Chapter 06: ETHICS IN COMMUNITY HEALTH NURSING PRACTICE
Test Bank
MULTIPLE CHOICE
- In which year was the first code of ethics for nursing written?
| a. | In 1893, by Lystra Gretter |
| b. | In 1950, by the American Nurses Association (ANA) House of Delegates |
| c. | In 1954, by the International Council of Nurses (ICN) |
| d. | In 2001, by the American Nurses Association (ANA) House of Delegates |
ANS: A
The Nightingale Pledge, considered nursing’s first code of ethics, was written by Lystra Gretter in 1893.
DIF: Cognitive Level: Knowledge REF: p. 166 OBJ: 1
TOP: CRNE Competency: Professional Practice
- A community health nurse (CHN) is facing an ethical dilemma and is not able to determine which option would have the best outcome. She finally decides to talk to her supervisor and let the supervisor decide which action to take. Ethically, into which category does the CHN’s decision fall?
| a. | The decision is appropriate because the supervisor is responsible for the CHN’s choices. |
| b. | The decision is intelligent because the supervisor has access to resource persons (spiritual leaders, physicians, administrators) who may know of options that the CHN has not considered. |
| c. | The decision is advisable, but only as an opportunity to further discuss the issue because ultimately the CHN is still responsible for her own choice. |
| d. | The decision is smart because the supervisor would be more aware of community priorities. |
ANS: C
Ethically, each CHN is responsible for his or her own decisions. A CHN cannot circumvent ethical accountability by avoiding decision making and relying solely on a supervisor or any external rule or policy to make a decision.
DIF: Cognitive Level: Application REF: p. 167 OBJ: 2
TOP: CRNE Competency: Professional Practice
- Which of the following is the first and most crucial step in the ethical decision-making process?
| a. | Assessing the context or environment in which a decision must be made |
| b. | Considering the various ethical principles or theories |
| c. | Identifying the ethical concerns |
| d. | Making a decision and acting on it |
ANS: C
The first step in the ethical decision-making framework is to carefully identify the ethical issue or dilemma.
DIF: Cognitive Level: Application REF: p. 167, Table 6-1
OBJ: 3 TOP: CRNE Competency: Professional Practice
- A CHN has been asked to meet with a couple that recently emigrated from Botswana. The clinic doctor told the man about his wife’s diagnosis of breast cancer, and the couple was about to leave. Although all of the following actions by the CHN might be appropriate, which one is probably the most important action, ethically?
| a. | Insisting that the family set up a surgical appointment for the wife immediately |
| b. | Assessing the family’s current living situation, including insurance and other assets |
| c. | Educating the family about breast cancer, including the standard treatment and the prognosis |
| d. | Interviewing the family to find out about their perception of the threat to the family’s well-being |
ANS: D
Canada is a country made up of diverse ethnic groups and diverse cultural values. Before any intervention can be made, health care professionals must understand the family’s cultural, psychological, social, communal, environmental, and other contexts because these contexts affect the way issues are perceived and decisions made. Therefore, it is crucial to first interview the family to assess their understanding of the situation before deciding on the next step.
DIF: Cognitive Level: Application REF: p. 167, Table 6-1
OBJ: 3 TOP: CRNE Competency: Professional Practice
- A CHN finds that a family has decided not to accept medical intervention for a particular health concern because the intervention could affect the family member’s ability to return to work, and consequently the family’s resources would be drastically reduced. Which of the following actions by the CHN would ethically be most appropriate in this situation?
| a. | The CHN should appreciate that the couple has made the decision that they feel is best for their family and take no further action if it is clear that they have made an informed choice. |
| b. | The CHN should insist that every individual in society has a right to health care and that the family will have to find some way to raise funds for the needed treatment. |
| c. | The CHN should talk to the social worker on the health care team to see if he or she can convince the couple to agree to the medical intervention. |
| d. | The CHN should arrange a meeting with the family to discuss the consequences of the couple’s decision. |
ANS: A
Although the CHN may attempt to change the couple’s thinking through persuasion, in the absence of immediate and grievous harm, there is no ethical requirement to interfere in the family’s decision making. The CHN respects and promotes the autonomy of persons and helps them express their health needs and values and obtain desired information to make informed decisions.
