- Which of the following is the most important reason for offering culturally sensitive care?
1. | To make patients feel comfortable |
2. | To offer safe care |
3. | It is required by law |
4. | It increases patient satisfaction |
ANS: 2
| Feedback |
1 | Even though making a patient feel comfortable is important, safety is of higher priority |
2 | Patient safety is a cornerstone of nursing practice. |
3 | While some aspects of cultural sensitivity, i.e., provision of interpreters for individuals who are deaf, may be required, most elements of culturally sensitive care are not mandated by law. |
4 | Even though patient satisfaction is important, safety is of higher priority. |
PTS: 1
KEY: Content Area: Introduction to culture | Integrated Process: Caring | Client Need: Safe and Effective Care Environment | Cognitive Level: Evaluation | Question Type: Multiple Choice
- According to Taylor, which of the following is not considered to be one of the three levels of culture?
1. | Cultural tradition |
2. | Subculture with shared traits in a different society |
3. | Cultural universals |
4. | Socioeconomics |
ANS: 4
Rationale:
Cultural tradition, subculture with shared traits in a different society, and cultural universals are all considered by Taylor to represent levels of culture. Socioeconomics is important but not considered by Taylor to be part of the levels of culture.
PTS: 1
KEY: Content Area: Introduction to culture (Box 6.01) | Integrated Process: Caring | Client Need: Safe and Effective Care Environment | Cognitive Level: Comprehension | Question Type: Multiple Choice
- Which of the following factors would be the least likely to represent a cultural factor?
1. | Gender identity |
2. | Family of origin |
3. | Religion |
4. | IQ |
ANS: 4
Rationale:
While IQ measurement can be influenced by culture, gender identity, family of origin, and religion all represent stronger cultural factors.
PTS: 1
KEY: Content Area: Identifying culture (define culture) | Integrated Process: Caring | Client Need: Safe and Effective Care Environment | Cognitive Level: Evaluation | Question Type: Multiple Choice
- Which of the following statements would NOT be considered a characteristic of personal bias or stereotype?
1. | Ideas that are oversimplified in regards to a specific group |
2. | Views that one group holds about another group |
3. | Bias can be a useful starting point to offering culturally sensitive care |
4. | Bias is hard to identify in one’s self |
ANS: 3
| Feedback |
1 | Ideas that are oversimplified in regards to a specific group is a characteristic of bias or stereotype. |
2 | Views that one group holds about another group is a component of bias or stereotype. |
3 | Bias is an ineffective starting point to offering culturally sensitive care because it does not allow for open communication. |
4 | Often, individuals are not aware of biases or stereotypes, and such beliefs can be difficult to identify. |
PTS: 1
KEY: Content Area: Bias and stereotype (stereotypical images) | Integrated Process: Caring | Client Need: Safe and Effective Care Environment | Cognitive Level: Evaluation | Question Type: Multiple Choice
- Which of the following is an example of ethnocentric thinking?
1. | Freedom is an important factor for individual development. |
2. | Human interactions are complex. |
3. | There is more than one way to look at a problem. |
4. | No two families are the same. |
ANS: 1
| Feedback |
1 | In ethnocentric thinking, one sees her/his own worldview or values as applicable to everyone else. The concept of freedom is not universally defined or valued. |
2 | Understanding that complexity is part of human interactions minimizes the likelihood of ethnocentric thinking. |
3 | In ethnocentric thinking, people only consider one way of looking at a problem. |
4 | In ethnocentric thinking, people often generalize their own experience to others and assume that all families are the same. |
PTS: 1
KEY: Content Area: Ethnocentrism (cultural ambiguity) | Integrated Process: Caring | Client Need: Safe and Effective Care Environment | Cognitive Level: Comprehension | Question Type: Multiple Choice
- Which of the following changes in population demographics need to be taken into consideration in providing culturally sensitive nursing care for families?
