Varcarolis’ Foundations of Psychiatric Mental Health Nursing A Clinical Approach 7th Edition By Margaret Jordan Halter – Test Bank

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Chapter 05: Cultural Implications for Psychiatric Mental Health Nursing

MULTIPLE CHOICE

1. 2. 3. Which Western cultural feature may result in establishing unrealistic outcomes for patients of

other cultural groups?

a. Interdependence

b. Present orientation

c. Flexible perception of time

d. Direct confrontation to solve problems

ANS: D

Directly confronting problems is a highly valued approach in the American culture but not

part of many other cultures in which harmony and restraint are valued. American nurses

sometimes mistakenly think that all patients should take direct action. Patients with other

values will be unable to meet this culturally inappropriate outcome. Present orientation,

interdependence, and a flexible perception of time are not valued in Western culture. These

views are more predominant in other cultures. See relationship to audience response

question.

PTS: 1 REF: Page 88 (Table 5-4) MSC: Client Needs: Psychosocial Integrity

DIF: Cognitive Level: Understand (Comprehension)

TOP: Nursing Process: Planning

A psychiatric nurse leads a medication education group for Hispanic patients. This nurse holds

a Western worldview and uses pamphlets as teaching tools. Groups are short and concise.

After the group, the patients are most likely to believe:

a. the nurse was uncaring. c. the teaching was efficient.

b. the session was effective. d. they were treated respectfully.

ANS: A

Hispanic individuals usually value relationship behaviors. Their needs are for learning through

verbal communication rather than reading and for having time to chat before approaching the

task.

PTS: 1 REF: Page 85-86 (Table 5-2) MSC: Client Needs: Psychosocial Integrity

DIF: Cognitive Level: Apply (Application)

TOP: Nursing Process: Evaluation

To provide culturally competent care, the nurse should:

a. b. c. d. accurately interpret the thinking of individual patients.

predict how a patient may perceive treatment interventions.

formulate interventions to reduce the patient’s ethnocentrism.

identify strategies that fit within the cultural context of the patient.

ANS: D

The correct answer is the most global response. Cultural competence requires ongoing effort.

Culture is dynamic, diversified, and changing. The nurse must be prepared to gain cultural

knowledge and determine nursing care measures that patients find acceptable and helpful.

Interpreting the thinking of individual patients does not ensure culturally competent care.

Reducing a patient’s ethnocentrism may not be a desired outcome.4. 5. 6. PTS: 1 DIF: Cognitive Level: Apply (Application)

REF: Page 93 TOP: Nursing Process: Planning/Outcomes Identification

MSC: Client Needs: Psychosocial Integrity

A black patient, originally from Haiti, has a diagnosis of depression. A colleague tells the

nurse, “This patient often looks down and is reluctant to share feelings. However, I’ve

observed the patient spontaneously interacting with other black patients.” Select the nurse’s

best response.

a. “Black patients depend on the church for support. Have you consulted the patient’s

pastor?”

b. “Encourage the patient to talk in a group setting. It will be less intimidating than

one-to-one interaction.”

c. “Don’t take it personally. Black patients often have a resentful attitude that takes a

long time to overcome.”

d. “The patient may have difficulty communicating in English. Have you considered

using a cultural broker?”

ANS: D

Society expects a culturally diverse patient to accommodate and use English. Feelings are

abstract, which requires a greater command of the language. This may be especially difficult

during episodes of high stress or mental illness. Cultural brokers can be helpful with language

and helping the nurse to understand the Haitian worldview and cultural nuances.

PTS: 1 DIF: Cognitive Level: Apply (Application)

REF: Page 88-89 TOP: Nursing Process: Implementation

MSC: Client Needs: Psychosocial Integrity

A Haitian patient diagnosed with depression tells the nurse, “There’s nothing you can do. This

is a punishment. The only thing I can do is see a healer.” The culturally aware nurse assesses

that the patient:

a. has delusions of persecution.

b. has likely been misdiagnosed with depression.

c. may believe the distress is the result of a curse or spell.

d. feels hopeless and helpless related to an unidentified cause.