DIF: Cognitive Level: Application REF: pp. 168–169 OBJ: 7
TOP: CRNE Competency: Professional Practice
- A pregnant teenage client asks a CHN to provide information on abortions and a list of health care providers who offer abortion services. The CHN has very strong personal beliefs against abortion that would get in the way of helping the client. What should the CHN do?
| a. | Call in another CHN to care for this client. |
| b. | Explain, from the personal perspective, all the reasons why abortion should be made illegal. |
| c. | Offer the client a combination of oral contraceptives to induce spontaneous abortion. |
| d. | Provide information on alternatives to abortion and give the client information on adoption agencies. |
ANS: A
This creates an ethical dilemma for the CHN. An ethical dilemma is a puzzling moral problem in which a person can envision morally justified reasons for both taking and not taking a certain course of action. If the CHN feels strongly that he or she cannot work with the client in this situation, another CHN should be called on for help, or the client should be referred to other health care providers who can provide the care she needs.
DIF: Cognitive Level: Analysis REF: p. 167, Table 6-1; p. 171
OBJ: 7 TOP: CRNE Competency: Professional Practice
- Some CHNs are disagreeing strongly about the appropriate action to take in relation to a particular family in which one member is ill and the other family members have chosen to continue working at their jobs instead of take time off to care for the ill family member. One CHN states, “It is the wife’s responsibility to care for her ill husband.” Which of the following types of thinking is this CHN applying?
| a. | Consequentialism |
| b. | Deontological ethics |
| c. | Principlism |
| d. | Utilitarianism |
ANS: B
The CHN is focusing on duty with a deontological approach—the moral obligation to engage in certain actions.
DIF: Cognitive Level: Application REF: p. 169 OBJ: 7
TOP: CRNE Competency: Professional Practice
- Some CHNs are disagreeing strongly about the appropriate action to take in relation to a particular family in which one member is ill and the other family members have chosen to continue working at their jobs rather than take time off to care for the ill family member. One CHN states, “The whole family is being affected and will fall apart if they don’t focus on the family’s needs first.” Which of the following types of thinking is this CHN applying?
| a. | Communitarianism |
| b. | Deontological ethics |
| c. | Principlism |
| d. | Utilitarianism |
ANS: D
The CHN is focusing on the whole family, not individual members, and the consequences or outcomes for the whole family during this time of stress.
DIF: Cognitive Level: Application REF: p. 169 OBJ: 3
TOP: CRNE Competency: Professional Practice
- Some CHNs are disagreeing strongly about the appropriate action to take in relation to a particular family in which one member is ill and the other family members have chosen to continue working at their jobs instead of take time off to care for the ill family member. One CHN asks, “What sort of example does this behaviour set for the community? What if everyone always put their jobs before their families?” Which of the following types of thinking is this CHN applying?
| a. | Communitarianism |
| b. | Deontological ethics |
| c. | Principlism |
| d. | Utilitarianism |
ANS: A
The CHN is focusing on the whole community, with consideration for tradition and the interaction among community members that creates their history and tradition.
DIF: Cognitive Level: Application REF: p. 171 OBJ: 7
TOP: CRNE Competency: Professional Practice
- Some CHNs are disagreeing strongly about the appropriate action to take in relation to a particular family in which one member is ill and the other family members have chosen to continue working at their jobs rather than take time off to care for the ill family member. One CHN states, “But it doesn’t have to be either–or. Perhaps the family members could take turns calling in sick for just 2 or 3 days. That way, they could all help and yet not upset their employers. Wouldn’t that be fair?” Which of the following types of thinking is this CHN applying?
| a. | Communitarianism |
| b. | Deontological ethics |
| c. | Principlism |
| d. | Utilitarianism |
ANS: C
The CHN is focusing on ethical principles such as beneficence (doing good for the ill family member), nonmaleficence (doing no harm, even to the employer), and justice (taking turns and sharing equally).
