Test Bank for Contemporary Nursing, 6th Edition, By

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Test Bank for Contemporary Nursing, 6th Edition, By Barbara Cherry, Susan R. Jacob,

Chapter 10: Cultural Competency and Social Issues in Nursing and Health Care
Test Bank

MULTIPLE CHOICE

1. When planning health care, the nurse should be mindful that members of the Asian culture
tend to:
a. miss appointments because they are present oriented and time is viewed as
flexible.
b. look to their ancestors for guidance.
c. plan ahead and be future oriented.
d. arrive early because they have no concept of time.
ANS: A
Correct: In Asian culture, individuals tend to be present oriented and time is viewed as being
more flexible than in the Western culture; being on time for appointments is not seen as a
priority.
Incorrect:
b. The people of the Asian culture usually have close, extended family ties, and emphasis is
on family needs rather than individual needs; all members participate in health care decisions.
c. The Asian culture is present oriented.
d. The Asian culture is present oriented, and Asian individuals are often late for appointments
because they are less concerned with planning ahead.

DIF: Comprehension REF: p. 194

2. A nurse is admitting a Mexican-American child, and the mother comments that the child was
exposed to mal ojo. The nurse should expect to find which symptom associated with this
exposure?
a. Fever
b. Nervous tension
c. Bruising
d. Somnolence
ANS: A
Correct: The child has what is referred to as mal ojo or “evil eye,” which can lead to diarrhea,
fever, and even death.
Incorrect:
b. A child said to have fits of rage or bilis would experience nervous tension and fatigue.
c. Bruising is associated with cupping, a common practice among Southeast Asians.
d. Somnolence is not a symptom of mal ojo.

DIF: Application REF: p. 200

3. A Mexican-American patient is attacked and beaten. This patient is at risk for “fright disease,”
which is known as:
a. susto.
b. empacho.
c. bilis.
d. mal ojo.

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 ANS: A
Correct: Susto is an emotion-based illness common among Mexicans. An unexpected fall, a
barking dog, or a car accident could cause susto. Symptoms include colic, diarrhea, high
temperature, and vomiting.
Incorrect:
b. Empacho, a disease that can affect children or adults, is caused by food particles that
become lodged in the intestinal tract, causing sharp pains.
c. Bilis is a disease that is brought on by anger. It primarily affects adults and commonly
occurs a day or two after a fit of rage.
d. Mal ojo is associated with “evil eye,” which causes fever, diarrhea, and restlessness.

DIF: Comprehension REF: p. 200

4. A priority action for the nurse who works with culturally diverse clients is completion of a:
a. sign language course.
b. cultural self-assessment.
c. cultural client assessment.
d. continuing education course on how to speak Spanish.
ANS: B
Correct: The first step to becoming a culturally sensitive and competent health care provider
is to conduct a cultural self-assessment. Through identification of health-related attitudes,
values, beliefs, and practices, the nurse can better understand the cultural aspects of health
care from the client’s perspective.
Incorrect:
a. A sign language course is not a priority because interpreters are usually available.
c. The nurse should always perform a cultural self-assessment first, before performing the
patient’s cultural assessment.
d. Taking a Spanish class is not a priority action and would be helpful only with patients who
speak Spanish; the nurse may encounter many other patients with different language needs.

DIF: Application REF: p. 198

5. A nurse is caring for a recent Asian immigrant client and is overheard making the following
comment, “These rituals you believe in are false. You live in America now and must believe
in realistic health practices, like Americans do.” The nurse is exhibiting:
a. stereotyping.
b. ethnocentrism.
c. cultural accommodation.
d. empathy.
ANS: B
Correct: Ethnocentrism is the belief that one’s own ethnic group, culture, or nation is best.
Incorrect:
a. Stereotyping is defined as assigning certain beliefs and behaviors to groups without
recognizing individuality.
c. Cultural accommodation involves making adjustments or adaptations to the beliefs of
others.
d. Empathy is mentally identifying with a person’s situation or character.
 DIF: Application REF: p. 184