ANS: C

Individuals of African American or Caribbean cultures who have a fatalistic attitude about

illness may believe they are being punished for wrongdoing or are victims of witchcraft or

voodoo. They may be reticent to share information about curses with therapists. No data are

present in the scenario to support delusions. Misdiagnosis more often labels a patient with

depression as having schizophrenia.

PTS: 1 REF: DIF: Cognitive Level: Apply (Application)

Page 86 (Table 5-2) | Page 88 (Table 5-4)

TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity

A group activity on an inpatient psychiatric unit is scheduled to begin at 1000. A patient, who

was recently discharged from United States Marine Corps, arrives at 0945. Which analysis

best explains this behavior?

a. The patient wants to lead the group and give directions to others.7. 8. b. c. d. The patient wants to secure a chair that will be close to the group leader.

The military culture values timeliness. The patient does not want to be late.

The behavior indicates feelings of self-importance that the patient wants others to

appreciate.

ANS: C

Culture is more than ethnicity and social norms; it includes religious, geographic,

socioeconomic, occupational, ability- or disability-related, and sexual orientation-related

beliefs and behaviors. In this instance, the patient’s military experience represents an aspect of

the patient’s behavior. The military culture values timeliness. The distracters represent

misinterpretation of the patient’s behavior and have no bearing on the situation.

PTS: 1 DIF: Cognitive Level: Analyze (Analysis)

REF: Page 84 TOP: Nursing Process: Assessment

MSC: Client Needs: Psychosocial Integrity

A nurse in the clinic has a full appointment schedule. A Hispanic American patient arrives at

1230 for a 1000 appointment. A Native American patient does not keep an appointment at all.

What understanding will improve the nurse’s planning? These patients are:

a. b. c. members of cultural groups that have a different view of time.

immature and irresponsible in health care matters.

acting out feelings of anger toward the system.

d. displaying passive-aggressive tendencies.

ANS: A

Hispanic Americans and Native Americans traditionally treat time in a way unlike the Western

culture. They tend to be present-oriented; that is, they value the current interaction more than

what is to be done in the future. If engaged in an activity, for example, they may simply

continue the activity and appear later for an appointment. Understanding this, the nurse can

avoid feelings of frustration and anger when the nurse’s future orientation comes into conflict

with the patient’s present orientation.

PTS: 1 REF: Page 85-86 (Table 5-2) MSC: Client Needs: Psychosocial Integrity

DIF: Cognitive Level: Understand (Comprehension)

TOP: Nursing Process: Assessment

The sibling of an Asian American patient tells the nurse, “My sister needs help for pain. She

cries from the hurt.” Which understanding by the nurse will contribute to culturally competent

care for this patient? Persons of an Asian American heritage:

a. b. c. d. often express emotional distress with physical symptoms.

will probably respond best to a therapist who is impersonal.

will require prolonged treatment to stabilize these symptoms.

should be given direct information about the diagnosis and prognosis.

ANS: A

Asian Americans commonly express psychological distress as a physical problem. The patient

may believe psychological problems are caused by a physical imbalance. Treatment will likely

be short. The patient will probably respond best to a therapist who is perceived as giving.

Asian Americans usually have strong family ties and value hope more than truth.

PTS: 1 REF: Page 89-90 (Table 5-5) DIF: Cognitive Level: Understand (Comprehension)

TOP: Nursing Process: Assessment9. 10. 11. MSC: Client Needs: Psychosocial Integrity

Which communication techniques would be most effective for a nurse to use during an

assessment interview with an adult Native American patient?

a. Open and friendly; ask direct questions; touch the patient’s arm or hand

occasionally for reassurance.

b. Frequent nonverbal behaviors, such as gestures and smiles; make an unemotional

face to express negatives.

c. d. Soft voice; break eye contact occasionally; general leads and reflective techniques.

Stern voice; unbroken eye contact; minimal gestures; direct questions.

ANS: C

Native American culture stresses living in harmony with nature. Cooperative, sharing styles

rather than competitive or intrusive approaches are preferred; thus, the more passive style

described would be best received. The other options would be more effective to use with

patients of a Western orientation.