DIF: Cognitive Level: Application REF: p. 171 OBJ: 7
TOP: CRNE Competency: Professional Practice
- Some CHNs are disagreeing strongly about the appropriate action to take in relation to a particular family in which one member is ill and the other family members have chosen to continue working at their jobs rather than take time off to care for the ill family member. A CHN states, “It’s not up to us; it’s the family’s decision.” Which of the following types of thinking is this CHN applying?
| a. | Communitarianism |
| b. | Deontological ethics |
| c. | Principlism |
| d. | Utilitarianism |
ANS: C
The CHN is using an ethical principle, namely autonomy, in which each person or group can choose actions that synchronize with their values and goals.
DIF: Cognitive Level: Application REF: p. 171 OBJ: 7
TOP: CRNE Competency: Professional Practice
- Three CHNs are disagreeing about the appropriate treatment for Mrs. Mehta, who is probably an excellent candidate for hospice care. The first CHN says that deciding on care, rather than cure, is up to Mrs. Mehta, and no one else can decide for her. The second CHN says that it is the responsibility of the health care team to do what is best for Mrs. Mehta, and if the physician thinks there is still a possibility of cure, then the CHNs should do everything they can to implement the treatment plan. The third CHN says it is not fair for the family to expend all their resources on Mrs. Mehta, who is probably going to die in spite of the care provided by the health care team. Which one of the following conclusions can be drawn from this dispute?
| a. | Ethical principles can conflict with each other. |
| b. | The first CHN is correct because autonomy demands that the patient herself decide. |
| c. | The second CHN is correct because professional health care providers profess or promise to always do the best for those under their care. |
| d. | The third CHN is correct because utility demands the maximization of benefit for the majority. |
ANS: A
One of the criticisms of using ethical principles is that they can conflict in any given situation, and there are no rules to help resolve such conflicts.
DIF: Cognitive Level: Application REF: p. 168 OBJ: 7
TOP: CRNE Competency: Professional Practice
- Having heard several debates about the appropriate thing to do for a specific client, a CHN feels a real need for a rule that would help with decision making. Which one of the following criteria could the CHN apply to this rule for his or her decision making?
| a. | The rule absolutely will not get the CHN in trouble with employer. |
| b. | The rule will gain the support of an expert, such as a spiritual leader. |
| c. | The CHN would recommend the rule to anyone in a similar situation. |
| d. | The supervisor would feel comfortable reporting the rule to the administration. |
ANS: C
One of the rules in deontological decision making is to determine whether the proposed actions can be generalized so that all persons in similar situations are treated in the same way. Principlism suggests that the CHN examine the context and make the decision that could be morally justified within that context.
DIF: Cognitive Level: Application REF: p. 169, How To box
OBJ: 3 TOP: CRNE Competency: Professional Practice
- A man is bleeding profusely and screaming, perhaps out of fear, “I’ve got a right to see a doctor. I’m hurt. Someone has to take care of me!” Ethically, which one of the following premises could justify such a demand?
| a. | All hospitals receive provincial/territorial funding, and all employed adults pay taxes; so, all adults have a right to what their tax money has purchased. |
| b. | Saving an individual’s life improves society and upholds tradition. |
| c. | Our society believes that all persons should be treated equally and that basic needs, such as being saved from death, if possible, should be met. |
| d. | The man has a property right to his own body, and government is responsible to ensure that property rights are protected. |
ANS: C
The ethical theory of egalitarianism suggests that everyone is entitled to equal rights, equal treatment, and an equal share of the goods of society, and that government’s role is to ensure that this happens—at least on a basic level. Therefore, the man does have the right to emergency care.
