would interfere with the development of trust and undermine the nurseclient relationship. There is no reason to expect that the clients response to treatment would be poor. Seeking assistance from family members would not be the priority. Additionally, they too may have the same belief.

2.DCommunication is key. Therefore, using the services of a translator is best to ensure that the messages from the sender and receiver are clear and interpreted accurately. Gestures and pictures would be helpful but only in addition to the use of a translator. Evaluating the clients ability to understand written English would be ineffective and probably time consuming. Assigning the client to a private room would have little effect on communication, and doing so isolates the client.

3.A

Applying cultural care accommodation/negotiation, the nurse adapts care to accommodate the clients beliefs and negotiates with the client about incorporating the curandero in his or her plan of care. Cultural care preservation/maintenance involves assisting the client in maintaining health practices derived from the clients membership in a specific ethnic group. Cultural care repatterning/restructuring involves educating the client to change practices that are not conducive to health. Leininger does not identify supporting/providing as a culturally congruent nurse care mode.

4.CThe biologic or genetic basis for the differences in response to psychotropic drugs among different ethnic groups is related to the hepatic cytochrome P450 microsomal enzyme system.

5.BTo elicit the most appropriate information, the nurse would use indirect questioning, thereby allowing the client to tell the story in his or her own words and providing an opportunity for the client to express feelings. Using yesno direct questioning limits the amount of information provided and does not provide an opportunity for the client to express his or her feelings. Additionally, this type of questioning could intimidate the client. A supportive and empathetic approach, rather than a confrontational approach, is most effective. Asking the family to provide information is appropriate only with the clients consent and if the culture allows.

6.B, D, and E

The culture-bound syndrome of ghost sickness typically associated with American Indian tribes is manifested by a preoccupation with death and the deceased, bad dreams, weakness, feelings of danger, anxiety, and possible hallucinations. Uncontrollable crying and shouting are associated with the culture-bound syndrome of ataque de nervios. Indigestion and anorexia are associated with the culture-bound syndrome of hwa-byung. A sudden outburst of agitation and aggression is associated with boufe delirante.