Essentials of Psychiatric Mental Health Nursing 7th Edition By Mary C – Test Bank

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Chapter 5: Cultural and Spiritual Concepts Relevant to Psychiatric/Mental Health Nursing

Multiple Choice

Identify the choice that best completes the statement or answers the question.

____ 1. An African American youth, growing up in an impoverished neighborhood, seeks affiliation with a black gang. Soon he is engaging in theft and assault. What cultural consideration should a nurse identify as playing a role in this youth’s choices?

1.	Most African American homes are headed by strong, dominant father figures.
2.	Most African Americans choose to remain within their own social organization.
3.	Most African Americans are uncomfortable expressing emotions and seek out belonging.
4.	Most African Americans have few religious beliefs, which contributes to criminal activity.

____ 2. Northern European Americans value punctuality, hard work, and the acquisition of material possessions and status. A nurse should recognize that these values may contribute to which form of psychopathology?

1.	Dissociative disorders
2.	Alzheimer’s dementia
3.	Stress-related disorders
4.	Schizophrenia-spectrum disorders

____ 3. A community health nurse is planning a health fair at a local shopping mall. Which middle-class socioeconomic cultural group should the nurse anticipate would most value preventive medicine and primary health care?

1.	Northern European Americans
2.	Native Americans
3.	Latino Americans
4.	African Americans

____ 4. Which rationale by a nursing instructor best explains why it is challenging to globally classify the Asian American culture?

1.	Extremes of emotional expression prevent accurate assessment of this culture.
2.	Suspicion of Western civilization has understandably resulted in minimal participation in cultural research.
3.	The small size of this subpopulation makes research virtually impossible.
4.	The Asian American culture includes individuals from Japan, China, Vietnam, Korea, and other countries.

____ 5. A Latin American woman refuses to participate in an assertiveness training group. Which cultural belief should a nurse identify as most likely to affect this client’s decision?

1.	Future orientation causes the client to devalue assertiveness skills.
2.	Decreased emotional expression makes it difficult to be assertive.
3.	Assertiveness techniques may not be aligned with the client’s definition of the female role.
4.	Religious prohibitions prevent the client’s participation in assertiveness training.

____ 6. A Latin American man refuses to acknowledge responsibility for hitting his wife, stating instead, “It’s the man’s job to keep his wife in line.” Which cultural belief should a nurse associate with this client’s behavior?

1.	That families are male-dominated, with clear male–female role distinctions
2.	That religious tenets support the use of violence in a marital context
3.	That the nuclear family is female-dominated and the mother has ultimate authority
4.	That marriage dynamics are controlled by dominant females in the family

____ 7. When working with clients of a particular culture, which action should a nurse avoid?

1.	Making direct eye contact
2.	Assuming that all individuals who share a culture or ethnic group are similar
3.	Supporting the client in participating in cultural and spiritual rituals
4.	Using an interpreter to clarify communication

____ 8. To effectively plan care for Asian American clients, a nurse should be aware of which cultural factor?

1.	Obesity and alcoholism are common problems.
2.	Older people maintain positions of authority within the culture.
3.	“Tai” and “chi” are the fundamental concepts of Asian health practices.
4.	Asian Americans are likely to seek psychiatric help.

____ 9. A Native American client is admitted to an emergency department (ED) with an ulcerated toe, secondary to uncontrolled diabetes mellitus. The client refuses to talk to a physician unless a shaman is present. Which nursing intervention is most appropriate?

1.	Try to locate a shaman who will agree to come to the ED.
2.	Explain to the client that “voodoo” medicine will not heal the ulcerated toe.
3.	Ask the client to explain what the shaman can do that the physician cannot.
4.	Inform the client that refusing treatment is a client’s right.

____ 10. When planning client care, which folk belief that may affect health-care practices should a nurse identify as characteristic of the Latino American culture?

1.	The root doctor is often the first contact made when illness is encountered.
2.	The yin and yang practitioner is often the first contact made when illness is encountered.
3.	The shaman is often the first contact made when illness is encountered.
4.	The curandero is often the first contact made when illness is encountered.