DIF: Cognitive Level: Application REF: p. 170 OBJ: 7
TOP: CRNE Competency: Professional Practice
- Most of us believe that everyone should receive his or her fair share, that one should always be fair, and that each person should be allowed maximum liberty to make decisions about the self. Which one of the following does such an approach not take into account?
| a. | The needs of society as a whole |
| b. | The inconsistent desire or need for a share of resources |
| c. | The predisposition in some people for a need to be taken care of |
| d. | Insufficient resources to give everyone a fair share |
ANS: A
All of these principles of justice focus on the individual, which ignores the needs of society as a whole.
DIF: Cognitive Level: Application REF: pp. 171–172 OBJ: 3
TOP: CRNE Competency: Professional Practice
- A physician refuses to order pain medication for a drug addict who was severely injured in a car accident. When the CHN requests medication to be used p.r.n., the physician states that the client’s suffering from the pain of his injuries will build character. Which ethical theory is the physician using (or misusing)?
| a. | Consequentialism |
| b. | Communitarianism |
| c. | Virtue ethics |
| d. | Utilitarianism |
ANS: C
Virtue ethics emphasizes practical reasoning applied to character development. Although such action by a care provider is paternalistic and unethical on many grounds, the physician may truly have cared about enabling the injured addict to learn from his experience and possibly become addiction-free.
DIF: Cognitive Level: Application REF: p. 172 OBJ: 7
TOP: CRNE Competency: Professional Practice
- Which one of the following is the central, most important concept or action in nursing today?
| a. | Adapting to the use of computers and other technological advances |
| b. | Caring |
| c. | Distinguishing nursing care from medical care |
| d. | Seeking evidence-based outcomes |
ANS: B
Since the mid-1980s, nurses have written about caring being the essence of nursing—the ethical ideal.
DIF: Cognitive Level: Knowledge REF: p. 172 OBJ: 6
TOP: CRNE Competency: Nurse–Client Partnership
- Gilligan and Noddings both believe in the morality of responsibility in relationships. They emphasize connection. Which term is used to describe this belief?
| a. | A distributive justice approach |
| b. | A feminine ethic |
| c. | A principled approach |
| d. | Virtue ethics |
ANS: B
Because Gilligan and Noddings believe in the morality of responsibility in relationships that emphasized connection and caring as a moral imperative, their approach has been called a feminine ethic.
DIF: Cognitive Level: Knowledge REF: p. 173 OBJ: 3
TOP: CRNE Competency: Professional Practice
- Which of the following outcomes needs to occur in order to claim that advocacy has been truly successful or effective?
| a. | Audiences agree with a CHN who is advocating a change. |
| b. | Legislators discuss appropriate legislation to better allocate resources. |
| c. | People demand that the disenfranchised be better treated. |
| d. | Systematic social changes are made to improve quality of life. |
ANS: D
Advocacy is the application of information and resources to effect systematic changes in a community in order to reduce death and disability and improve quality of life. Although all of the above might be helpful, only when systematic social changes are made to improve quality of life can advocacy be considered effective.
DIF: Cognitive Level: Application REF: pp. 176–177 OBJ: 6
TOP: CRNE Competency: Professional Practice
- Which of the following methods is the best way to determine if a CHN has been effective in assessing community health needs and planning and implementing appropriate interventions?
| a. | Asking the CHN about the basis for the interventions and the CHN’s perception of their effectiveness |
| b. | Examining the community’s morbidity and mortality rate |
| c. | Reassessing community health needs to determine if they have been met |
| d. | Systematically surveying community residents regarding their perception |
ANS: B
Although all the above information is helpful, the outcome of appropriate advocacy should be decreased morbidity and mortality.
DIF: Cognitive Level: Application REF: p. 177 OBJ: 6
TOP: CRNE Competency: Professional Practice
- Which one of the following is probably the first step in resolving any ethical conflict?
| a. | Evaluating desirable outcomes |
| b. | Obtaining all relevant information |
| c. | Recognizing ethical issues and dilemmas |
| d. | Reviewing ethical principles and theories |
ANS: C
Ethical decision making begins with identification of the ethical issues and dilemmas. Those concerned cannot make sound ethical decisions if they cannot identify ethical issues and dilemmas.
