- Which of the following is a description of metacommunication?
| a. | Communication style |
| b. | Nonverbal communication |
| c. | Verbal communication |
| d. | Nonverbal and verbal communication |
ANS: D
Metacommunication is a broad term used to describe all of the factors that influence how the message is perceived. It is a message about how to interpret what is going on. Metacommunicated messages may be hidden within verbalizations or be conveyed as nonverbal gestures and expressions. Communication style refers to the manner in which one communicates. Nonverbal style includes facial expression, gestures, body posture, etc. Verbal style includes pitch, tone, and frequency.
DIF: Cognitive Level: Comprehension REF: p. 100
TOP: Step of the Nursing Process: All phases
MSC: Client Needs: Psychosocial Integrity
- The nurse puts his arm around an older adult client when assisting her to transfer to a chair. The client could interpret the nurse’s touch as
| a. | a positive gesture only. |
| b. | a threat. |
| c. | denotation. |
| d. | paralanguage. |
ANS: A
Touching a client is one of the most powerful ways a nurse has to communicate nonverbally. Within a professional relationship, affective touch can convey caring and reassurance. In studies, nurses’ touching clients has been reported to be perceived both positively as an expression of caring and negatively as a threat. Denotation refers to the generalized meaning of a word. Paralanguage is the way a verbal message is expressed.
DIF: Cognitive Level: Application REF: p. 103
TOP: Step of the Nursing Process: Implementation
MSC: Client Needs: Psychosocial Integrity
- A description of denotation is
| a. | a personalized meaning of a word or phrase. |
| b. | a generalized meaning assigned to a word. |
| c. | a meaning shared by families. |
| d. | a meaning generally shared within a specific culture. |
ANS: B
Denotation refers to the generalized meaning assigned to a word. Connotation refers to a personalized meaning of a word. Jargon or slang is referred to a meaning generally shared within a specific culture.
DIF: Cognitive Level: Knowledge REF: p. 101
TOP: Step of the Nursing Process: All phases
MSC: Client Needs: Psychosocial Integrity
- When communicating about a client with a health care provider from another culture, the nurse states, “The client stopped taking his medications last week when he fell off the wagon.” The health care provider looks at the nurse blankly. This is an example of
| a. | connotation. |
| b. | information processing. |
| c. | time span between messages. |
| d. | nonverbal cultural variations. |
ANS: A
Connotation refers to the use of words in a personalized way that is culturally specific. Processing is not the problem; the health care provider requires an explanation of the meaning. The health care provider does not need more time to translate the message. This is an example of connotation, not nonverbal communication.
DIF: Cognitive Level: Application REF: p. 101
TOP: Step of the Nursing Process: All phases
MSC: Client Needs: Psychosocial Integrity
- The nurse is assigned to care for a client who has been diagnosed with multiple sclerosis. Which communication behavior will have the most impact on the client?
| a. | What is said |
| b. | Tone of voice |
| c. | Sense of confidence |
| d. | Verbal message |
ANS: B
The oral delivery of a verbal message, expressed through tone of voice, inflection, sighing, and so on, is referred to as paralanguage. It is important to understand this component of communication because it affects how the verbal message is likely to be interpreted. When the tone of voice does not fit the words, the message is less easily understood and is less likely to be believed. Pitch and tone can either support or contradict the content of the verbal message. Sense of confidence will be reflected in tone of voice. Verbal message is affected by voice inflection.
DIF: Cognitive Level: Application REF: p. 101
TOP: Step of the Nursing Process: All phases
MSC: Client Needs: Psychosocial Integrity
- Communication is a combination of
| a. | verbal and nonverbal behaviors. |
| b. | pitch, tone, and paralanguage. |
| c. | proxemics, touch, and kinesics. |
| d. | eye contact, facial expressions, and nonverbal messages. |
ANS: A
Communication is a combination of verbal and nonverbal behaviors integrated for the purpose of sharing information. Pitch, tone, and paralanguage are all components of vocalization. Proxemics, touch, and kinesics are all nonverbal components. Eye contact and facial expressions are nonverbal communication.
