1. According to Leininger, “cultural imposition” is a major concern in nursing because nurses have a tendency to impose their values, beliefs, and practices on patients of other cultures. The discussion topic most likely to be without cultural imposition would be:
a. abortion.
b. wound management.
c. blood transfusion.
d. advance directives.
2. Cultural diversity is the term used to describe a vast range of cultural differences. Events have symbolic meanings for the nurse manager and the staff. The event that would be most likely to provide symbolic meaning to a nurse manager and staff is a:
a. task force formed to commemorate a New Year’s celebration in the Western tradition.
b. project to provide Christmas gifts to the children in a daycare program.
c. celebration of National Nurses Week with the focus on cultural care.
d. task force to develop a poster for the unit depicting religions of the world.
3. One of the staff nurses on your unit makes the comment, “All this time I thought Mary was black. She says she is Jamaican.” The best response would be to say:
a. “Who cares what she is?”
b. “What did you think when you learned she was Jamaican?”
c. “Why did you assume she was black?”
d. “We have never had a Jamaican on this unit.”
4. As a nurse manager, you notice that Maria, a Hispanic nurse aide, is visibly upset. When you ask her if something is wrong, she becomes tearful and says, “Why is it that when John and I work together in giving patients care, he jokes about my being “a little fat Mexican”? The nurse manager’s best response is, “Do you think he:
a. is sensitive to your culture?”
b. wants to learn more about you?”
c. has been hurt and wants to hurt others?”
d. is stereotyping you without thinking?”
5. The nurse manager of a unit is asked by a family member of a dying Native American patient if it is possible to have the patient’s eight-member family recite the rosary by the bedside. The manager responds affirmatively. The nurse manager is most likely exhibiting behavior related to:
a. acculturation.
b. ethnocentricity.
c. cultural diversity.
d. cultural sensitivity.
6. A 66-year-old native Chinese patient, hospitalized for a myocardial infarction, asks the nurse manager about seeing his “acupuncture doctor” for treatment of his migraine headache. The best response to this patient would be:
a. “How long have you been using acupuncture treatment?”
b. “Do you think acupuncture relieves your pain satisfactorily?”
c. “What have you told your heart specialist about your migraines and treatment?”
d. “Have you tried nonprescription pain medication or been given a prescription drug for your headaches?”
7. Maintaining a culturally diverse staff and working with a culturally diverse patient population is an important function of a nurse manager who works in the hospital of a large medical center. On your palliative care unit, you have recently received complaints from families about ineffective pain management for their family members and you determine this occurs primarily when certain nurses are working. What approach might you take to resolve the concerns of the families, patients, and potentially, the staff?
a. Reinforce to staff that practice guidelines support as-needed analgesia for the terminally ill.
b. Ask staff input on the development of stricter guidelines to ensure that all terminally patients are given sufficient analgesia.
c. Encourage conversation with patients and among staff that facilitates learning about cultural beliefs and priorities in dying.
d. Advise families that the administration of analgesia is based on the expert clinical judgment of nurses who are familiar with care of patients in palliative care.
8. Because an increasing number of Hispanic patients are being admitted, a nurse manager designs a staff-development program to help her staff understand the Hispanic culture. A nurse should understand that culture is determined by which of the following?
a. Behavior
b. Love for people
c. Shared vision
d. Genetic predisposition
9. The nurse manager for a unit’s culturally diverse staff creates a staff-development program so the professional nursing staff members can enhance their understanding of cultures on the basis of published literature. The literature reveals that the following characteristic is inherent in a culture. It
a. develops over time.
b. maintains a strong work ethic.
c. changes easily.
d. develops quickly.
10. In designing programs through your institution to address the health needs of Hispanics in your community, you most likely would develop programs related to:
a. diabetes.
b. cardiovascular disease.
c. cancer.
d. asthma.
11. Within the deaf culture, there is considerable disagreement about the use of SEE (Signed Exact English) and ASL (American Sign Language). This is indicative of:a. dominant versus nondominant behaviors.
a. dominant versus nondominant behaviors.
b. the need to recognize diversity within groups.
c. the impact of cross-culturalism.
d. how language separates subgroups.
12. When interviewing a candidate for a nursing position who has an Aboriginal background, you recognize that the candidate’s lack of eye contact reflects the candidate’s:
a. lack of confidence.
b. professional behavior.
c. cultural sensitivity.
d. ethnicity.
13. When interviewing a candidate for a nursing position who has an Aboriginal background, you recognize that the candidate’s lack of eye contact reflects the candidate’s cultural sensitivity. You are exhibiting:
b. cultural sensitivity.
c. ethnocentrism.
d. transculturalism.