____ 11. In what probable way should a nurse expect an Asian American client to view mental illness?

1.	Mental illness relates to uncontrolled behaviors that bring shame to the family.
2.	Mental illness is a curse from God related to immoral behaviors.
3.	Mental illness is cured by home remedies based on superstitions.
4.	Mental illness is cured by “hot and cold” herbal remedies.

____ 12. Which cultural considerations should a nurse identify as reflective of Western European Americans?

1.	They are present-time oriented and perceive the future as God’s will.
2.	They value youth, and older adults are commonly placed in nursing homes.
3.	They are at high risk for alcoholism, because of a genetic predisposition.
4.	They are future oriented and practice preventive health care.

____ 13. A nurse should recognize that clients who have a history of missed or late medical appointments are most likely to come from which cultural group?

1.	African Americans
2.	Asian Americans
3.	Native Americans
4.	Jewish Americans

Multiple Response

Identify one or more choices that best complete the statement or answer the question.

____ 14. When interviewing a client of a different culture, which of the following questions should a nurse consider? (Select all that apply.)

1.	Would using perfume products be acceptable?
2.	Who may be expected to be present during the client interview?
3.	Should communication patterns be modified to accommodate this client?
4.	How much eye contact should be made with the client?
5.	Would hand shaking be acceptable?

____ 15. A female nurse is caring for an Arab American male client. When planning effective care for this client, the nurse should be aware of which of the following cultural considerations? (Select all that apply.)

1.	Limited touch is acceptable only between members of the same sex.
2.	Conversing individuals of this culture stand far apart and do not make eye contact.
3.	Devout Muslim men may not shake hands with women.
4.	The man is the head of the household, and women take on a subordinate role.
5.	Men of this culture are responsible for the education of their children.

____ 16. In which of the following cultural groups should a nurse expect to find assessment of mood and affect most challenging, owing to the characteristics of the groups? (Select all that apply.)

1.	Arab Americans
2.	Native Americans
3.	Latino Americans
4.	Western European Americans
5.	Asian Americans

____ 17. A nursing instructor is developing a lesson plan to teach about the Northern European American culture. Which of the following information should be included? (Select all that apply.)

1.	About half of first marriages end in divorce in this cultural group.
2.	This cultural group does not use preventive medicine and primary health care.
3.	Punctuality and efficiency are highly valued in this cultural group.
4.	This cultural group tends to be future oriented.
5.	A typical diet of this cultural group includes rice, vegetables, and fish.

____ 18. The United States, viewed as a “melting pot” of multiple worldwide ethnic groups, has its own unique culture that impacts the health and care of individuals. Which of the following are characteristics common to U.S. culture? (Select all that apply.)

1.	The culture values independence, self-reliance, and determining one’s life.
2.	There is a strong emphasis on achievement in jobs, sports, and physical beauty.
3.	Constructive criticism is considered personally offensive.
4.	The culture favors structured and formal behaviors, speech, and relationships with others.
5.	Overconsumption of food in this culture leads to increased obesity and decreased health.

Completion

Complete each statement.

19.___________________ exists within each individual, regardless of belief system, and serves as a force for interconnectedness between the self and others, the environment, and a higher power.

Chapter 5: Cultural and Spiritual Concepts Relevant to Psychiatric/Mental Health Nursing

Answer Section

MULTIPLE CHOICE

1.ANS:2

Chapter: Chapter 5, Cultural and Spiritual Concepts Relevant to Psychiatric/Mental Health Nursing

Objective:  Describe cultural variances, based on the six phenomena, for African Americans.

Page: 100

Heading: Application of the Nursing Process > African Americans

Integrated Processes: Nursing Process

Client Need: Psychosocial Integrity

Cognitive Level: Application [Applying]

Concept: Culture

Difficulty: Easy

	Feedback
1	Most African American homes are headed by strong, dominant maternal figures.
2	The nurse should identify that a tendency to remain within one’s own social organization may have played a role in the youth’s choice to join a black gang.
3	It is incorrect that most African Americans are uncomfortable expressing emotions.
4	It is incorrect that most African Americans have few religious beliefs.