6. The nurse is preparing a plan of care for an African-American patient who has had a change
of bowel habits from being constipated and having only two firm stools weekly to having
three or more loose stools daily. Which comment is related to cultural variation for health
information?
a. The individual states, “I will need to discuss health care options with my
grandmother.”
b. The eldest male member of the family will make all health care decisions.
c. The patient has high respect for the nurse and nods approvingly, although she has
no intention of complying with instructions or plan of care.
d. The individual speaks very quietly and gently reaches to hold the nurse’s hand for
support.
ANS: A
Correct: In the African-American culture, women, especially “Granny,” play a key role in
health care decisions.
Incorrect:
b. Males often make decisions in Asian cultures.
c. In the Asian culture, it is important for an individual to agree with those in authority and to
appear compliant, even if there is no intention of complying with instructions or plan of care.
d. A low tone of voice is consistent with the American Indian culture, and touching another’s
hand is not common among Asians or American Indians.

DIF: Application REF: p. 193

7. A nurse is submitting a grant application to improve access to health care and mortality for
minority groups. The grant focuses on the six causes of death that are identified as priorities
for minorities, which include:
a. chronic obstructive pulmonary disease.
b. malnutrition.
c. cirrhosis of the liver.
d. cancer.
ANS: D
Correct: Cancer is identified as a leading cause of excessive death among minority group
members. The six leading causes are cancer, cardiovascular disease and stroke, chemical
dependency, diabetes, homicides/accidents, and infant mortality.
Incorrect:
a. Chronic obstructive pulmonary disease is not identified as one of the six leading causes of
death among minority groups.
b. Malnutrition is not identified as one of the six leading causes of death among minority
groups.
c. Cirrhosis of the liver is not identified as one of the six leading causes of death among
minority groups.

DIF: Comprehension REF: p. 185

 8. A nurse is given a referral to make a home visit to a Russian immigrant. The nurse knows
very little about the health beliefs of this ethnic group. To research this group, she can use an
Internet search engine and enter the term “Russian cultures” or “Russian health beliefs.” To
obtain more generalized information, she could also search under:
a. federally recognized minorities.
b. marginalized populations.
c. Asian/Pacific Islander cultures.
d. Latino cultures.
ANS: B
Correct: Marginalized populations include recently arrived immigrants. Their lives and health
care needs often are kept secret and are understood only by them.
Incorrect:
a. Russian immigrants are not federally recognized minorities.
c. A search for Asian/Pacific Islander cultures would not provide any information on Russian
Immigrants.
d. A search for Latino cultures would not provide any information on Russian immigrants.

DIF: Application REF: p. 185

9. Which statement is true regarding health care for minorities?

a. Federal legislation that provides free health insurance for minorities has resulted in
fewer minorities than members of the general population who lack health
insurance.
b. Higher costs of health care coupled with lower wages for minorities have
prevented most minorities from seeking health care.
c. Because many Mexican Americans are highly skilled workers with comparable
wages, they have the lowest uninsured rate.
d. Asians, because of their quiet demeanor and unwillingness to challenge the health
care system, have the highest rate of uninsured people.
ANS: B
Correct: Most families with racially or ethnically diverse backgrounds have a lower
socioeconomic status than is observed in the population at large. Dramatic changes in
technology and specialization in the health care field have caused health care costs to
skyrocket. Therefore, not everyone can afford health care services.
Incorrect:
a. More minorities than general population members lack health insurance.
c. At 40%, Mexican Americans have one of the highest uninsured rates.
d. African Americans, Hispanics, and Native Americans have much higher rates of poverty
than do non-Hispanic whites and Asians. The median family income of Asians is slightly
higher than that of non-Hispanic whites; because their income is higher, Asians have better
access to health care.