PTS: 1 REF: DIF: Cognitive Level: Apply (Application)

Page 86 (Table 5-2) | Page 87 (Table 5-3) | Page 90

TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity

A Native American patient sadly describes a difficult childhood. The patient abused alcohol as

a teenager but stopped 10 years ago. The patient now says, “I feel stupid and good for nothing.

I don’t help my people.” How should the treatment team focus planning for this patient?

a. b. c. d. Psychopharmacological and somatic therapies should be central techniques.

Apply a psychoanalytic approach, focused on childhood trauma.

Depression and alcohol abuse should be treated concurrently.

Use a holistic approach, including mind, body, and spirit.

ANS: D

Native Americans, because of their beliefs in the interrelatedness of parts and about being in

harmony with nature, respond best to a holistic approach. No data are present to support dual

diagnosis, because the patient has resolved the problem of excessive alcohol use.

Psychopharmacological and somatic therapies may be part of the treatment, but the focus

should be more holistic. Psychoanalysis is a long-term expensive therapy; cognitive therapy

might be a better choice.

PTS: 1 DIF: Cognitive Level: Apply (Application)

REF: Page 86-87 | Page 86 (Table 5-2) | Page 88(Table 5-4)

TOP: Nursing Process: Planning/Outcomes Identification

MSC: Client Needs: Psychosocial Integrity

A Native American patient describes a difficult childhood and dropping out of high school.

The patient abused alcohol as a teenager to escape feelings of isolation but stopped 10 years

ago. The patient now says, “I feel stupid. I’ve never had a good job. I don’t help my people.”

Which nursing diagnosis applies?

a. Risk for other-directed violence c. Deficient knowledge

b. Chronic low self-esteem d. Social isolation

ANS: B12. 13. 14. The patient has given several indications of chronic low self-esteem. Forming a positive self-

image is often difficult for Native American individuals because these indigenous people must

blend together both American and Native American worldviews. No defining characteristics

are present for the other nursing diagnoses.

PTS: 1 DIF: Cognitive Level: Apply (Application)

REF: Page 92-93 TOP: Nursing Process: Diagnosis/Analysis

MSC: Client Needs: Psychosocial Integrity

Which viewpoint of an Asian American family will most affect decision making about care?

a. b. c. d. The father is the authority figure.

The mother is head of the household.

Women should make their own decisions.

Emotional communication styles are desirable.

ANS: A

Asian American families traditionally place the father in the position of power as the head of

the household. Mothers, as well as other women, are usually subservient to fathers in these

cultures. Asian Americans are more likely to be reserved.

PTS: 1 DIF: Cognitive Level: Understand (Comprehension)

REF: Page 89 (Table 5-5) | Page 93-95 TOP: Nursing Process: Planning/Outcomes Identification

MSC: Client Needs: Psychosocial Integrity

Which intervention best demonstrates that a nurse correctly understands the cultural needs of

a hospitalized Asian American patient diagnosed with a mental illness?

a. b. c. d. Encouraging the family to attend community support groups

Involving the patient’s family to assist with activities of daily living

Providing educational pamphlets to explain the patient’s mental illness

Restricting homemade herbal remedies the family brings to the hospital

ANS: B

The Asian community values the family in caring for each other. The Asian community uses

traditional medicines and healers, including herbs for mental symptoms. The Asian

community describes illness in somatic terms. The Asian community attaches a stigma to

mental illness, so interfacing with the community would not be appealing.

PTS: 1 REF: Page 89 (Table 5-5) MSC: Client Needs: Psychosocial Integrity

DIF: Cognitive Level: Apply (Application)

TOP: Nursing Process: Implementation

A nurse speaks with family members of a Chinese American parent recently diagnosed with

major depression. Which comment by the nurse will the family find most comforting? “The

nursing staff will:

a. b. c. d. take good care of your parent.”

pray with your parent several times a day.”

teach your parent important self-care strategies.”

educate your parent about safety information regarding medication.”