PTS: 1 CON: Culture

2.ANS:3

Chapter: Chapter 5, Cultural and Spiritual Concepts Relevant to Psychiatric/Mental Health Nursing

Objective: Identify cultural differences based on six characteristic phenomena.

Page: 97

Heading: Application of the Nursing Process > Northern European American Values

Integrated Processes: Nursing Process 

Client Need: Psychosocial Integrity

Cognitive Level: Application [Applying]

Concept: Culture

Difficulty: Easy

	Feedback
1	Dissociative disorders are not indicative of Northern European American values.
2	Alzheimer’s dementia is not indicative of Northern European American values.
3	The nurse should correlate many Northern European American values, such as punctuality, hard work, and acquisition of material possessions, with stress-related disorders. Psychopathology may occur when individuals fail to meet the expectations of the culture.
4	Schizophrenia-spectrum disorders are not indicative of Northern European American values.

PTS: 1 CON: Culture

3.ANS:1

Chapter: Chapter 5, Cultural and Spiritual Concepts Relevant to Psychiatric/Mental Health Nursing

Objective: Identify cultural differences based on six characteristic phenomena.

Page: 97

Heading: Application of the Nursing Process > Northern European Americans

Integrated Processes: Nursing Process

Client Need: Psychosocial integrity

Cognitive Level: Application [Applying]

Concept: Culture

Difficulty: Easy

	Feedback
1	The community health nurse should anticipate that Northern European Americans, especially those who achieve middle-class socioeconomic status, place the most value on preventative medicine and primary health care. This value is most likely related to this group’s educational level and financial capability.
2	Many members of the Native American subgroups value folk medicine practices.
3	Many members of the Latino American subgroups value folk medicine practices.
4	Many members of the African American subgroups value folk medicine practices.

PTS: 1 CON: Culture

4.ANS:4

Chapter: Chapter 5, Cultural and Spiritual Concepts Relevant to Psychiatric/Mental Health Nursing

Objective: Identify cultural differences based on six characteristic phenomena.

Page: 101–102

Heading: Application of the Nursing Process > Asian/Pacific Islander Americans

Integrated Processes: Teaching and Learning

Client Need: Psychosocial integrity

Cognitive Level: Application [Applying]

Concept: Culture

Difficulty: Easy

	Feedback
1	This statement is not accurate regarding the Asian American culture.
2	Minimal participation in research is not a factor that has made classifying Asian American culture difficult.
3	The Asian American subculture is large.
4	The nursing instructor’s best explanation is that the Asian American culture is difficult to classify globally because of the number of countries that identify with this culture. The Asian American culture includes peoples and descendants from Japan, China, Vietnam, the Philippines, Thailand, Cambodia, Korea, Laos, India, and the Pacific Islands. Within this culture there are vast differences in values, religious practices, languages, and attitudes.

PTS: 1 CON: Culture

5.ANS:3

Chapter: Chapter 5, Cultural and Spiritual Concepts Relevant to Psychiatric/Mental Health Nursing

Objective: Identify cultural differences based on six characteristic phenomena.

Page: 102–103

Heading: Application of the Nursing Process > Latino Americans

Integrated Processes: Nursing Process

Client Need: Psychosocial integrity

Cognitive Level: Application [Applying]

Concept: Culture

Difficulty: Easy

	Feedback
1	It is not likely that the Latin American woman devalues assertiveness skills.
2	It is not likely that the Latin American woman has decreased emotional expression.
3	The nurse should identify that the Latin American woman’s refusal to participate in an assertiveness training group may be affected by the Latin American cultural definition of the female role. Latin Americans place a high value on the family, which is male dominated. The father usually possesses the ultimate authority.
4	It is not likely that the Latin American woman has religious prohibitions.