DIF: Cognitive Level: Knowledge REF: p. 100
TOP: Step of the Nursing Process: All phases
MSC: Client Needs: Psychosocial Integrity
- The majority of person-to-person communication is
| a. | verbal. |
| b. | process. |
| c. | nonverbal. |
| d. | content. |
ANS: C
The majority of person-to-person communication is nonverbal. Actions speak louder than words. Process refers to interpersonal sensitivity. Content refers to giving information.
DIF: Cognitive Level: Knowledge REF: p. 102
TOP: Step of the Nursing Process: All phases
MSC: Client Needs: Psychosocial Integrity
- When the nurse asks a client, “How are you?” the client states, “I am fine.” As the client turns away, she is crying. This is an example of
| a. | nonverbal communication. |
| b. | incongruence. |
| c. | proxemics. |
| d. | congruence. |
ANS: B
When nonverbal and verbal cues do not match, it is known as incongruence. This situation includes both verbal and nonverbal content. Proxemics refers to personal space. Congruence occurs when verbal and nonverbal messages match.
DIF: Cognitive Level: Application REF: p. 107
TOP: Step of the Nursing Process: All phases
MSC: Client Needs: Psychosocial Integrity
- An adult client responds to questions inappropriately. The nurse should do which of the following?
| a. | Assume that the client is depressed and seek further information. |
| b. | Ask other staff members whether the client is sick. |
| c. | Leave the client alone for now and return to reassess. |
| d. | Observe the client’s nonverbal behavior. |
ANS: D
When nonverbal cues are incongruent with the verbal information, messages are likely to be misinterpreted. When the verbal message is inconsistent with the nonverbal expression of the message, the nonverbal expressions assume prominence and are generally perceived as more trustworthy than the verbal content.
DIF: Cognitive Level: Application REF: p. 102
TOP: Step of the Nursing Process: Assessment
MSC: Client Needs: Psychosocial Integrity
- The nurse is assessing a newly admitted Native American client. When assessing the client’s perception of touch, the nurse should
| a. | casually touch the client. |
| b. | use timing with touch. |
| c. | ask the client for permission to touch. |
| d. | shake the client’s hand. |
ANS: C
Care must be taken to abide by the client’s cultural proscriptions about the use of touch. This varies across cultures. Some Native Americans use touch in healing, so that casual touching may be taboo. The nurse should ask for permission before the use of touch.
DIF: Cognitive Level: Application REF: p. 103
TOP: Step of the Nursing Process: Assessment
MSC: Client Needs: Psychosocial Integrity
- When communicating with a client, which of the following best demonstrates the use of nonverbal communication?
| a. | Ignoring nonverbal cues |
| b. | Holding the client’s hand |
| c. | Conversing with the client |
| d. | Using incongruent nonverbal behaviors |
ANS: B
Skilled use of nonverbal communication through [therapeutic] silences, use of congruent nonverbal behaviors, body language, touch, proximics, and attention to client nonverbal cues such as facial expression can improve the relationship and build rapport with a client. Conversing with the client is an example of verbal communication.
DIF: Cognitive Level: Application REF: p. 103
TOP: Step of the Nursing Process: Implementation
MSC: Client Needs: Psychosocial Integrity
- A client states he is feeling fine, but the nurse observes that he has a tense body posture and a frown on his face. The nurse suspects that he is experiencing pain based on knowledge of
| a. | confirming responses. |
| b. | denotation. |
| c. | proxemics. |
| d. | kinesics. |
ANS: D
Kinesics is an important component of nonverbal communication. Commonly referred to as body language, it is defined as involving the conscious or unconscious body positioning or actions of the communicator. Words direct the content of a message, whereas emotions accentuate and clarify the meaning of the words. Confirming responses are responses used by the nurse. Denotation refers to generalized meaning of words. Proxemics refers to personal space.