DIF: Cognitive Level: Knowledge REF: p. 167, Table 6-1
OBJ: 2 TOP: CRNE Competency: Professional Practice
- Much ethical debate has revolved around issues in acute health care, for example, the continuation or withdrawal of medical treatment. In such a specific situation, which of the following is usually the dominant issue?
| a. | Doing what is best for the community |
| b. | Doing what is best for the family |
| c. | Obeying legal mandates |
| d. | Upholding the client’s autonomy |
ANS: D
In acute care settings, in the case of a specific issue, where primary ethical principles usually are applied, client autonomy is the dominant or most crucial principle.
DIF: Cognitive Level: Knowledge REF: pp. 168–169 OBJ: 2
TOP: CRNE Competency: Professional Practice
Stanhope: Community Health Nursing in Canada, Second Canadian Edition
Chapter 07: DIVERSITY
Test Bank
MULTIPLE CHOICE
- Which of the following practices applies to nursing care for clients with a foreign cultural background?
| a. | Altering nonverbal behaviour to reflect the cultural norms the client is used to |
| b. | Keeping all behaviours culturally neutral to avoid misinterpretation |
| c. | Relying on friendly gestures to communicate a caring attitude |
| d. | Avoiding showing prejudice by using the same behaviour with all clients |
ANS: A
Cultural competence in community health nurses (CHNs) includes the adoption of culturally congruent behaviours. CHNs need to make sure their nonverbal communication techniques take into consideration the client’s use of eye contact, facial expressions, body language, touch, and space.
DIF: Cognitive Level: Comprehension REF: p. 203, Table 7-5
OBJ: 7 TOP: CRNE Competency: Nurse–Client Partnership
- A CHN often used to sit with his legs crossed at the knees when collecting a client’s history. However, he stopped doing this around his Iranian clients after being told that they were offended because this posture exposed the sole of his foot. In changing his behaviour, which culture-related response did the CHN exhibit?
| a. | Cultural sensitivity |
| b. | Cultural awareness |
| c. | Cultural knowledge |
| d. | Cultural skill |
ANS: D
Cultural skill refers to the effective integration of cultural awareness and cultural knowledge to obtain relevant cultural data and meet the needs of culturally diverse clients. The CHN’s use of cultural skill ensures that nonverbal communication techniques take into consideration the client’s use of eye contact, facial expressions, body language, touch, and space.
DIF: Cognitive Level: Analysis REF: p. 203, Table 7-5
OBJ: 7 TOP: CRNE Competency: Nurse–Client Partnership
- A CHN states, “The best way to treat clients from other countries is to care for them the same way we would want to be cared for ourselves. After all, we are all human beings with the same expectations and needs.” Which culture-related response does this statement exemplify?
| a. | Cultural awareness |
| b. | Cultural blindness |
| c. | Cultural knowledge |
| d. | Cultural preservation |
ANS: B
Cultural blindness is a denial of diversity and the inability to recognize the uniqueness of individual clients. An example is CHNs who, attempting to be culturally unbiased, treat all clients in the same manner by conducting their nursing assessments using the same questions, do not actively listen to the responses, and fail to modify their questioning to gain an understanding of client culture and client uniqueness.
DIF: Cognitive Level: Comprehension REF: p. 204 OBJ: 7
TOP: CRNE Competency: Professional Practice
- A CHN rearranges the room and moves the bed of a bedridden Muslim client so that the client is facing toward Mecca for his daily prayers. What does the CHN’s culture-related response exemplify?
| a. | Cultural skill |
| b. | Cultural awareness |
| c. | Cultural brokering |
| d. | Cultural imposition |
ANS: A
Cultural skill refers to the effective integration of cultural awareness and cultural knowledge to obtain relevant cultural data and meet the needs of clients from diverse cultural backgrounds. For this client, daily prayers in the tradition of Islam are important, possibly more important from the client’s perspective than medical treatment.
