A nurse is caring for a Chinese client who is hospitalized due to pneumonia

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1. An American nurse tries to speak with a Korean client who cannot understand the English language. To effectively communicate to a client with a different language, which of the following should the nurse implement?

1. Have an interpreter to translate.
   
2. Speak slowly.
   
3. Speak loudly and closely to the client.
   
4. Speak to the client and family together.

2. Which of the following clients has the lowest risk of diabetes mellitus and stroke?

1. A 45-year-old African-American woman.
2. A 35-year-old Native-American man.
3. A 30-year-old Hispanic-American man.
4. A 25-year-old Asian-American woman.

3. The nurse is providing instructions to a Chinese-American client about the frequency and dosages of the take home medicines. When conducting the teaching, the client continuously turns away from the nurse. The nurse should do which of the following appropriate action?

1. Walk around the client so that the nurse can constantly face the client.
2. Call the attention of the client by speaking loudly.
3. Continue with the instructions, then confirming client’s understanding.
4. Hand over a written instruction and discuss only what the client doesn’t understand.

4. The ambulatory care nurse is discussing preoperative procedures with a Japanese American client who is scheduled for surgery the following week. During the discussion, the client continually smiles and nods the head. How should the nurse interpret this nonverbal behavior?

1. An acceptance of the treatment.
2. Client understanding of the preoperative procedures.
3. Reflecting a cultural value.
4. Client agreement to the required procedures.

5.The nurse identifies low-risk therapies to a client and should include which therapy(s) in the discussion, except?

1. Acupuncture.
2. Relaxation.
3. Touch.
4. Prayer.

6. A clinic nurse is preparing to examine a Hispanic child who was brought by the mother for his first physical check-up. While assessing the child, the nurse would avoid doing which of the following?

1. Weighing the client.
2. Asking the mother questions about the child.
3. Having an interpreter if necessary.
4. Admiring the child.

7. A nurse is preparing to deliver a food tray to a Jewish client. The nurse checks the food on the tray and notes that the client has received hamburger and whole milk as a beverage. Which is the appropriate action for the nurse?

1. Ask the dietary department to replace the hamburger with crabs.
2. Replace the whole milk with fat-free milk.
3. Call the dietary department and ask for a new meal tray.
4. Deliver the designated food tray to the client.

8. A clinic nurse is performing an admission assessment for an African-American client scheduled for an emergency appendectomy. Which of the following questions would be inappropriate for the nurse to ask for the initial evaluation?

1. Do you have any allergy to medicines?
2. When did the pain start?
3. Do you have any difficulty breathing?
4. How close is your family during these situations?

9. A nurse is caring for a Chinese client who is hospitalized due to pneumonia. Based on their culture, which of the following is believed to be the cause of the illness?

1. An illness is cast by an enemy.
2. An illness is a result of punishment for sins.
3. An illness may be attributed to overexertion.
4. An illness may be given by someone who did not want it.

10. A nurse is caring for a client who has symptoms of chills, fever, no sweating, headache, nasal congestion, and stiffness and pain in the shoulders, upper back, neck, and back of the head that are common in Chinese culture and is called as syndromes of Wind. This is an example of which of the following?

1. Culture shock.
2. Culture-bound syndrome.
3. Cultural awareness.
4. Culture biased.

11. A nurse is caring a Native American client who experiences emotional distress due to a family problem. In anticipating pharmacological treatment for the client, the nurse understands that they would most likely:

1. Establish the trust of the health care provider first before accepting the treatment.
2. Call a clergy to ask for the religious preference of the treatment.
3. Manage the emotional distress on their own to avoid disgrace.
4. Resort with the use of herbal medicines with healing properties.

12. A nurse is conducting an assessment of an American Indian woman who has come to the clinic complaining of a headache. The patient tells the nurse that the medicines prescribed by the tribal healer have done some good. What is the appropriate response of the nurse at this time?

1. Tell me about these medicines and how often you are using them.
2. I advise you to refrain taking those medicines from the tribal healer.
3. Could these medicines cause your headaches?
4. Maybe you should increase the frequency of the healer’s medicines.

13. A nurse is preparing a plan of care for a client who is a Jehovah’s Witness. The client has been told that the surgery is necessary. The nurse considers the client’s religious preferences in developing the plan of care and documents that:

1. Giving any medication is not allowed.
2. Surgery is strictly prohibited.
3. Blood products can not be administered.
4. Alternative medicines can be advised.