DIF: Cognitive Level: Application REF: p. 103
TOP: Step of the Nursing Process: Assessment
MSC: Client Needs: Psychosocial Integrity
- In relation to gender differences in communication, which of the following is true?
| a. | Men use more verbal communication in interpersonal relationships. |
| b. | Women smile more often. |
| c. | Men require less personal space than women. |
| d. | Men have a greater range of vocal pitch. |
ANS: B
Studies show that women tend to use more facial expressiveness, smile more often, maintain eye contact, touch more often, and nod more often. Men use less verbal communication than women in interpersonal relationships. Studies show that men prefer a greater interpersonal distance between themselves and others and that they use gestures more often. Women have a greater range of vocal pitch and also tend to use different informal patterns of vocalization than men. They use more tones signifying surprise, cheerfulness, and unexpectedness.
DIF: Cognitive Level: Comprehension REF: p. 106
TOP: Step of the Nursing Process: All phases
MSC: Client Needs: Psychosocial Integrity
- Social cognitive competency refers to
| a. | the ability to use verbal and nonverbal interventions. |
| b. | understanding the relationships between the roles of the sender and receiver. |
| c. | the ability to interpret message content within interactions from the point of view of each participant. |
| d. | interpreting emotional content by observing body language. |
ANS: C
Social cognitive competency is the ability to interpret message content within interactions from the point of view of each of the participants. The ability to use verbal and nonverbal interventions refers to message competency. Understanding relationships of the sender and receiver refers to role relationship. Interpreting emotional content by observing body language refers to body cues.
DIF: Cognitive Level: Knowledge REF: p. 109
TOP: Step of the Nursing Process: All phases
MSC: Client Needs: Psychosocial Integrity
- Which of the following messages would validate the worth of the individual?
| a. | The nurse says, “Take that tray to room 6 bed 2.” |
| b. | “I want to know about your physical symptoms following the chemotherapy.” |
| c. | “Now dear, we are going to have a nice bath.” |
| d. | “I would like to meet your family and we could talk to them about your aftercare.” |
ANS: D
Styles that convey “caring” send a message of individual worth that sustains the relationship with the client. For example, clients prefer that providers use a “warm” communication style to show caring, give information, and to allow them time to talk about their own feelings. Confirming responses validate the intrinsic worth of the person. These are responses that affirm the right of the individual to be treated with respect. They also affirm the client’s autonomy (i.e., his or her right, ultimately, to make his or her own decisions). Giving directives is a disconfirming message. Discussing physical symptoms is a behavior that decreases involvement with client’s emotional self. “Now dear, we are going to have a nice bath” depersonalizes the client.
DIF: Cognitive Level: Application REF: p. 102
TOP: Step of the Nursing Process: All phases
MSC: Client Needs: Psychosocial Integrity
- A communication style the nurse can use to ensure that the message sent is the same as the one received is to
| a. | refer to the client by diagnosis. |
| b. | establish a common vocabulary. |
| c. | have interactions that focus on physical care. |
| d. | refer to the client by bed number. |
ANS: B
For successful communication, words used should have a similar meaning to both individuals in the interaction. An important part of the communication process is the search for a common vocabulary so that the message sent is the same as the one received. Referring to the client by diagnosis, having interactions focus on physical care, and referring to the client by bed number are communication styles that do not ensure that the message sent is the same as the one received.
DIF: Cognitive Level: Knowledge REF: p. 109
TOP: Step of the Nursing Process: Planning
MSC: Client Needs: Psychosocial Integrity
- Message competency refers to which phase of the nursing process?
| a. | Assessment |
| b. | Planning |
| c. | Intervention |
| d. | Evaluation |
ANS: C
Message competency refers to the ability to use language and nonverbal behaviors strategically in the intervention phase of the nursing process to achieve the goals of the interaction. The assessment, planning, and evaluation phases of the nursing process are incorrect answers.