1. | Increase in migration patterns of different ethnicities |
2. | Increasing recognition of GLBT families |
3. | Increase in single parent families |
4. | All of the above |
ANS: 4
Rationale:
All demographic shifts should be considered when providing culturally sensitive nursing care for families, including migration patterns and changes in family structure.
PTS: 1
KEY: Content Area: Demographic changes (family households) | Integrated Process: Caring | Client Need: Safe and Effective Care Environment | Cognitive Level: Comprehension | Question Type: Multiple Choice
- Which of the following factors is likely to impact nursing care related to aging populations?
1. | There is a surplus of available nursing homes. |
2. | More people will find themselves as the “sandwich generation,” caring for parents and children at the same time. |
3. | Most elderly people are sick, frail, and dependent on others. |
4. | All of the above. |
ANS: 2
| Feedback |
1 | There is not a surplus of available nursing homes. Many homes have waiting lists for admission. The lack of available spaces will impact nursing care related to aging populations. |
2 | Nursing care for aging populations will be affected by the growing “sandwich generation” of people caring for parents and children at the same time. |
3 | While elderly people may be sick, frail, and dependent on others, this is not a characteristic of most elderly people. |
4 | There is not a surplus of available nursing homes and many elderly people live independently and are not sick, frail, and dependent on others. It is true that nursing care for aging populations will be affected by the growing “sandwich generation” of people caring for parents and children at the same time. |
PTS: 1
KEY: Content Area: Aging (using cultural models) | Integrated Process: Caring | Client Need: Safe and Effective Care Environment | Cognitive Level: Evaluation | Question Type: Multiple Choice
- Which of the following theoretical models would best help explain why a family might bring in their own “hot” and “cold” foods for healing after a birth?
1. | The Family Health Model |
2. | The Sunrise Model |
3. | The Health Promotion Model |
4. | The Health Beliefs Model |
ANS: 2
| Feedback |
1 | The focus of the Family Health Model is more on the role of family than the health needs of the individual. This answer is not wrong, but not the best answer. |
2 | The Sunrise Model helps nurses understand the importance of understanding and respecting patients’ cultural health beliefs. |
3 | The Health Promotion Model focuses on how individuals can achieve changes that promote health; the focus is less on culturally based nutritional habits |
4 | The Health Beliefs Model focuses on beliefs that people have regarding their health and how they can make changes. This model is useful for patient with illnesses that require lifestyle changes (e.g., diabetes). |
PTS: 1
KEY: Content Area: Theoretical models (using models to understand culture) | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Application | Question Type: Multiple Choice
- Which of the following areas of cultural behaviors would a nurse be assessing if using the transcultural nursing assessment tool?
1. | Communication, social organization, biological variation, and socioeconomic factors |
2. | Communication, time, biological variation, and socioeconomic factors |
3. | Space, time, biological variation, and socioeconomic factors |
4. | Communication, social organization, time, and biological variation |
ANS: 4
Rationale:
Communication, social organization, time, and biological variation are elements of the transcultural assessment tool.
PTS: 1
KEY: Content Area: Nursing assessment tools (Box 6.08 Culturally distinct behaviors) | Integrated Process: Nursing Process | Client Need: Safe and Effective Care Environment | Cognitive Level: Comprehension | Question Type: Multiple Choice
- Which of the following is an example of cultural humility?
1. | A nurse familiarizes herself with the requirements of kosher food. |
2. | A nurse believes that giving Jell-O to all patients after surgery has no cultural implications. |
3. | Patients and family members are discouraged from praying on the floor to protect their hygiene and safety. |
4. | All of the above. |
ANS: 1
| Feedback |
1 | Understanding a patient’s cultural nutritional requirements is an example of cultural humility. |
2 | Jell-O contains animal products/pork and is not eaten by certain cultures. |
3 | Religious practices may have great significance and importance for patients. If the nurse believes these are problematic, solutions must be sought agreeable to all rather than simply discouraging practices. |
4 | Understanding a patient’s cultural nutritional requirements is an example of cultural humility. The other answers support the nurse’s own beliefs rather than focusing the patient’s needs. |
PTS: 1
KEY: Content Area: Cultural humility | Integrated Process: Caring | Client Need: Safe and Effective Care Environment | Cognitive Level: Application | Question Type: Multiple Choice
- Which area is typically not included in the Assessment of Culturally Distinct Behavior (according to Giger and Davidhizer)?