ANS: A15. 16. 17. Chinese Americans hold an Eastern (balance) worldview. Persons who are ill or need health

care are vulnerable and need protection. The family will find comfort in a nurse’s statement

that good care will be provided. The distracters apply to persons with a Western or indigenous

worldview.

PTS: 1 REF: Page 86 (Table 5-2) MSC: Client Needs: Psychosocial Integrity

DIF: Cognitive Level: Analyze (Analysis)

TOP: Nursing Process: Implementation

A patient in the emergency department shows a variety of psychiatric symptoms, including

restlessness and anxiety. The patient says, “I feel sad because evil spirits have overtaken my

mind.” Which worldview is most applicable to this individual?

a. Eastern/balance c. Western/scientific

b. Southern/holistic d. Indigenous/harmony

ANS: D

Persons of an indigenous worldview believe disease results from a lack of personal,

interpersonal, environmental, or spiritual harmony and that evil spirits exist. The holism of

body-mind-spirit is a key component of this view. If one believes an evil spirit has taken

control, distress results. Western and Eastern worldviews do not embrace spirits. See

relationship to audience response question.

PTS: 1 REF: Page 85-86 (Table 5-2) MSC: Client Needs: Psychosocial Integrity

DIF: Cognitive Level: Understand (Comprehension)

TOP: Nursing Process: Assessment

A nurse prepares to teach important medication information to a patient of Mexican heritage.

How should the nurse manage the teaching environment?

a. b. c. d. Stand very close to the patient while teaching.

Maintain direct eye contact with the patient while teaching.

Maintain a neutral emotional tone during the teaching session.

Sit 4 feet or more from the patient during the teaching session.

ANS: A

Latin American cultures use close personal space, closer than many other minority groups.

Standing very close to the patient frequently indicates acceptance. Direct eye contact should

not be prolonged with this patient. Persons of this cultural heritage have high emotionality.

PTS: 1 DIF: Cognitive Level: Apply (Application)

REF: Page 87 (Table 5-3) TOP: Nursing Process: Implementation

MSC: Client Needs: Health Promotion and Maintenance

A Chinese American patient diagnosed with an anxiety disorder says, “My problems began

when my energy became imbalanced.” The nurse asks for the patient’s ideas about how to

treat the imbalance. Which comment would the nurse expect from this patient?

a. b. c. d. “My family will bring special foods to help me get well.”

“I hope my health care provider will prescribe some medication to help me.”

“I think I would benefit from talking to other patients with a similar problem.”

“I would like to have a native healer perform a ceremony to balance my energy.”

ANS: A18. 19. 20. The concept of energy imbalance as a source of illness is an explanatory model familiar to

Asian cultures. A source of healing is dietary change to include either “hot” or “cold” foods to

correct the imbalance. “Hot” and “cold” in this case do not refer to thermal properties of the

foods. Medication would not be a treatment suggested by a patient with an Eastern worldview.

Someone from an indigenous culture may suggest rituals. Group discussion of mental illness

would not be appealing to a Chinese American.

PTS: 1 REF: Page 86 (Table 5-2) MSC: Client Needs: Psychosocial Integrity

DIF: Cognitive Level: Apply (Application)

TOP: Nursing Process: Planning

An experienced psychiatric nurse plans to begin a new job in a community-based medication

clinic. The clinic sees culturally diverse patients. Which action should the nurse take first to

prepare for this position?

a. b. c. d. Investigate cultural differences in patients’ responses to psychotropic medications.

Contact the clinical nurse specialist for guidelines regarding cultural competence.

Examine the literature on various health beliefs of members of diverse cultures.

Complete an online continuing education offering about psychopharmacology.

ANS: A

An experienced nurse working on a mental health inpatient unit would be familiar with the

action and side effects of most commonly prescribed psychotropic medications. However,

because the clinic serves a culturally diverse population, reviewing cultural differences in

patients’ responses to these medications is helpful and vital to patient safety. The distracters

identify actions the nurse would take later.