DIF: Cognitive Level: Knowledge REF: p. 109
TOP: Step of the Nursing Process: Implementation
MSC: Client Needs: Psychosocial Integrity
MULTIPLE RESPONSE
- Which of the following is true in relation to the context of the message? (Select all that apply.)
| a. | It is shaped by the situation in which the interaction occurs. |
| b. | Taking time to evaluate the time and space in which the contact takes place allows for flexibility in choosing the appropriate context. |
| c. | Communication is shaped by the environment in which it takes place. |
| d. | Evaluating the physical setting in which the contact takes place allows for flexibility in choosing the appropriate context. |
| e. | The environment has little effect on communication. |
ANS: A, B, C, D
Communication is always influenced by the environment in which it takes place. It does not occur in a vacuum but is shaped by the situation in which the interaction occurs. Taking time to evaluate the physical setting and the time and space in which the contact takes place, as well as the psychological, social, and cultural characteristics of each individual involved, gives the nurse flexibility in choosing the most appropriate context. The environment always influences communication.
DIF: Cognitive Level: Knowledge REF: p. 110
TOP: Step of the Nursing Process: Planning
MSC: Client Needs: Psychosocial Integrity
Chapter 7: Intercultural Communication
Arnold: Interpersonal Relationships, 7th Edition
MULTIPLE CHOICE
- Cultural competence
| a. | involves a lack of acceptance of cultural differences in others. |
| b. | requires self-awareness of one’s own cultural values. |
| c. | is a nonessential skill set required for health care providers. |
| d. | begins with developing knowledge and acceptance of cultural differences in others. |
ANS: B
Cultural competence is defined as “a set of cultural behaviors and attitudes integrated into the practice methods of a system, agency, or its professionals that enables them to work effectively in cross-cultural situations.” Cultural competence is an essential skill set required for health care providers. Self-awareness of unintentional bias in health care is essential. Value judgments are hard to eliminate, particularly those outside of awareness. Developing competence begins with self-awareness of one’s own cultural values, attitudes, and perspectives, followed by developing knowledge and acceptance of cultural differences in others.
DIF: Cognitive Level: Knowledge REF: p. 117
TOP: Step of the Nursing Process: All phases
MSC: Client Needs: Management of Care
- Which of the following best describes cultural diversity?
| a. | Encompasses variations between cultural groups |
| b. | A smaller group of people living within the dominant culture who have adopted a cultural lifestyle distinct from that of the mainstream population |
| c. | Groups in which members share a cultural heritage from one generation to another |
| d. | Heterogeneous society in which diverse cultural worldviews can coexist |
ANS: A
Cultural diversity refers to variations among cultural groups. People notice differences related to language, mannerisms, and behaviors in people of different cultures, in ways that don’t happen with people from their own culture. Subculture refers to a smaller group of people living within the dominant culture, who have adopted a cultural lifestyle distinct from that of the mainstream population. Ethnicity is used to describe “groups in which members share a cultural heritage from one generation to another.” Personal awareness of a common racial, geographic, religious, or history binds people together, with a strong commitment to ethnic values and practices. Multiculturalism describes a heterogeneous society in which diverse cultural worldviews can coexist with some general characteristics shared by all cultural groups and some perspectives that are unique to a particular population.
