Cultural Diversity in Health and Illness 9th Edition Spector Test Bank

Cultural Diversity in Health and Illness
9th Edition Spector Test Bank

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Cultural Diversity in Health and Illness, 7e (Spector)
Chapter 9 HEALTH and ILLNESS in the American Indian and Alaska Native Population
1) Which is a characteristic of health insurance usage by the American Indian and Alaska Native
population?
1. Less than among the general population
2. Dependent on federal monies
3. Subsidized by tribal income
4. Greater than among the general population
Answer: 1
Explanation: 1. American Indian and Alaska Native populations have less health insurance
coverage than the rest of the population.
2. Health insurance for this population is not dependent on federal monies.
3. Health insurance for these populations is not subsidized by tribal income.
4. American Indian and Alaska native populations have less health insurance, not more, than that
of the rest of the population.
Cognitive Level: Remembering
Patient Need: Health Promotion and Maintenance
Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: LO01 - Discuss the historical and demographic backgrounds of the
American Indian and Alaska Native population.
2) Prior to the 1860 census, how were American Indians documented?

1. Counted those living in the general states' populations
2. Limited to those living on reservations
3. Separated them into their respective tribal affiliations
4. Differentiated between Alaska Natives and American Indians
Answer: 1
Explanation: 1. The 1890 census was the first to count American Indians throughout the
country. Prior to this census, the counting was limited to those American Indians living in the
general population of various states.
2. American Indians living on reservations were not included in census counts.
3. Separation into tribal affiliations is not a part of the census count.
4. Differentiation between American Indians and Alaska Natives did not occur until the 1940
census.
Cognitive Level: Remembering
Patient Need: Psychosocial Integrity
Nursing/Integrated Concepts: Nursing Process: Assessment
1
Copyright © 2017 Pearson Education, Inc.
3) The nurse practitioner desires to provide healthcare to American Indians. In what part of the
United States would the nurse find the largest concentration of American Indians to provide
care?
1. West
2. North
3. South
4. East
Answer: 1
Explanation: 1. The West has the largest American Indian population, as well as the highest
proportion of American Indians in its total population.
2. The North has significant numbers of American Indians, but not as many as the West.
3. The South is home to a number of American Indian tribes, but not as many as the western
section of the United States.
4. The East has fewer American Indians than the West.
Cognitive Level: Applying
Nursing/Integrated Concepts: Nursing Process: Planning
4) An American Indian patient tells the nurse about how her family was originally from Northern
New England, but ended up in Florida. What would explain the relocation of American Indian
tribes in the United States?
1. Forcible relocation as treaties took over much of the native lands
2. Diminished populations from death and disease
3. Moving for better employment opportunities
4. Voluntary relocation for land exchange in other areas of the country
Answer: 1
Explanation: 1. Forcible relocation of some Indian tribes, most notably that of the Cherokee
nation, occurred when treaties took away native lands and the tribes were relocated to other areas
of the country.
2. Exposure to different illnesses brought about by European settlement resulted in increased
mortality among Indian tribes, but not to the extent of eradicating Indian presence in areas of the
country where they are no longer present.
3. Employment opportunities were not a factor explaining why some tribes are no longer in their
ancestral origin area.
4. While some tribes agreed to voluntary relocation, this was not the common practice among
Indian tribes.
Cognitive Level: Analyzing
2
5) During a health history, the nurse asks a patient of American Indian heritage to explain the
concept of HEALTH. In this heritage, how is HEALTH defined? Select all that apply.
1. Living in total harmony with nature
2. Survival instinct
3. Treating the body with respect
4. Treating the earth with respect
Answer: 1, 2, 3, 4
Explanation: 1. The traditional American Indian belief about HEALTH is it reflects living in
total harmony with nature.
2. The traditional American Indian belief about HEALTH is it reflects the ability to survive
under difficult circumstances.
3. The traditional American Indian belief about HEALTH includes treating the body with
respect.
4. The traditional American Indian belief about HEALTH includes treating the Earth with
respect.
Learning Outcome: LO02 - Describe the traditional definitions of HEALTH and ILLNESS of
the American Indian and Alaska Native population.