14. A Chinese-American client experiencing cough with clear white phlegm, which is believed to be a yin disorder, is likely to treat it with:

1. Foods considered being yin.
2. Foods considered being yang.
3. Aromatherapy.
4. Touch therapy.

15. Which of the following food items would be appropriate for a Jewish client  who follows a kosher diet?

1. Shrimp and mussels.
2. Beef and pork.
3. Tuna and salmon.
4. Cheese and milk.

1. Answer: A. Have an interpreter to translate. Having an interpreter would be would be the best practice when communicating with a client who speaks a different language.

2. Answer: D. A 25-year-old Asian-American woman. Among the choices, Asian Americans have the lowest risk of diabetes mellitus and stroke due to their health and dietary practices.

3. Answer: C. Continue with the instructions, verifying client understanding. Most Chinese maintains a formal personal space with others, which is a form of respect. Most Chinese are uncomfortable with face-to-face communications, especially when eye contact is direct. If the client turns away from the nurse during a conversation, the most appropriate action is to continue with the instructions

• Option A: Walking around to the client so that the nurse faces the client is in direct conflict with the cultural practice.
• Option B: Calling the attention and speaking loudly is viewed as a rude gesture.
• Option D: Discussing only what the client cannot understand is not an acceptable practice of a nurse.

4. Answer: C. Reflecting a cultural value. Nodding or smiling by a Japanese American client may reflect only the cultural value of interpersonal harmony. This nonverbal behavior may not be an indication of acceptance of the treatment, agreement with the speaker, or understanding of the procedure.

5. Answer: A. Acupuncture. Low-risk therapies are therapies that have no adverse effects and when implementing care, can be used by the nurse who has training and experiences in their use. It includes meditation, relaxation techniques, imagery, music therapy, massage, touch, laughter and humor, and spiritual measures, such as prayer.

6. Answer: D. Admiring the child. Admiring a Hispanic-American child during the first encounter with a stranger should be avoided since this may give the child with the “evil eye” (the child will get sick). If this is done, it can be avoided by touching the child afterward.

7. Answer: C. Call the dietary department and ask for a new meal tray. “You may not cook a young animal in the milk of its mother” -Torah says (Ex.23:19). From this, it is derived that milk and meat products may not be combined together. Not only may they not be cooked together, but they may not be served together on the same table and surely not eaten at the same time. This rule is followed observantly by the Jewish people so the appropriate nursing action is to call the dietary department to change the meal tray of the patient.

8. Answer: D. How close is your family during these situations? For African-Americans, asking personal questions during the initial encounter is prohibited since it may view as a way of interfering with them.

9. Answer: C. An illness may be attributed to overexertion. Illness for Chinese people may be attributed to prolonged sitting or lying or to overexertion.

10. Answer: B. Culture-bound syndrome. Culture-bound syndrome is a combination of psychiatric and somatic symptoms that are common in one culture group or not another.

11. Answer: D. Resort with the use of herbal medicines with healing properties. Native American cultures often use a variety of herbs or other plant and root remedies.

• Option A: Usually Northern European American people value medicine and primary health care hence already having an established health care provider.
• Option B: Latin Americans offer to call clergy because of the significance of religious preference related to any illness.
• Option C: Asian American culture views mental illness as shameful and will keep the stress on their own to manage it.

12. Answer: A. Tell me about these medicines and how often you are using them. Asking the patient about the nature of these medicines and how often the client  uses them allows the nurse to collect data about the medicines and their uses, to learn more about the practices used by this patient to improve her health, and to check for potential drug interaction before prescribing other medications or treatment.

• Option B: Advising the client to stop taking any nonprescription medicines is inappropriate until the nurse knows the details about all medicines used by the client.
• Option C: Suggesting the client’s headaches are caused by the healer’s medicines is inappropriate until the nurse knows details about the medicines.
• Option D: Telling the patient to increase the frequency of the healer’s medicines is not within the practice of a nurse.

13. Answer: C. Blood products can not be administered. Among Jehovah’s Witnesses, the administration of blood and blood products is prohibited.

14. Answer: B. foods considered to be yang. In the yin and yang theory, health is believed to exist when all aspects of the person are in perfect balance. Yin foods are cold and yang foods are hot. One eats cold foods when hot has a hot illness and one eats hot foods when one has a cold illness.

15. Answer: C. Tuna and salmon. In the Jewish religion, Only fish that have scales and fins are allowed such as tuna and salmon;

• Option A: Shellfish such as shrimps, crabs, mussels, and lobsters are forbidden.
• Option B: Meats that are allowed include animals that are vegetable eaters, cloven-hoofed, and ritually slaughtered.
• Option D: Cheese and milk coming from animal fat are prohibited.