1. | Communication |
2. | Social organization |
3. | Time |
4. | Developmental stage |
ANS: 4
Rationale:
Communication, social organization, and time are a part of the Assessment of Culturally Distinct Behavior (according to Giger and Davidhizer). Developmental stage is not a part of the cultural assessment, although it should be taken into consideration.
PTS: 1
KEY: Content Area: Assessment of culturally distinctive behavior (cultural models) | Integrated Process: Nursing Process | Client Need: Safe and Effective Care Environment | Cognitive Level: Comprehension | Question Type: Multiple Choice
- Which of the following is the most important reason for knowing “family stories”?
1. | It is essential in relationship building. |
2. | It helps the nurse predict future care needs. |
3. | It is considered a best practice in customer service. |
4. | None of the above. |
ANS: 2
| Feedback |
1 | Although hearing a patient’s story can help establish a relationship , the most important reason for assessing them is to get insights in possible future needs. |
2 | Family stories relate past experiences that can help predict future needs. |
3 | Although hearing a patient’s story can help increase patient satisfaction , the most important reason for assessing them is to get insights in possible future needs. |
4 | Although hearing a patient’s story can help increase patient satisfaction and establish a relationship, the most important reason for assessing them is to get insights in possible future needs. |
PTS: 1
KEY: Content Area: Family story telling (the power of family stories for learning about cultural needs) | Integrated Process: Caring | Client Need: Safe and Effective Care Environment | Cognitive Level: Evaluation | Question Type: Multiple Choice
- Which of the following resources is the most important source of cultural information to understand the culture of a patient and family?
1. | CIA World Factbook |
2. | Multicultural Resources for Health Information |
3. | Office of Minority Health: Cultural Appropriate Services |
4. | None of the above |
ANS: 4
Rationale:
The family and patient are the most important source or information. Sources of information, such as websites and books, can support understanding but should not be used as primary source.
PTS: 1
KEY: Content Area: Cultural resources (use of cultural resources) | Integrated Process: Nursing Process | Client Need: Safe and Effective Care Environment | Cognitive Level: Comprehension | Question Type: Multiple Choice
MULTIPLE RESPONSE
- Which of the following are assumptions of the Health Belief Model?
1. | Individuals interact with the environment, transforming it and being transformed in the process. |
2. | Health professionals must initiate the changes in order for change to occur. |
3. | Individuals actively seek to regulate personal behaviors. |
4. | Healthcare professionals are part of the interpersonal environment that influences people across their lifespan. |
ANS: 1, 3, 4
Rationale:
The key person for making change is the patient.
PTS: 1
KEY: Content Area: Health Belief Model (cultural models) | Integrated Process: Nursing Process | Client Need: Safe and Effective Care Environment | Cognitive Level: Comprehension | Question Type: Multiple Response
- Which of the following are reasons to involve an interpreter when working with a patient who speaks a different language than the nurse?
1. | It is required by law. |
2. | In order to make an accurate assessment. |
3. | In order to develop a trusting relationship. |
4. | An interpreter is likely to provide the intent of the discussion. |
ANS: 2, 4
Rationale: Not having all the assessment data can lead to misdiagnosing a patient and thus puts the patient at risk. Family members can provide observations of behavior and information about physical, emotional, and mental status of individual members.
PTS: 1
KEY: Content Area: Use of interpreters (using translators and interpreters with families) | Integrated Process: Caring | Client Need: Safe and Effective Care Environment | Cognitive Level: Evaluation | Question Type: Multiple Response
COMPLETION
- Ideas about cultural sensitivity and cultural competence assert that the only culture that can truly be known is ____________________, and that the starting point of understanding is in ____________________.