14. Mary joins 5W nursing unit. Mary is a new graduate who is anxious to fit in. She soon learns that some of her “book learning” is being criticized by her colleagues, so she adapts her practice to what others on the unit are doing. She is demonstrating:
a. cultural awareness.
c. acculturation.
d. cultural marginality.
15. At Health Center XYZ, staff members on the rehabilitation unit have a head nurse who is intolerant of error and publicly chides anyone who makes a mistake. Over time, the rules on the unit dictate that mistakes are hidden and that areas of concern related to the functioning of the unit are discussed in tub rooms and are never openly discussed during periodic meetings. New staff members are quickly made to realize that silence is expected. The situation described is an example of:
a. ethnicity.
b. work environment.
c. work culture.
d. marginalization.
16. As a nurse manager, you have hired two new staff members who have recently come to the United States from other countries. Which of the following strategies might indicate your efforts to assist these staff members with acculturation to your unit?
a. Analyze a recent situation with them in which an order with a physician was not clarified and explore their beliefs about nurse-physician relationships.
b. Expect them to behave in ways that are expected of staff who have grown up and been educated in the United States.
c. Stress to these new staff that your unit is a “family” and that staff members take pride in saying that they are from Unit 4.
d. Recognize that culture develops over time and leave them alone to figure out differences between their culture and that of the unit.
17. During managers’ meetings, Lindsay is surprised by the forthrightness of male managers. She finds that, during discussions, she would be more likely to say:
a. “I wonder if we should consider changing our policy on performance appraisals? What do you think?”
b. “Sean, your approach to appraisal is completely off track and does not reflect available evidence.”
c. “The system that has been developed needs to be implemented. We have already spent enough time in discussion.”
d. “Forget about change in this policy. It is fine as it is.”
18. As a manager, you are responsUibleSforNtwoTseparaOte units: a CCU and a cardiac step-down unit. The organization and relationships on these units are distinct and very different from one another. Your decision has been to support the uniqueness of these units because each is effective in different ways in providing patient care. This approach is consistent with which principle?
a. Transculturalism
b. Cross-culturalism
c. Multiculturalism
d. Acculturation
19. During performance appraisal, you praise Xia for her attention and care to nursing details. You suggest that her care would be further enhanced by greater acknowledgment of patients’ feelings. Xia bursts into tears and leaves the office. Later, you learn that criticism is perceived as akin to failure in Xia’s culture. You reflect on how you could modify your approach in the future to acknowledge different cultural interpretations of feedback. Your response is indicative of:
a. bias.
b. cultural awareness.
d. ethnocentricity.
20. Individuals living with asthma, who also live in poverty, are much less likely to seek early care and are more likely to go to emergency rooms for assistance. This example reflects:
a. stereotyping.
b. cultural diversity.
c. ethnocentricity.
d. transcultural care.
21. Sarah, RN, complains to you that a male nurse from a different culture sits very close during charting and leans toward her when speaking. In responding to Sarah, you consider that differences across cultures that are relevant to this situation include:
a. eye contact.
b. personal space.
c. harassment.
d. expressions of feeling.
22. A new graduate RN joins your unit. After a few weeks, she complains about some of her peers on the unit and compares their practices negatively to what she learned in her nursing program. She also is vocal about how she has learned so much here that she did not learn in her program. She is best described as:
a. having cultural sensitivity.
b. experiencing cultural diversity.
c. experiencing cultural marginality.
d. experiencing acculturation.
23. In caring for a patient from an East Indian culture, the staff expresses frustration that many people are in the room at any one time, which interferes with care. As the nurse manager, you provide leadership in understanding that this behavior of the family and friend network reflects:
a. lack of understanding of the seriousness of the patient’s illness.
b. lack of communication between family members.
c. the social organization of friendships and family networks in East Indian culture.
d. lack of caring about the hospital environment by the friends and family.
24. Sarah, one of your RNs, tells you that she can’t understand why Jim, an Aboriginal patient, wants to do a smudge. Sarah’s response is based on her:
a. cultural marginality.
b. circle of familiarity.
c. cultural understanding.
d. acculturation.
1. As a nurse manager, you have to be effective in managing a culturally diverse staff. Which of the following nurse manager attributes would assist you in addressing the cultural needs of your staff? (Select all that apply.)
a. Stereotyping of others
b. Respecting others
c. Understanding the importance of language
d. Encouragement of potential in all staff
e. Age bias
f. Disrespect for others