PTS: 1 DIF: Cognitive Level: Analyze (Analysis)

REF: Page 91-92 TOP: Nursing Process: Planning

MSC: Client Needs: Physiological Integrity

A psychoeducational session will discuss medication management for a culturally diverse

group of patients. Group participants are predominantly members of minority cultures. Of the

four staff nurses below, which nurse should lead this group?

a. Very young registered nurse c. Newly licensed registered nurse

b. Older, mature registered nurse d. A registered nurse who is very thin

ANS: B

Persons of minority cultures value age and wisdom. Persons with a Western worldview tend to

value youth. An older, mature registered nurse would be the most credible leader of this

group. The nurse’s size has no bearing on credibility.

PTS: 1 REF: Page 88-89 (Table 5-4) MSC: Client Needs: Psychosocial Integrity

DIF: Cognitive Level: Apply (Application)

TOP: Nursing Process: Planning

A nurse wants to engage an interpreter for a severely anxious 21-year-old male who

immigrated to the United States two years ago. Of the four interpreters below who are

available and fluent in the patient’s language, which one should the nurse call?

a. 65-year-old female professional interpreter

b. 24-year-old male professional interpreter

c. A member of the patient’s family21. 22. 23. d. The patient’s best friend

ANS: B

A professional interpreter will be most effective because he/she will be able to interpret both

language and culture. When an interpreter is engaged, the interpreter should be matched to the

patient as closely as possible in gender, age, social status, and religion. Interpreters should not

be relatives or friends of the patient. The stigma of mental illness may prevent the openness

needed during the encounter.

PTS: 1 DIF: Cognitive Level: Analyze (Analysis)

REF: Page 88-90 TOP: Nursing Process: Planning

MSC: Client Needs: Psychosocial Integrity

A patient who has been hospitalized for 3 days with a serious mental illness says, “I’ve got to

get out of here and back to my job. I get 60 to 80 messages a day, and I’m getting behind on

my email correspondence.” What is this patient’s perspective about health and illness?

a. Fateful, magical c. Western, biomedical

b. Eastern, holistic d. Harmonious, religious

ANS: C

The Western biomedical perspective holds the belief that sick people should be as independent

and self-reliant as possible. Self-care is encouraged; one gets better by “getting up and getting

going.” An ability to function at a high level is valued. See relationship to audience response

question.

PTS: 1 REF: Page 89 (Table 5-5) MSC: Client Needs: Psychosocial Integrity

DIF: Cognitive Level: Understand (Comprehension)

TOP: Nursing Process: Assessment

A white patient of German descent rocks back and forth, grimaces, and rubs both temples.

What is the nurse’s best action?

a. b. c. d. Assess the patient for extrapyramidal symptoms.

Sit beside the patient and rock in sync.

Offer to pray with the patient.

Assess the patient for pain.

ANS: D

This patient of German descent would hold a Western worldview and be stoic about pain. This

patient will keep pain as silent as possible and be reluctant to disclose pain unless the nurse

actively assesses for it. The patient’s nonverbal communication suggests pain rather than EPS.

The patient would probably not respond positively to prayer or the nurse’s rocking behavior.

PTS: 1 REF: Page 89 (Table 5-5) MSC: Client Needs: Physiological Integrity

DIF: Cognitive Level: Apply (Application)

TOP: Nursing Process: Assessment

A Vietnamese patient’s family reports that the patient has wind illness. Which menu selection

will be most helpful for this patient?

a. Iced tea b. Ice cream c. Warm broth

d. Gelatin dessert

ANS: C24. 25. 26. Wind illness is a culture-bound syndrome found in the Chinese and Vietnamese population. It

is characterized by a fear of cold, wind, or drafts. It is treated by keeping very warm and

avoiding foods, drinks, and herbs that are cold. Warm broth would be most in sync with the

patient’s culture and provide the most comfort. The distracters are cold foods.

PTS: 1 REF: Page 91 (Box 5-2) MSC: Client Needs: Psychosocial Integrity

DIF: Cognitive Level: Analyze (Analysis)

TOP: Nursing Process: Implementation

A Mexican American patient puts a picture of the Virgin Mary on the bedside table. What is

the nurse’s best action?

a. b. c. d. Move the picture so it is beside a window.

Send the picture to the business office safe.