6) In traditional American Indian beliefs, what controls the body's spiritual energy? Select all
that apply.
1. Positive energy pole
2. Negative energy pole
3. Purpose and identity
4. Communion with nature
Answer: 1, 2, 3, 4
Explanation: 1. According to American Indian belief, the human body is divided into two
halves, with one energy pole being positive.
2. According to American Indian belief, the human body is divided into two halves, with one
energy pole being negative.
3. According to American Indian belief, the human body can be controlled through individual
purpose and identity.
4. Communion with nature is viewed as controlling the body's spiritual energy within the
American Indian heritage.
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7) What might a patient from the American Indian heritage use to prevent disease?
1. Wear certain objects or charms as a preventive measure.
2. Perform specific daily rituals against disease.
3. Deny that disease or ILLNESS can harm a person.
4. Accept that disease is a part of life.
Answer: 1
Explanation: 1. Disease can be attributed to a lack of prevention, so many American Indians
wear charms or other material objects to prevent disease.
2. Some rituals are designed to prevent ILLNESS, but are not done on a daily basis.
3. Denial of ILLNESS or disease causing harm is not characteristic of Indian belief.
4. While ILLNESS is accepted as something that must be, it is not the same as accepting it as
being a part of life.
Nursing/Integrated Concepts: Nursing Process: Implementation
8) What is the cause of ILLNESS in the American Indian heritage? Select all that apply.
1. Something that happened in the past
2. Something that will happen in the future
3. Illness is something that must be.
4. Illness is a consequence of mistreating the Earth.
Answer: 1, 2, 3, 4
Explanation: 1. In traditional American Indian heritage, it is believed that ILLNESS is the price
to be paid for something that happened in the past.
2. In traditional American Indian heritage, it is believed that ILLNESS is the price to be paid for
something that will happen in the future.
3. American Indians do not believe the germ theory of modern medicine, but rather explain
ILLNESS as something that must be.
4. American Indians may believe that ILLNESS is the consequence from mistreating the Earth.
4
9) Which American Indian tribe associates illness with evil spirits?
1. Hopi
2. Passamaquoddy
3. Sioux
4. Cherokee
Answer: 1
Explanation: 1. The Hopi associate ILLNESS with evil spirits, and the responsible evil spirit is
identified by the medicine man.
2. Evil spirits as a cause of ILLNESS is not associated with Passamaquoddy beliefs.
3. Evil spirits as a cause of ILLNESS is not associated with the beliefs of the Sioux.
4. The medicine man determines the ILLNESS in the Cherokee belief, even when the person is
not personally aware of being ill.
Nursing/Integrated Concepts: Nursing Process: Diagnosis
10) The nurse is planning care for a Navajo American Indian. How does this patient view the
cause of ILLNESS? Select all that apply.
1. Caused by displeasing holy people
2. Caused by annoying the elements
3. Caused by disturbing plant life
4. Caused by disturbing animal life
Answer: 1, 2, 3, 4
Explanation: 1. Traditional Navajo American Indians see ILLNESS as displeasing holy people.
2. Traditional Navajo American Indians see ILLNESS as caused by annoying the elements.
3. Traditional Navajo American Indians see ILLNESS as caused by disturbing plant life.
4. Traditional Navajo American Indians see ILLNESS as caused by disturbing animal life.
5
11) In the American Indian heritage, what is the purpose of herbs and plants when caring for an
ILLNESS?
1. Spiritual helpers
2. Diagnostic agents
3. Stimulants
4. Medications
Answer: 1
Explanation: 1. The medicine man or woman must understand the characteristics of plants and
herbs, and their use for illness is seen as spiritual help.
2. Diagnostic agents are more prevalent in the modern medical tradition than the American
Indian tradition.
3. Stimulants are not considered to be a specific traditional healing method in the American
Indian tradition.
4. Medications are not in the American Indian tradition for treating illness.
Learning Outcome: LO03 - Explain the traditional methods of HEALING of the American
Indian and Alaska Native population.
12) The diagnostician told a patient of Navajo American Indian heritage that his ILLNESS is
minor, and he will recover. What activities does the diagnostician in this heritage perform?