DIF: Analysis REF: p. 186 | p. 191

10. While completing a nursing degree in Virginia, a student who is interested in teaching in
Laredo, Texas, enrolls in Spanish classes for 4 years, knowing that a high number of
Mexican-Americans live there. This nursing student values:
a. cultural competence.
b. ethnocentrism.
 c. prejudice.
d. stereotyping.
ANS: A
Correct: Cultural competence is the responsibility of all nurses to become knowledgeable
about the values, beliefs, and health care practices of the culturally diverse groups that are
dominant in the nurse’s particular practice area.
Incorrect:
b. Ethnocentrism is the belief that one’s own ethnic group, culture, or nation is best.
c. Prejudice is a preconceived, deeply held, usually negative judgment that has been formed
about other groups.
d. Stereotyping is assigning particular beliefs and behaviors to specific groups without
recognition of individuality.

DIF: Application REF: pp. 190-191

11. A Southeast Asian woman brings her baby into the clinic because the baby is lethargic. The
nurse determines that the baby has had diarrhea and vomiting for several days, resulting in
dehydration. Physical examination reveals small, round burns on the abdomen. These burns
probably are the result of cigarettes or burning cotton used to:
a. try to quiet the child and is considered child abuse.
b. bring out toxic wind from the body.
c. balance heat loss from the body.
d. brush the body with ruda to allow spirits to return.
ANS: C
Correct: In the Southeast Asian culture, touching a burning cigarette or piece of cotton to the
skin, usually the abdomen, is done to compensate for “heat” lost through diarrhea. This type
of burning is a common part of self-care.
Incorrect:
a. Quieting a child by burning his or her skin is not a practice of Southeast Asian culture.
b. Using burns to bring out toxic wind from the body is not a practice of Southeast Asian
culture.
d. Brushing the body with ruda to allow spirits to return is not a practice of Southeast Asian
culture.

DIF: Application REF: p. 199

12. A cultural phenomenon that is based on biologic variation would include:

a. belief that exposure of a pregnant woman to an eclipse can result in cleft lip.
b. denser bones in African Americans result in less morbidity associated with
osteoporosis.
c. the grandmother who determines that her grandchild has scoliosis and should seek
treatment, then informs the parents of her decision.
d. a family that participates in feasts prepared to celebrate and make decisions.
ANS: B
Correct: Biologic variations include denser bones in African Americans. Biologic variations
such as body build and structure, genetic variations, skin characteristics, susceptibility to
disease, and nutritional variations exist among different cultures. Other common variations
include skin color, eye shape, hair texture, and adipose tissue deposits.
 Incorrect:
a. The belief that exposure of a pregnant woman to an eclipse can result in cleft lip is an
example of environmental control.
c. A grandmother who has a lot of say in health care decisions is an example of ways that
social organization affects cultural beliefs.
d. Family feasts to celebrate and make decisions and Vietnamese immigrants gathering at an
altar into which the names of ancestors have been carved are examples of ways that social
organization affects cultural beliefs.

DIF: Analysis REF: p. 193

13. A nurse plans to move to an area that is rich in immigrants from several countries and is
concerned about respecting others’ cultural beliefs. The nurse’s first step to ensure cultural
competence and sensitivity is to:
a. enroll in a nursing theories course to increase knowledge about transcultural
practices.
b. become immersed in nursing literature about culturally diverse clients.
c. participate in continuing education that focuses on health assessment variations
among cultural groups.
d. conduct a cultural self-assessment.
ANS: D
Correct: A cultural self-assessment allows the nurse to identify attitudes about individuals
from different cultures.
Incorrect:
a. To gain maximum benefit, the nurse must first identify his own attitudes before enrolling in
a nursing theories course.
b. To gain maximum benefit, the nurse must first identify his own attitudes before immersing
himself in nursing literature about culturally diverse clients.
c. To gain maximum benefit, the nurse must first identify his own attitudes before
participating in continuing education that focuses on health assessment variations among
cultural groups.