DIF: Cognitive Level: Knowledge REF: p. 114
TOP: Step of the Nursing Process: All phases
MSC: Client Needs: Management of Care
- When communicating with a client from Thailand who speaks limited English, the nurse should
| a. | use technical jargon and complex sentences. |
| b. | recognize nodding as an indicator the client agrees with what the nurse is saying. |
| c. | speak quickly and concisely, using complex words. |
| d. | provide advice in a matter-of-fact, concise manner. |
ANS: D
People tend to think and process information in their native language, translating back and forth from English. This results in delayed responses that need to be taken into account, particularly in health teaching. Sometimes the nurse is aware only that the client seems to be taking more time than usual. All written information should be provided in the person’s native language whenever possible to avoid misinterpretation. It is important that the translator of information be as well-versed in medical interpretations as in relevant terms used in both languages. With clients demonstrating limited English proficiency, the nurse should speak slowly and clearly; use simple words; and avoid slang, technical jargon, and complex sentences. Asian clients prefer a polite, friendly, but formal approach in communication. They appreciate clinicians willing to provide advice in a matter-of-fact, concise manner. Confrontation is avoided; clients will nod and smile in agreement, even when they strongly disagree.
DIF: Cognitive Level: Application REF: p. 130
TOP: Step of the Nursing Process: All phases
MSC: Client Needs: Management of Care
- When practicing cultural awareness, the nurse recognizes that cultural patterns
| a. | are socially transmitted through ethnic groups. |
| b. | are nonessential parts of personal identity. |
| c. | are minor determinants of health-related attitudes. |
| d. | are important determinants of health-related beliefs. |
ANS: D
Cultural patterns are socially transmitted through family and other social institutions. They are an essential part of personal identity. Cultural patterns are important determinants of health-related beliefs, attitudes, values, and behaviors.
DIF: Cognitive Level: Analysis REF: p. 113
TOP: Step of the Nursing Process: Diagnosis
MSC: Client Needs: Management of Care
- The nurse is performing an admission assessment on an Asian client. The intake includes a cultural assessment. The nurse should ask the client,
| a. | “Does a minister, priest, or rabbi visit you?” |
| b. | “Do you feel understood and loved?” |
| c. | “What language do you prefer to speak?” |
| d. | “Does life have meaning and value for you?” |
ANS: C
A cultural assessment is defined as a systematic appraisal of beliefs, values, and practices conducted to determine the context of client needs and to tailor nursing interventions. It is composed of three progressive, interconnecting elements: (1) a general assessment; (2) a problem-specific assessment; and (3) the cultural details needed for successful implementation. Asking about visits from a spiritual leader would be part of the spiritual assessment. Feelings and value of life do not assess cultural issues.
DIF: Cognitive Level: Application REF: p. 122
TOP: Step of the Nursing Process: Assessment
MSC: Client Needs: Management of Care
- The nurse is caring for a Hispanic client. When communicating with the client’s family about the client’s illness, which family member should the nurse contact?
| a. | Oldest female family member |
| b. | Oldest male family member |
| c. | Oldest daughter of client |
| d. | Oldest son of client |
ANS: B
Hispanics are an extroverted people who value interpersonal relationships. Hispanic clients trust feelings more than facts. Strict rules govern social relationships (respecto), with higher status being given to older individuals, and to male over female individuals. Nurses are viewed as authority figures, to be treated with respect. Clients hesitate to ask questions, so it is important to ask enough questions to ensure that clients understand their diagnosis and treatment plan.
DIF: Cognitive Level: Application REF: p. 125
TOP: Step of the Nursing Process: All phases
MSC: Client Needs: Management of Care
- A nursing instructor is teaching a group of student nurses about culture. When teaching the students nurses about the concept of ethnocentrism, the student nurses demonstrate cultural sensitivity when they state that their culture
| a. | is superior to others. |
| b. | has the right to impose its standards of “correct” behavior and values on another. |
| c. | is a culture that warrants a sense of pride. |
| d. | should be the norm because it is considered better or more enlightened than others. |
ANS: C
Ethnocentrism refers to a belief that one’s own culture should be the norm because it is considered better or more enlightened than others. Other cultures are judged as inferior. Taking pride in one’s culture is appropriate, but when a person fails to respect the value of other cultures, it is easy to develop stereotypes and prejudice. Ethnocentrism fosters the belief that one culture has the right to impose its standards of “correct” behavior and values on another. Prejudice can be felt or expressed, and directed to either a group as a whole or toward an individual associated with the group.