DIF: Cognitive Level: Application REF: p. 203, Table 7-5
OBJ: 7 TOP: CRNE Competency: Nurse–Client Partnership
- Which one of the following is an example of “overt racism”?
| a. | Using traditional food and traditional dress |
| b. | Restricting the burning of sweet grass |
| c. | Participating in hate crimes |
| d. | Making job positions available only to persons who are Canadian-born |
ANS: C
Overt racism is an open demonstration by attitudes, actions, policies, and practices of a feeling of superiority over individuals or groups with the intent of harming or damaging. Hate crimes, for example, are considered to be one example of overt racism.
DIF: Cognitive Level: Analysis REF: p. 205 OBJ: 7
TOP: CRNE Competency: Professional Practice
- A health care provider states, “I’m not going to change the way I practise medicine regardless of where the client is from, because research shows that Western medicine is the best.” Which of the following behaviours does this statement exemplify?
| a. | Ethnocentrism |
| b. | Prejudice |
| c. | Racism |
| d. | Stereotyping |
ANS: A
Ethnocentrism, a type of cultural prejudice at the cultural population level, is the belief that one’s own cultural group determines the standards of behaviour by which all other groups are to be judged. CHNs who assume that their way of providing nursing care is the only right way are ethnocentric.
DIF: Cognitive Level: Application REF: p. 204 OBJ: 9
TOP: CRNE Competency: Nurse–Client Partnership
- A health care worker tells the CHN, “It does no good to try to teach those Aboriginal clients about nutrition because they will just eat whatever they want to, no matter how much we teach them.” Which of the following behaviours does this statement exemplify?
| a. | Cultural imposition |
| b. | Ethnocentrism |
| c. | Racism |
| d. | Stereotyping |
ANS: D
Stereotyping occurs when generalizations are applied to an individual without exploring individual values, beliefs, and behaviours. In this instance, the health care worker makes the assumption that all Aboriginal people are not educable. The health care worker is also guilty of making assumptions about noncompliance among other Aboriginal people she has known; this noncompliance may have had to do with their inability to buy nutritious foods, which tend to be more expensive.
DIF: Cognitive Level: Application REF: p. 205 OBJ: 9
TOP: CRNE Competency: Nurse–Client Partnership
- Migrant workers tend to have high occupational mobility, are often poor, and have limited formal education. They may seek health care only when they are ill and unable to work. What does the CHN need to do whenever she has a chance to interact with migrant workers?
| a. | Advocate for emergency health care. |
| b. | Teach prevention and health maintenance. |
| c. | Ensure funding is available for adequate nutrition. |
| d. | Contact the Workplace Safety and Insurance Board (WSIB). |
ANS: B
CHNs work with clients from diverse cultural backgrounds, and one example is migrant workers. Because migrant workers are highly mobile and tend to seek health care only when they are ill and unable to work, whenever a CHN interacts with these clients, it is important to teach them about disease prevention, health maintenance, health protection, and health promotion activities before the clients move on.
DIF: Cognitive Level: Application REF: p. 205 OBJ: 6
TOP: CRNE Competency: Health and Wellness
- A family from Mexico presents to the public health department. None of the family members speak English, and no one at the health department speaks Spanish. Which of the following will be the most appropriate action on the part of the CHN?
| a. | Attempting communication using an English–Spanish phrase book |
| b. | Calling the local hospital and arranging a referral |
| c. | Emphatically stating, “No hablo Español” (I don’t speak Spanish) and repeating as necessary |
| d. | Finding an interpreter to translate |
ANS: D
Communication with the client or family is required for a cultural assessment. When CHNs do not speak or understand the client’s language, they need to obtain an interpreter.