PTS: 1 CON: Culture

6.ANS:1

Chapter: Chapter 5, Cultural and Spiritual Concepts Relevant to Psychiatric/Mental Health Nursing

Objective: Apply the nursing process in the care of individuals from various cultural groups.

Page: 102–103

Heading: Application of the Nursing Process > Latino Americans

Integrated Processes: Teaching and Learning 

Client Need: Psychosocial integrity

Cognitive Level: Application [Applying]

Concept: Culture

Difficulty: Easy

	Feedback
1	The nurse should associate the cultural belief that families are male-dominated, with clear male–female role distinctions with the client’s abusive behavior. The father in the Latin American family usually has the ultimate authority.
2	Religious tenets do not support the use of violence.
3	The Latin American family is male-dominated.
4	This statement is untrue, because Latin American families are male-dominated.

PTS: 1 CON: Culture

7.ANS:2

Chapter: Chapter 5, Cultural and Spiritual Concepts Relevant to Psychiatric/Mental Health Nursing

Objective: Apply the nursing process in the care of individuals from various cultural groups.

Page: 95

Heading: Cultural Concepts

Integrated Processes: Teaching and Learning

Client Need: Psychosocial integrity

Cognitive Level: Application [Applying]

Concept: Culture

Difficulty: Easy

	Feedback
1	Avoiding eye contact is not necessary in all cultures.
2	The nurse should avoid assuming that all individuals who share a culture or ethnic group are similar.
3	The nurse should always strive to support the client in cultural and spiritual rituals.
4	The nurse should assess whether or not an interpreter is needed.

PTS: 1 CON: Culture

8.ANS:2

Chapter: Chapter 5, Cultural and Spiritual Concepts Relevant to Psychiatric/Mental Health Nursing

Objective: Apply the nursing process in the care of individuals from various cultural groups.

Page: 101–102

Heading: Application of the Nursing Process > Asian/Pacific Islander Americans

Integrated Processes: Teaching and Learning

Client Need: Psychosocial integrity

Cognitive Level: Application [Applying]

Concept: Culture

Difficulty: Easy

	Feedback
1	Obesity and alcoholism are low among Asian Americans.
2	To effectively care for Asian American clients, the nurse should be aware that older people in this culture maintain positions of authority.
3	The balance of yin and yang is the fundamental concept of Asian health practices.
4	Psychiatric illness is often believed to be out-of-control behavior and would be considered shameful to individuals and families.

PTS: 1 CON: Culture

9.ANS:1

Chapter: Chapter 5, Cultural and Spiritual Concepts Relevant to Psychiatric/Mental Health Nursing

Objective: Apply the nursing process in the care of individuals from various cultural groups.

Page: 100–101

Heading: Application of the Nursing Process > Native American

Integrated Processes: Teaching and Learning

Client Need: Psychosocial integrity

Cognitive Level: Application [Applying]

Concept: Culture

Difficulty: Easy

	Feedback
1	The most appropriate nursing intervention would be to try to locate a shaman that will agree to come to the ED.
2	The nurse should understand that in the Native American culture, religion, and health-care practices are often intertwined.
3	The shaman, a medicine man, may confer with physicians regarding the care of a client.
4	The client is not refusing treatment at this time.

PTS: 1 CON: Culture

10.ANS:4

Chapter: Chapter 5, Cultural and Spiritual Concepts Relevant to Psychiatric/Mental Health Nursing

Objective: Apply the nursing process in the care of individuals from various cultural groups.

Page: 102–103

Heading: Application of the Nursing Process > Latino Americans

Integrated Processes: Teaching and Learning

Client Need: Psychosocial integrity

Cognitive Level: Application (Application)

Concept: Culture

Difficulty: Easy

	Feedback
1	This is not true of Latin American culture.
2	Yin and yang is present in Asian American culture.
3	The shaman is a healer in the Native American culture.
4	The nurse should understand that it is characteristic of Latin American culture for a client to contact a curandero when illness is initially encountered.

PTS: 1 CON: Culture

11.ANS:1

Chapter: Chapter 5 Cultural and Spiritual Concepts Relevant to Psychiatric/Mental Health Nursing

Objective: Apply the nursing process in the care of individuals from various cultural groups.