ANS:
one’s own, self-knowledge
Rationale: One of the best ways to become culturally competent is to identify one’s own biases, assumptions, and prejudices, and to identify goals for oneself with the aim of neutrality.
PTS: 1
KEY: Content Area: Assessing culture (through a family lens) | Integrated Process: Nursing Process | Client Need: Safe and Effective Care Environment | Cognitive Level: Comprehension | Question Type: Completion
Chapter 7- Using Family Theory to Guide Nursing Practice
MULTIPLE CHOICE
- The professional caregiver who is knowledgeable about instrumental family rituals and routines:
1. | Knows that to make any health promoting changes in families, these rituals and routines must be altered. |
2. | Knows that illness management does not alter rituals and routines. |
3. | Knows that successful intervention depends upon changing theses rituals and routines. |
4. | Knows that successful intervention depends upon incorporating new health-care practices into the family’s rituals and routines. |
ANS: 4
| Feedback |
1 | Rituals and routines help families maintain integrity, so altering them may not be health-promoting. |
2 | The activities necessary for illness management can alter normal rituals and routines a great deal. |
3 | Changing rituals and routines may be seen as a threat to family integrity. |
4 | Nurses who recognize that they are temporary guests as they work within the family’s routines and rituals are honoring family integrity. |
PTS: 1
KEY: Content Area: Nursing practice | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Application | Question Type: Multiple Choice
- Use of a family nursing model in practice:
1. | Helps to provide a framework for assessment and decision-making. |
2. | Contributes to other disciplines. |
3. | Is essential so that nursing can be considered a profession. |
4. | Is too time-consuming to be used in modern health care. |
ANS: 1
| Feedback |
1 | Use of a model gives the nurse a framework of components or concepts that aid in considering broad approaches to assessment and decision-making in planning care. |
2 | A nursing model does not necessarily contribute to other disciplines. |
3 | Use of a family nursing model is not enough to guarantee that nursing is considered a profession; there are several additional criteria. |
4 | There is evidence that time spent using a family nursing model conserves nursing time. |
PTS: 1
KEY: Content Area: Family nursing models | Integrated Process: Nursing process | Client Need: Safe and Effective Care Environment | Cognitive Level: Comprehension | Question Type: Multiple Choice
- When using the Calgary Family Assessment Model (CFAM), it is important to know that:
1. | The developmental assessment yields the most important information to guide nursing actions. |
2. | Synthesis of the family development assessment, structural assessment, and functional assessment yields the most information to guide nursing actions. |
3. | The structural assessment yields the most important information to guide nursing actions. |
4. | The functional assessment yields the most important information to guide nursing actions. |
ANS: 2
| Feedback |
1 | Assessing just the developmental component of the CFAM is not sufficient to guide comprehensive family nursing actions. |
2 | According to the authors of the CFAM, the most information needed to guide nursing actions with families are gained from a synthesis of assessing family development, structure, and function. |
3 | Assessing just the structural component of the CFAM is not sufficient to guide comprehensive family nursing actions. |
4 | Assessing just the functional component of the CFAM is not sufficient to guide comprehensive family nursing actions. |
PTS: 1
KEY: Content Area: Family nursing models | Integrated Process: Nursing Process | Client Need: Safe and Effective Care Environment | Cognitive Level: Knowledge | Question Type: Multiple Choice
- According to Wright and Leahy, effective family nursing actions are those that:
1. | The nurse believes to be in the best interest of the family. |
2. | Are developed in collaboration with the family experiencing the illness event. |
3. | Are informed by a family nursing theory. |
4. | Are interdisciplinary in nature. |
ANS: 2
| Feedback |
1 | The nurse may not actually know what is in the best interest of the family if the nurse has not interacted with the family at a meaningful level to know their values, beliefs, and goals. |
2 | The most effective nursing actions are those developed in collaboration with the family. |