DIF: Cognitive Level: Analysis REF: p. 208 OBJ: 11
TOP: CRNE Competency: Nurse–Client Partnership
- A 40-year-old Bosnian Muslim woman who does not speak English presents to a community health centre in obvious pain and requests a female health care provider. She indicates through gestures that the pain originates in either the pelvic or the genital region. Assuming several people are available to interpret, which of the following persons would be the most appropriate choice of interpreter?
| a. | A female who does not know the client |
| b. | A female from the client’s community |
| c. | A male who is certified as a medical interpreter |
| d. | The client’s 20-year-old daughter |
ANS: A
Although it is important to use an experienced medical interpreter, in many cultures, it is considered inappropriate to have a male interpreter for a female client. This client has specifically requested a female health care provider; therefore, one might anticipate that the client will prefer a female interpreter as well. In spite of a male interpreter’s certification and ability, he cannot be effective if the client is withholding information that she feels is not right to discuss in front of a man. This client may also consider it inappropriate to have her daughter interpret private matters (especially of a sexual nature or if they involve infidelity). Additionally, the CHN should not use an interpreter from the same community as the client, in order to avoid breach of confidentiality.
DIF: Cognitive Level: Analysis REF: pp. 211–212, How To box
OBJ: 11 TOP: CRNE Competency: Nurse–Client Partnership
- At a local hospital, postpartum care policy requires that nurses observe the mother to assess her ability to care for the new baby and to promote bonding. A new immigrant mother says that, in her country, all infant care is provided by family members so that the mother can rest and recover. In her home country, it is believed that if the mother does not recover sufficiently, she will be unable to provide the best care. Which of the following actions will the culturally competent nurse take?
| a. | Allow family members to provide care to the baby and assess the mother’s knowledge of child care through discussion. |
| b. | Explain the importance of bonding and how all good mothers gladly assume these responsibilities. |
| c. | Explain that the process of postpartum recovery does not require this much rest, but does require that she provide infant care. |
| d. | Explain that the mother must abide by hospital policy because documentation of this ability is required for discharge. |
ANS: A
Culturally competent nursing care is individualized for each client, reflecting the client’s beliefs and values, and is provided with sensitivity.
DIF: Cognitive Level: Analysis REF: p. 187 OBJ: 7
TOP: CRNE Competency: Professional Practice
- The CHN who wishes to develop cultural competence can improve cultural awareness by doing which one of the following?
| a. | Completing a survey of all the ethnic groups in the CHN’s community |
| b. | Considering how the CHN’s personal beliefs and decisions are reflective of his or her culture |
| c. | Inviting a family from another cultural background to participate in an event with the CHN |
| d. | Studying the beliefs and traditions of persons coming from other cultures |
ANS: B
Cultural awareness is self-examination and in-depth exploration of one’s own beliefs and values as they influence behaviour.
DIF: Cognitive Level: Analysis REF: p. 202, Table 7-5
OBJ: 8 TOP: CRNE Competency: Professional Practice
- The incidence of type 2 diabetes among Aboriginal peoples (First Nations, Inuit, and Métis) is three to five times higher than in the general population. When teaching a nutrition class to a group of students, of which a large percentage is Aboriginal, the CHN incorporates into the presentation such foods as bannock and other healthy dishes familiar to Aboriginal students. Which level of prevention does this culturally sensitive action represent?
| a. | Primary prevention |
| b. | Secondary prevention |
| c. | Tertiary prevention |
| d. | Both primary and secondary prevention |
ANS: A
Primary prevention involves such activities as health teaching to prevent a problem from occurring.
DIF: Cognitive Level: Application REF: p. 209 OBJ: 12
TOP: CRNE Competency: Health and Wellness
- A nurse practitioner (NP) has just found out that her immigrant client is not taking the penicillin prescribed because his illness is “hot” and he feels that penicillin, a “hot” medicine, will not provide balance. If the NP changes the penicillin to a different but equally effective antibiotic, which cultural attribute will the NP be demonstrating?
| a. | Cultural awareness |
| b. | Cultural brokering |
| c. | Cultural knowledge |
| d. | Cultural skill |
ANS: D
Cultural skill refers to the effective integration of cultural awareness and cultural knowledge to obtain relevant cultural data and meet the needs of culturally diverse clients. Cultural skill involves providing care that is beneficial, safe, and satisfying to the client.
DIF: Cognitive Level: Analysis REF: p. 202, Table 7-5
OBJ: 12 TOP: CRNE Competency: Health and Wellness