DIF: Application REF: p. 198

14. A nurse is preparing discharge teaching for an Asian-American woman with a fractured hip.
The nurse reviews the client’s diet history while hospitalized and is concerned that the patient
refused milk and yogurt, placing her at risk for osteoporosis. What cultural variation is the
nurse overlooking? Asian Americans:
a. have denser bones that other ethnic groups.
b. consume diets rich in pork bone and shells, reducing the risk of osteoporosis.
c. would participate in the practice of burning to compensate for this injury.
d. would consult a curandero for dietary consultation.
ANS: B
Correct: Pork bones and shells are rich in calcium, reducing the risk of osteoporosis.
Incorrect:
a. African Americans have denser bones than other ethnic groups.
c. Although Southeast Asians participate in burning, it is used to compensate for heat loss
such as with diarrhea.
 d. Hispanic clients consult with curanderos, whereas Asian clients would seek an
acupuncturist or bone setter.

DIF: Application REF: p. 199

15. A nurse is preparing to teach a class related to risk factors for cancer to a diverse ethnic group
attending a health fair. The nurse should be aware:
a. that Hispanic women overestimate the prevalence of cancer and strictly following
breast self-exam guidelines.
b. of the importance of risk factors such as smoking and alcohol consumption that
increase esophageal cancer when speaking with African American.
c. that American-Indian women have a higher rate of ovarian cancer than the general
population.
d. that cancer as well as heart disease and stroke are lower in ethnic groups.
ANS: B
Correct: African-American men have a higher risk for esophageal cancer than the general
population so teaching risk factors is needed.
Incorrect:
a. Hispanic women tend to underestimate the power of prevention and prevalence of cancer
and have fewer screenings performed.
c. American women have a higher prevalence of diabetes than the general public and lower
incidence of cancer than the general public.
d. Heart disease and stroke are leading cause of death in minorities with cancer being the
second leading cause.

DIF: Application REF: p. 193

16. A nurse performing a history and physical on a newly admitted Hispanic patient learns the
patient has just used the services of a savador to:
a. determine which herbs would best reduce hot flashes in a menopausal woman.
b. communicate with a family member who recently died.
c. receive treatments to reduce lower back pain.
d. receive acupuncture to stop smoking.
ANS: C
Correct: Hispanic patients may want the support and care of a savador, which is similar to
that offered by a chiropractor.
Incorrect:
a. A verbo would be consulted regarding herbs.
b. A spiritualist would be consulted to communicate with decreased family or friends.
d. Acupuncturists deliver treatment for many reasons, including pain relief, smoking
cessation, and eating disorders.

DIF: Comprehension REF: p. 196

17. An Asian teenager is admitted with an eating disorder which she contributes to by not meeting
the academic expectations of her parents. The nurse is overheard saying, “That isn’t the
reason; all Asians are really smart.” This nurse is demonstrating:
a. cultural humility.
b. stereotyping.
 c. cultural assimilation.
d. acculturation.
ANS: B
Correct: Stereotyping is associating certain behavior or competencies with an ethnic group
without considering the individual.
Incorrect:
a. Cultural humility is a lifelong commitment to reduce the power imbalances due to lack of
cultural consideration.
c. Cultural assimilation is the cultural absorption of a minority group into the main cultural
body.
d. Acculturation is the process of becoming adapted to a new or different culture.

DIF: Application REF: p. 184

18. A nurse caring for a Hispanic child admitted with diarrhea notices the child is wearing red
yarn around the wrist. The nurse compliments the child’s “jewelry,” knowing it is believed to
prevent:
a. mal ojo.
b. susto.
c. bilis.
d. empacho.
ANS: A
Correct: Mal ojo is due to “admiration” from a stranger resulting in diarrhea.
Incorrect:
b. Susto is “fright disease” such as caused by a bicycle wreck or loud shouting.
c. Bilis follows a rage.
d. Empacho is believed to be caused by lodged food particles.