3 | Even if nursing actions are informed by a family nursing theory, they may not be relevant for the particular family unless values, beliefs, and goals are considered. |
4 | Even if nursing actions are interdisciplinary in nature, they may not be relevant for the particular family unless values, beliefs, and goals are considered. |
PTS: 1
KEY: Content Area: Family nursing practice | Integrated Process: Nursing Process | Client Need: Safe and Effective Care Environment | Cognitive Level: Comprehension | Question Type: Multiple Choice
- Integrating conceptual and theoretical frameworks when working with families is:
1. | Confusing, because integration makes it difficult to create evidence-based approaches. |
2. | Important, because no one conceptual or theoretical framework is sufficient. |
3. | Not necessary if a middle-range nursing theory is used. |
4. | Helpful, because the nurse can see the uniqueness of the individual through this lens. |
ANS: 2
| Feedback |
1 | Integration of frameworks assists the nurse in creating evidence-based approaches. |
2 | Integrating conceptual and theoretical frameworks gives the nurse broader choices from which to create evidence-based approaches. |
3 | One middle-range theory may not be appropriate for specific families. |
4 | Seeing the uniqueness of the individual is not necessarily supported by use of any one conceptual or theoretical framework; the process of assessment is still needed. |
PTS: 1
KEY: Content Area: Family nursing frameworks | Integrated Process: Nursing Process | Client Need: Safe and Effective Care Environment | Cognitive Level: Comprehension | Question Type: Multiple Choice
- The family development realm of assessment within family-focused care addresses family development as:
1. | A functional process that is not influenced by contextual systems. |
2. | Family change and transformation occurring in a pattern over time. |
3. | A process that has a set end goal. |
4. | Predictable and accurate. |
ANS: 2
| Feedback |
1 | Family development is not considered a family functional process. |
2 | Family development is concerned with change and transformation over time, not simply stages and tasks. |
3 | Family development does not have a set end goal because it is an ongoing process. |
4 | Family development is unpredictable and does not follow a specific path of accuracy. |
PTS: 1
KEY: Content Area: Family development | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension | Question Type: Multiple Choice
- Family health beliefs are:
1. | Always the same as the culture from which the family originates. |
2. | Usually the same as the nurse’s health beliefs. |
3. | Inaccessible to the nurse. |
4. | Unique to the family. |
ANS: 4
| Feedback |
1 | Family health beliefs are not solely dependent on the family’s culture of origin. |
2 | Family health beliefs are not usually the same as the nurse’s health beliefs. |
3 | The nurse who completes an interactive and thorough family assessment can discover the family’s health beliefs. |
4 | Family health beliefs are unique to each family because they are developed from within the specific family over time. |
PTS: 1
KEY: Content Area: Family integrity | Integrated Process: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Comprehension | Question Type: Multiple Choice
- The nurse who uses the Family Management Style Framework (FMSF) would pay attention primarily to:
1. | Whether the family is developing along a normal trajectory. |
2. | The family’s health beliefs. |
3. | The family’s interaction style. |
4. | Whether the family is thriving, accommodating, enduring, struggling, and floundering. |
ANS: 4
| Feedback |
1 | The FMSF does not focus on family development. |
2 | The FMSF does not focus on family health beliefs. |
3 | The FMSF does not focus on family interaction style. |
4 | The nurse using the FMSF does assess whether the family is thriving, accommodating, enduring, struggling, or floundering based on definitions within the FMSF. |
PTS: 1
KEY: Content Area: Family nursing models | Integrated Process: Nursing Process | Client Need: Psychosocial Integrity | Cognitive Level: Application | Question Type: Multiple Choice
- When considering how to best maintain family integrity, the nurse would best focus on which of the following:
1. | Developmental tasks. |
2. | The family stress response. |
3. | Patterns of interaction. |
4. | Family boundaries. |
ANS: 4
| Feedback |
1 | Accomplishing developmental tasks are not necessarily essential for maintaining family integrity. |