Leave the picture where the patient placed it.

Send the picture home with the patient’s family.

ANS: C

Cultural heritage is expressed through language, works of art, music, dance, customs,

traditions, diet, and expressions of spirituality. This patient’s prominent placement of the

picture is an example of expression of cultural heritage and spirituality. The nurse should not

move it unless the patient’s safety is jeopardized.

PTS: 1 DIF: Cognitive Level: Apply (Application)

REF: Page 83-84 | Page 86-87 TOP: Nursing Process: Implementation

MSC: Client Needs: Psychosocial Integrity

A nurse begins work in an agency that provides care to members of a minority ethnic

population. The nurse will be better able to demonstrate cultural competence after:

a. identifying culture-bound issues.

b. implementing scientifically proven interventions.

c. correcting inferior health practices of the population.

d. exploring commonly held beliefs and values of the population.

ANS: D

Cultural competence is dependent on understanding the beliefs and values of members of a

different culture. A nurse who works with an individual or group of a culture different from

his or her own must be open to learning about the culture. The other options have little to do

with cultural competence or represent only a portion of the answer.

PTS: 1 REF: Page 86 | Page 93 MSC: Client Needs: Psychosocial Integrity

DIF: Cognitive Level: Apply (Application)

TOP: Nursing Process: Assessment

A nurse cares for a first-generation American whose family emigrated from Germany. worldview about the source of knowledge would this patient likely have?

a. b. c. d. Knowledge is acquired through use of affective or feeling senses.

Science is the foundation of knowledge and proves something exists.

Knowledge develops by striving for transcendence of the mind and body.

Knowledge evolves from an individual’s relationship with a supreme being.

Which

ANS: B27. 28. The European-American perspective of acquiring knowledge evolves from science. The

distracters describe the beliefs of other cultural groups. See relationship to audience response

question.

PTS: 1 REF: Page 89 (Table 5-5) MSC: Client Needs: Psychosocial Integrity

DIF: Cognitive Level: Understand (Comprehension)

TOP: Nursing Process: Assessment

The nurse administers medications to a culturally diverse group of patients on a psychiatric

unit. What expectation should the nurse have about pharmacokinetics?

a. b. Patients of different cultural groups may metabolize medications at different rates.

Metabolism of psychotropic medication is consistent among various cultural

groups.

c. Differences in hepatic enzymes will influence the rate of elimination of

psychotropic medications.

d. It is important to provide patients with oral and written literature about their

psychotropic medications.

ANS: A

Cytochrome enzyme systems, which vary among different cultural groups, influence the rate

of metabolism of psychoactive drugs. Renal function influences elimination of psychotropic

medication; hepatic function influences metabolism rates. Information about medication is

important but does not apply to pharmacokinetics.

PTS: 1 DIF: Cognitive Level: Understand (Comprehension)

REF: Page 91-92 TOP: Nursing Process: Assessment

MSC: Client Needs: Physiological Integrity

A nurse prepares to assess a newly hospitalized patient who moved to the United States 6

months ago from Somalia. The nurse should first determine:

a. if the patient’s immunizations are current.

b. the patient’s religious preferences.

c. the patient’s specific ethnic group.

d. whether an interpreter is needed.

ANS: D

The assessment depends on communication. The nurse should first determine whether an

interpreter is needed. The other information can be subsequently assessed.

PTS: 1 DIF: Cognitive Level: Apply (Application)

REF: Page 88-89 TOP: Nursing Process: Assessment

MSC: Client Needs: Psychosocial Integrity

MULTIPLE RESPONSE

1. Which questions should the nurse ask to determine an individual’s worldview? Select all that

apply.

a. What is more important: the needs of an individual or the needs of a community?

b. How would you describe an ideal relationship between individuals?

c. How long have you lived at your present residence?

d. Of what importance are possessions in your life?2. 3. e. Do you speak any foreign languages?

ANS: A, B, D

The answers provide information about cultural values related to the importance of

individuality, material possessions, relational connectedness, community needs versus

individual needs, and interconnectedness between humans and nature. These will assist the

nurse to determine a patient’s worldview. Other follow-up questions are needed to validate

findings.