DIF: Cognitive Level: Analysis REF: p. 116
TOP: Step of the Nursing Process: Diagnosis
MSC: Client Needs: Management of Care
- When caring for a client from a different culture, which of the following is the best assessment approach by the nurse?
| a. | “Are there any special cultural beliefs about your illness that might help me give you better care?” |
| b. | “Describe to me your position of greatest relief from pain and discomfort.” |
| c. | “I will return shortly to give you a pain medication. Is there anything else that you need?” |
| d. | “I will roll your bed down and place a pillow between your legs.” |
ANS: A
When assessing client preferences in a client from a different culture, an assessment approach can include asking about special cultural beliefs related to the illness that might help the nurse to provide better care. Questions regarding a client’s level of physical comfort do not address the client’s culture.
DIF: Cognitive Level: Application REF: p. 121
TOP: Step of the Nursing Process: Assessment
MSC: Client Needs: Psychosocial Integrity
- The nurse is assigned to provide a bed bath to a client who cannot speak English. Which of the following communication tools or strategies should the nurse use?
| a. | Nonverbal communication |
| b. | Trained interpreter |
| c. | Family member as interpreter |
| d. | Other staff member who speaks the same language |
ANS: B
Federal law (Title VI of the Civil Rights Act) mandates the use of a trained interpreter for any client experiencing communication difficulties in health care settings because of language. Interpreters should have a thorough knowledge of the culture, as well as the language. Interpreters should be carefully chosen, keeping in mind variations in dialects as well as differences in the sex and social status of the interpreter and the client if these factors are likely to be an issue. There are quality assurance and ethical issues associated with the use of untrained interpreters such as family, friends, or ancillary staff. They may not be familiar with medical terminology or may unintentionally misrepresent the meaning of a message. The client may or may not want a relative, friend, or nonprofessional staff to “know their business” or have access to subjective information.
DIF: Cognitive Level: Application REF: p. 122
TOP: Step of the Nursing Process: Implementation
MSC: Client Needs: Management of Care
- The nurse is caring for a postpartum client who is African American. The nurse recognizes that an essential component for successful communication when interacting with this client is the use of
| a. | clergy in treatment plans. |
| b. | only simple language strategies. |
| c. | folk-healing strategies. |
| d. | trust development. |
ANS: D
Although African Americans are represented in every socioeconomic group, approximately one third of them live in poverty. For many, their cultural heritage traces back to slavery and deprivation. This unfortunate legacy colors the expectations of African Americans with health care issues and explains the distrust many African Americans have about the American health care system. African Americans need to experience feeling respected by their caregivers to counteract the sense of powerlessness they feel in health care settings. Establishing trust is essential for successful communication with African American clients. They are more willing to participate in treatment when they feel respected and are treated as treatment partners in their health care. Trust must be established before any interventions, such as consultation with a folk healer or clergy. There is no language barrier mentioned in the question.
DIF: Cognitive Level: Application REF: p. 126
TOP: Step of the Nursing Process: All phases
MSC: Client Needs: Psychosocial Integrity
- Which of the following statements is true?
| a. | A Muslim client may refuse to take insulin if it contains beef. |
| b. | African American males have a lower chance of developing cancer. |
| c. | Hispanic clients make small talk before discussing their health problems. |
| d. | Asian clients frequently challenge health care workers. |
ANS: C
Hispanic clients need to develop trust (confianza) in the health care provider. They do this by making small talk before getting down to the business of discussing their health problems. Muslim clients are expected to follow the Hallal (lawful) diet, which calls for dietary restrictions on eating pork or pork products, and drinking alcohol. African American males have a significantly greater chance of developing cancer and of dying from it. Communication behaviors in the Asian culture are characterized by mutuality, respect, and honesty. Health care providers are considered health experts, so they are expected to provide specific advice and recommendations. Asian clients prefer a polite, friendly, but formal approach in communication. They appreciate clinicians willing to provide advice in a matter-of-fact, concise manner.