Page: 101–102

Heading: Application of the Nursing Process > Asian/Pacific Islander Americans

Integrated Processes: Teaching and Learning

Client Need: Psychosocial integrity

Cognitive Level: Application [Applying]

Concept: Culture

Difficulty: Easy

	Feedback
1	The nurse should expect that many Asian Americans are most likely to view mental illness as uncontrolled behavior that brings shame to the family.
2	Asian Americans do not view mental illness as a curse from God.
3	Asian Americans do not view mental illness as curable by home remedies.
4	Asian Americans do not view mental illness as curable by hot and cold herbal remedies.

PTS: 1 CON: Culture

12.ANS:1

Chapter: Chapter 5, Cultural and Spiritual Concepts Relevant to Psychiatric/Mental Health Nursing

Objective: Describe cultural variances, based on the six phenomena, for Western European Americans.

Page: 97

Heading: Application of the Nursing Process

Integrated Processes: Teaching and Learning

Client Need: Psychosocial integrity

Cognitive Level: Application (Application)

Concept: Culture

Difficulty: Easy

	Feedback
1	The nurse should identify that most Western European Americans are present oriented and perceive the future as God’s will.
2	Older adults are held in positions of respect and are often cared for in the home instead of in nursing homes.
3	Western European Americans are not at high risk for alcoholism.
4	The nurse should identify that most Western European Americans are present oriented.

PTS: 1 CON: Culture

13.ANS:3

Chapter: Chapter 5, Cultural and Spiritual Concepts Relevant to Psychiatric/Mental Health Nursing

Objective: Describe cultural variances, based on the six phenomena, for Native Americans.

Page: 100–101

Heading: Application of the Nursing Process > Native Americans

Integrated Processes: Teaching and Learning

Client Need: Psychosocial integrity

Cognitive Level: Application [Applying]

Concept: Culture

Difficulty: Easy

	Feedback
1	African Americans are not the mostly likely to be late for medical appointments.
2	Asian Americans are not the mostly likely to be late for medical appointments.
3	The nurse should recognize that Native American clients might have a history of missed or late medical appointments. Many Native Americans are not ruled by the clock. The concept of time is casual and focused on the present.
4	Jewish Americans are not the mostly likely to be late for medical appointments.

PTS: 1 CON: Culture

MULTIPLE RESPONSE

14.ANS:2, 3, 4, 5

Chapter: Chapter 5, Cultural and Spiritual Concepts Relevant to Psychiatric/Mental Health Nursing

Objective: Apply the nursing process in the care of individuals from various cultural groups.

Page: 96–97

Heading: Application of the Nursing Process > How Do Cultures Differ?

Integrated Processes: Teaching and Learning

Client Need: Psychosocial integrity

Cognitive Level: Application [Applying]

Concept: Nursing

Difficulty: Easy

	Feedback
1.	Use of perfume products should be avoided in case of allergies.
2.	When interviewing a client from a different culture, the nurse should consider who might be with the client during the interview
3.	When interviewing a client from a different culture, the nurse should consider whether communication patterns should be adjusted to accommodate the client’s culture.
4.	When interviewing a client from a different culture, the nurse should consider the amount of eye contact.
5.	When interviewing a client from a different culture, the nurse should consider the acceptability of hand-shaking.

PTS: 1 CON: Nursing

15.ANS:1, 3, 4

Chapter: Chapter 5, Cultural and Spiritual Concepts Relevant to Psychiatric/Mental Health Nursing

Objective: Describe cultural variances, based on the six phenomena, for Arab Americans.