PTS: 1 DIF: Cognitive Level: Apply (Application)

REF: Page 86 (Table 5-2) | Page 93-94 TOP: Nursing Process: Assessment

MSC: Client Needs: Psychosocial Integrity

Why is the study of culture so important for psychiatric nurses in the United States? Select all

that apply.

a. b. c. d. Psychiatric nurses often practice in other countries.

Psychiatric nurses must advocate for the traditions of the Western culture.

Cultural competence helps protect patients from prejudice and discrimination.

Patients should receive information about their illness and treatment in terms they

understand.

e. Psychiatric nurses often interface with patients and their significant others over a

long period of time.

ANS: C, D, E

One purpose of cultural competence is for the psychiatric nurse to relate and explain

information about the patient’s illness and treatment in an understandable way, incorporating

the patient’s own beliefs and values. A fundamental aspect of nursing practice is advocacy.

Cultural competence promotes recognition of prejudices in care, such as stigma and

misdiagnosis. Psychiatric nurses often interface with patients and families over years and in

community settings.

PTS: 1 DIF: Cognitive Level: Understand (Comprehension)

REF: Page 83-84 TOP: Nursing Process: Evaluation

MSC: Client Needs: Psychosocial Integrity

The nurse should be particularly alert to somatization of psychological distress among patients

whose cultural beliefs include: (select all that apply)

a. mental illness reflects badly on the family.

b. mental illness shows moral weakness.

c. intergenerational conflict is common.

d. the mind, body, and spirit are merged.

e. food choices influence one’s health.

ANS: A, B, D

Physical symptoms are seen as more acceptable in cultural groups in which interdependence

and harmony of the group are emphasized. Mental illness is often perceived as reflecting a

failure of the entire family. In groups in which mental illness is seen as a moral weakness and

both the individual and family are stigmatized, somatization of mental distress is better

accepted. In groups in which mind, body, and spirit are holistically perceived, somatization of

psychological distress is common. Somatization and food are not commonly related.

Intergenerational conflict has not been noted as a risk factor for somatization.PTS: 1 DIF: Cognitive Level: Understand (Comprehension)

REF: Page 90-91 TOP: Nursing Process: Assessment

MSC: Client Needs: Psychosocial Integrity

MATCHING

Match the culture-bound syndrome in the left column with the patient most likely to

experience it from the right column. Answers from the right column may be used more than

once.

Culture-Bound Syndrome

1. Ataque de nervios

2. Ghost sickness

3. Hwa-byung

4. Susto

5. Wind illness

Patient’s Cultural Heritage

a. Navajo

b. Korean

c. Latin American

d. Chinese

1. ANS: C PTS: 1 DIF: Cognitive Level: Understand (Comprehension)

REF: Page 90-91 (Box 5-2) TOP: Nursing Process: Assessment

MSC: Client Needs: Psychosocial Integrity. Culture-bound syndromes apply to selected population

groups.

2. ANS: A PTS: 1 DIF: Cognitive Level: Understand (Comprehension)

REF: Page 90-91 (Box 5-2) TOP: Nursing Process: Assessment

MSC: Client Needs: Psychosocial Integrity. Culture-bound syndromes apply to selected population

groups.

3. ANS: B PTS: 1 DIF: Cognitive Level: Understand (Comprehension)

REF: Page 90-91 (Box 5-2) TOP: Nursing Process: Assessment

MSC: Client Needs: Psychosocial Integrity. Culture-bound syndromes apply to selected population

groups.

4. ANS: C PTS: 1 DIF: Cognitive Level: Understand (Comprehension)

REF: Page 90-91 (Box 5-2) TOP: Nursing Process: Assessment

MSC: Client Needs: Psychosocial Integrity. Culture-bound syndromes apply to selected population

groups.

5. ANS: D PTS: 1 DIF: Cognitive Level: Understand (Comprehension)

REF: Page 90-91 (Box 5-2) TOP: Nursing Process: Assessment

MSC: Client Needs: Psychosocial Integrity. Culture-bound syndromes apply to selected population

groups.

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