DIF: Cognitive Level: Comprehension REF: p. 126
TOP: Step of the Nursing Process: All phases
MSC: Client Needs: Management of Care
- When assessing a 5-year-old Asian client in the emergency department, the nurse observes welts on the client’s body. The nurse’s first course of action should be to
| a. | report child abuse to the authorities. |
| b. | consult a traditional healer. |
| c. | question the family about cultural practices. |
| d. | ignore it because it is an imbalance between “yin and yang.” |
ANS: C
In some Asian countries, healers use a process of “coining,” in which a coin is heated and vigorously rubbed on the body to draw illness out of the body. The resulting welts can mistakenly be attributed to child abuse if this practice is not understood. A cultural assessment needs to be done first. The first course of action is to do a cultural assessment by questioning the family. The welts should not be ignored because they could indicate child abuse.
DIF: Cognitive Level: Analysis REF: p. 129
TOP: Step of the Nursing Process: Assessment
MSC: Client Needs: Management of Care
- When performing a newborn bath demonstration for the mother of a Native American infant, the nurse should
| a. | maintain constant eye contact with the mother. |
| b. | anticipate answering many of the mother’s questions. |
| c. | ask the mother to stand next to the nurse. |
| d. | deliver verbal instructions in a story-telling format. |
ANS: D
When the nurse is performing a newborn bath demonstration, the Native American mother is likely to watch from a distance, avoid eye contact with the demonstrator, ask few or no questions, and decline a return demonstration. This learning style should not be seen as indifference or lack of understanding. Being an experiential learner, the Native American woman is likely to assimilate the information provided and simply give the newborn a bath when it is needed. Their learning style is observational and oral, so the use of charts, written instructions, and pamphlets is usually not well received. Verbal instruction delivered in a story-telling format is more familiar to Native Americans.
DIF: Cognitive Level: Application REF: p. 131
TOP: Step of the Nursing Process: Assessment
MSC: Client Needs: Management of Care
- Which of the following is a true statement in relation to the concept of poverty?
| a. | Poverty affects only a small segment of the population. |
| b. | Poor people expect others to work with them in making things better. |
| c. | Communication strategies that empower the poor to take small steps toward dependence are most effective. |
| d. | Lack of essential resources is associated with political and personal powerlessness. |
ANS: D
Poverty is a difficult but important sociocultural concept because it has an adverse effect on a large segment of the population, limiting their options in health care. Lack of essential resources is associated with political and personal powerlessness. The idea that the poor can exercise choice or make a difference in their lives is not part of their worldview. People living in poverty may overlook opportunities simply because life experience tells them that they cannot trust their own efforts to produce change. Poor people often look to others, but do not expect others to work with them in making things better. Communication strategies that acknowledge, support, and empower the poor to take small steps to independence are most effective.
DIF: Cognitive Level: Knowledge REF: p. 131
TOP: Step of the Nursing Process: All phases
MSC: Client Needs: Psychosocial Integrity
- When caring for the poor client, a major component of care is
| a. | ignoring personal biases. |
| b. | allowing stereotypes to distort nursing interventions. |
| c. | maintaining respect for human dignity. |
| d. | treating all clients exactly the same. |
ANS: C
Respect for the human dignity of the poor client is a major component of proactive care. This means that the nurse pays strict attention to personal biases and stereotypes so as not to distort assessment or implementation of nursing interventions. It means treating each client as “culturally unique,” with a set of assumptions and values regarding the disease process and its treatment, and acting in a nonjudgmental manner that respects the client’s cultural integrity.
DIF: Cognitive Level: Knowledge REF: p. 132
TOP: Step of the Nursing Process: All phases
MSC: Client Needs: Management of Care