DIF: Application REF: p. 200

19. A Hispanic patient is visited by several family members and the nurse witnessed one visitor
who pinches a piece of skin at the waist. The nurse asks the purpose and learns the “provider”
is listening for a snap from the abdominal region, which is then repeated several times. The
patient most likely suffers from:
a. mal ojo.
b. susto.
c. bilis.
d. empacho.
ANS: D
Correct: Empacho is believed to be caused by lodged food particles, causing acute
stomach/intestinal pain.
Incorrect:
a. Mal ojo is due to “admiration” from a stranger resulting in diarrhea.
b. Susto is “fright disease” such as caused by a bicycle wreck or loud shouting.
c. Bilis follows a rage.

DIF: Application REF: p. 200

 20. A nurse is seeking to become culturally competent in regards to obtaining information during
health history and when performing physical diagnosis. The nurse is aware that which
biologic variation is found in all of the following ethnicities: African Americans, Asians,
Hispanics, and American Indians?
a. Mongolian spots
b. Sickle cell anemia
c. Lactose intolerance
d. Thalassemia
ANS: C
Correct: Lactose intolerance is found in all four of the noted ethnicities.
Incorrect:
a. Mongolian spots are found in African American, Asians, and Hispanics but not in American
Indians.
b. Sickle cell anemia is found only in African Americans.
d. Thalassemia is common only to Asians.

DIF: Application REF: p. 195; Table 10-1

MULTIPLE RESPONSE

1. Six cultural phenomena that vary among cultural groups are known to affect health care. The
influence of the consequences of these phenomena can be seen in which of the following?
(Select all that apply.)
a. Asians and American Indians tend to be nonadherent with medications because
they believe that the environment has no control over their fate.
b. Some cancers such as stomach cancer occur less frequently among African
Americans.
c. African Americans and American Indians often resist direct eye contact.
d. Mexican Americans are more likely to stand close and touch health care providers.
e. Whites are often late for health care appointments.
ANS: C, D
Correct:
c. The use of eye contact is a cultural communication phenomenon. Cultures such as African
American and American Indian may view direct eye contact as rude behavior.
d. Space and touch are cultural phenomena factors. In some cultures, touching strangers is
inappropriate. On the other hand, Mexican Americans tend to be comfortable with less space
because they like to touch persons with whom they are talking.
Incorrect:
a. Asians and American Indians believe that illness represents a disharmony with nature.
b. The occurrence of stomach cancer is twice as high among African-American men as among
white men.
e. Whites represent Western culture, in which punctuality and “watching the clock” are part of
the cultural phenomena.

DIF: Analysis REF: pp. 193-194

2. A nurse involved in researching the leading causes of death for minorities considers the
federally defined minority groups, which include: (Select all that apply.)
Test Bank for Contemporary Nursing, 6th Edition, By Barbara Cherry, Susan R. Jacob,

a. African Americans
b. Russians
c. Hispanics
d. Asians or Pacific Islanders
e. Scandinavians
ANS: A, C, D
Correct:
The Federally defined minority groups include African Americans, Hispanics, American
Indians, and Asians or Pacific Islanders.
Incorrect:
b. Russians are not a federally defined minority group.
e. Scandinavians are not a federally defined minority group

DIF: Comprehension REF: pp. 184-185

COMPLETION

1. On the scale from 1 to 10, with 1 being no prejudice and 10 being extreme prejudice, the
placement of hate on the continuum would be at number _____.

ANS:
10
Hate is the extreme negative manifestation of prejudice, followed by contempt, then tolerance,
which is more neutral.

DIF: Application REF: pp. 186-187

2. Although communication varies among members of different cultures, the greatest obstacle to
providing multicultural care is differences in _____.

ANS:
language
Language can be the greatest obstacle to providing multicultural care. If the client does not
speak the same language as the nurse, a skilled interpreter is mandatory.

DIF: Comprehension REF: p. 193

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