2 | The family’s stress response is not essential for maintaining family integrity. |
3 | Family patterns of interaction, while important, do not preserve family integrity. |
4 | Maintaining family boundaries, and adjusting family boundaries when necessary, is an essential part of preserving family boundaries. |
PTS: 1
KEY: Content Area: Family integrity | Integrated Process: Psychosocial Integrity | Client Need: Health Promotion and Maintenance | Cognitive Level: Application | Question Type: Multiple Choice
- The goal of care in support of family coping is to:
1. | Decrease the stress linked with illness experiences. |
2. | Provide the family with forms of support that will enhance individual healing and promote the construction of family health. |
3. | Make certain that the family’s perception of the illness event is as accurate as possible. |
4. | All of the above. |
ANS: 4
| Feedback |
1 | Decreasing the stressor alone will not support family coping fully. |
2 | Providing family support alone will not support family coping fully. |
3 | Correcting the family’s perception of the event along will not support family coping fully. |
4 | Answers number 1, 2, and 3 are all important goals for care supporting family coping. |
PTS: 1
KEY: Content Area: Family coping | Integrated Process: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Application | Question Type: Multiple Choice
- Family nursing models are an example of:
1. | Middle-range theories. |
2. | Grand theories. |
3. | Borrowed theories. |
4. | Social science theories. |
ANS: 1
| Feedback |
1 | Family nursing models are considered middle-range theories because they are not at the highly abstract level and they have largely been developed within nursing practice. |
2 | Family nursing models are not highly abstract as is the case with the grand theories. |
3 | Family nursing models are developed within nursing and are, therefore, not borrowed from other disciplines. |
4 | Family nursing models are developed within nursing and are, therefore, not social science theories. |
PTS: 1
KEY: Content Area: Family nursing theory | Integrated Process: Nursing Process | Client Need: Safe and Effective Care Environment | Cognitive Level: Comprehension | Question Type: Multiple Choice
- Health-seeking behaviors of the individual are influenced by:
1. | The family’s health beliefs. |
2. | The family’s identity. |
3. | The family’s values. |
4. | All of the above. |
ANS: 4
| Feedback |
1 | Health-seeking behaviors of the individual are influenced by the family’s health beliefs, but also by their identity and values. |
2 | Health-seeking behaviors of the individual are influenced by the family’s identity, but also by their health beliefs and values. |
3 | Health-seeking behaviors of the individual are influenced by the family’s values, but also by their identity and health beliefs. |
4 | Health-seeking behaviors of the individual are influenced by a combination of the family’s health beliefs, identity, and values. |
PTS: 1
KEY: Content Area: Health Promotion and Maintenance | Integrated Process: Teaching/Learning | Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension | Question Type: Multiple Choice
TRUE/FALSE
- A nurse’s definition of family health might influence the way the nurse practices with families.
ANS: T
Rationale:
A nurse’s definition of family health can influence how the nurse assesses families and the nursing actions chosen, thus influencing nursing practice.
PTS: 1
KEY: Content Area: Family health | Integrated Process: Nursing Process | Client Need: Safe and Effective Care Environment | Cognitive Level: Application | Question Type: True/False
- Altering a family’s perception of the illness event is possible.
ANS: T
Rationale:
Altering the family’s perception of the illness event through teaching, educating, and interpreting the situation is possible.
PTS: 1
KEY: Content Area: Family coping | Integrated Process: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Application | Question Type: True/False
- It is not possible to understand and attend to the individual and the family simultaneously in a care situation.
ANS: F
Rationale:
It is possible for the nurse to understand and attend to them simultaneously when guided by family nursing models, frameworks, and theories, and when the nurse intentionally interacts with family members.
PTS: 1
KEY: Content Area: Family coping | Integrated Process: Communication and Documentation | Client Need: Psychosocial Integrity | Cognitive Level: Comprehension | Question Type: True/False