Page: 103–104

Heading: Application of the Nursing Process > Arab Americans

Integrated Processes: Teaching and Learning

Client Need: Psychosocial integrity

Cognitive Level: Application [Applying]

Concept: Culture

Difficulty: Easy

	Feedback
1.	When planning effective care for this client, the nurse should be aware that limited touch in this culture is acceptable only between members of the same sex.
2.	When planning effective care for this client, the nurse should be aware that conversing individuals of this culture stand close together and maintain eye contact.
3.	When planning effective care for this client, the nurse should be aware that devout Muslim men may not shake hands with women.
4.	When planning effective care for this client, the nurse should be aware that devout Muslim men are considered the head of the household and that women take a subordinate role.
5.	When planning effective care for this client, the nurse should be aware that men are not responsible for the education of their children.

PTS: 1 CON: Culture

16.ANS:2, 5

Chapter: Chapter 5, Cultural and Spiritual Concepts Relevant to Psychiatric/Mental Health Nursing

Objective: Apply the nursing process in the care of individuals from various cultural groups.

Page: 100–102

Heading: Application of the Nursing Process > Native Americans, Asian/Pacific Islander Americans

Integrated Processes: Teaching and Learning

Client Need: Psychosocial integrity

Cognitive Level: Application (Application)

Concept: Culture

Difficulty: Easy

	Feedback
1.	Arab Americans are not the most challenging to assess mood affect.
2.	The nurse should expect that Native Americans may be difficult to assess for mood and affect.
3.	Latino Americans are not the most challenging to assess mood affect.
4.	Western European Americans are not the most challenging to assess mood affect.
5.	The nurse should expect that Asian Americans may be difficult to assess for mood and affect.

PTS: 1 CON: Culture

17.ANS:1, 3, 4

Chapter: Chapter 5, Cultural and Spiritual Concepts Relevant to Psychiatric/Mental Health Nursing

Objective: Describe cultural variances, based on the six phenomena, for Northern European Americans.

Page: 97, 99

Heading: Application of the Nursing Process > Northern European Americans

Integrated Processes: Teaching and Learning

Client Need: Psychosocial integrity

Cognitive Level: Application [Applying]

Concept: Culture

Difficulty: Easy

	Feedback
1.	Data on marriage, divorce, and remarriage in the United States show that about half of first marriages end in divorce.
2.	Northern European Americans, particularly those who achieve middle-class socioeconomic status, value preventive medicine and primary health care.
3.	Punctuality and efficiency are highly valued in the culture that promoted the work ethic.
4.	Most within this cultural group tend to be future oriented.
5.	A typical diet for many Northern European Americans is high in fats and cholesterol and low in fiber.

PTS: 1 CON: Culture

18.ANS:1, 2, 5

Chapter: Chapter 5, Cultural and Spiritual Concepts Relevant to Psychiatric/Mental Health Nursing

Objective: Describe cultural variances, based on the six phenomena, for Northern European Americans.

Page: 99

Heading: Box 5-3 Characteristics Common to the Culture of the United States

Integrated Processes: Teaching and Learning

Client Need: Psychosocial integrity

Cognitive Level: Application [Applying]

Concept: Culture

Difficulty: Easy

	Feedback
1.	Independence, self-reliance, and determining one’s life describes the characteristic of individuality.
2.	Strong emphasis on achievement in jobs, sports, and physical beauty describes the characteristic of perfectionism.
3.	Constructive criticism is considered helpful for others in U.S. culture.
4.	General behaviors, speech, and relationships with others are informal.
5.	The overconsumption of food, leading to increased obesity and decreased health relates to the characteristic of consumerism.

PTS: 1 CON: Culture

COMPLETION

19.ANS:

Spirituality

Chapter: Chapter 5, Cultural and Spiritual Concepts Relevant to Psychiatric/Mental Health Nursing

Objective: Identify clients’ spiritual and religious needs.

Page: 110

Heading: Core Concept

Cognitive Level: Application [Applying]

Integrated Processes: Teaching and Learning

Client Need: Psychosocial integrity

Concept: Spirituality

Difficulty: Easy

Feedback: Spirituality exists within each individual, regardless of belief system, and serves as a force for interconnectedness between the self and others, the environment, and a higher power. Spirituality is the human quality that gives meaning and sense of purpose to an individual’s existence.

PTS: 1 CON: Spirituality