Select all that apply.
1. Motion in the hand
2. Stargazing
3. Listening
4. The sweat lodge
Answer: 1, 2, 3
Explanation: 1. The practice of motion in the hand includes sprinkling sand around the sick
person and sitting with the eyes closed. While the HEALER's hands move during a song, the
disease, the causes, and the proper treatment are identified.
2. During stargazing, the HEALER prays the star prayer to the star spirit asking it to show the
cause of the ILLNESS.
3. The cause of the ILLNESS is determined by the sound that is heard by the HEALER.
4. The sweat lodge is a treatment for ILLNESS used in the Navajo American Indian heritage.
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13) Which action is considered to be a traditional practice among American Indians to maintain
their harmony with nature?
1. Purification
2. Lunar cycle agri-heritage
3. Eating ritual foods
4. Divination
Answer: 1
Explanation: 1. Purification is common among American Indians to maintain their harmony
with nature and cleanse the body and spirit. Purification can be as simple as bathing, or may
employ specific rituals to induce sweating.
2. Lunar cycle agri-heritage is not a practice that is considered to be a traditional remedy.
3. Eating ritual foods is not a traditional remedy.
4. Divination is a practice done by Navajo medicine men and women for diagnosing and treating
ILLNESS.
14) The nurse is observing a HEALING ceremony performed by people of the American Indian
heritage. What is a characteristic of this ceremony?
1. Sound
2. Quiet
3. Herbal teas
4. Hallucinogenic plants
Answer: 1
Explanation: 1. Sound is a common characteristic of HEALING ceremonies, as sound interferes
with the negative work of the spirits of the disease.
2. Quiet is not a common characteristic of HEALING ceremonies, which incorporate sound
through drumming and singing.
3. Herbal teas are used in HEALING, but are not common among all American Indians.
4. The use of hallucinogenic plants is not common among all American Indian groups.
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15) A patient of the American Indian heritage tells the nurse that the medicine man is consulted
when an ILLNESS develops. How does a person become a medicine man? Select all that apply.
1. Know the interrelationships between people, the earth, and the universe.
2. Understand the ways of plants and animals.
3. Perform special ceremonies.
4. Attend a specific course of study.
Answer: 1, 2, 3
Explanation: 1. The medicine men and women know the interrelationships of human beings, the
earth, and the universe.
2. The medicine men and women know the ways of the plants and animals.
3. The medicine men and women perform special ceremonies, which may take up to several days
to determine the cause and treatment of an illness.
4. The medicine men and women do not attend a specific course of classroom study.
Learning Outcome: LO04 - Describe the practice of a traditional HEALER.
16) What is the difference between the modern physician and the medicine man when
determining the cause of an illness?
1. The medicine man looks for the spiritual cause of the problem.
2. The medicine man looks for the physical cause of the problem.
3. The medicine man studies the patient's past medical history to determine the cause of the
illness.
4. The medicine man studies the dietary practices of the person being seen.
Answer: 1
Explanation: 1. Medicine men and women look for the spiritual cause of the ILLNESS.
2. Physical symptomatology is characteristic of the modern physician.
3. Using past medical history is characteristic of the modern physician in determining ILLNESS.
4. Attributing ILLNESS to dietary practices is seen more in the modern physician than with
medicine men and women.
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17) In which American Indian tribe are meditation and herbs used to create a trance to provide
the vision of the evil that causes an ILLNESS?
1. Hopi
2. Sioux
3. Navajo
4. Cherokee
Answer: 1, 4
Explanation: 1. In the Hopi tradition for healing, the medicine man or woman uses meditation to
determine the cause of ILLNESS. Herbs may be used to induce a trance.
2. The Sioux use meditation, but not as the method to determine ILLNESS.
3. The Navajo practices are myriad, but do not use meditation as a primary method to determine
ILLNESS.
4. The Cherokee tradition does use meditation and herbs to determine ILLNESS.
18) Which Navajo American Indian divination method will women practice to diagnose the
cause of an ILLNESS?
1. Motion in the hand
2. Listening
3. Singing
4. Stargazing
Answer: 1
Explanation: 1. Motion in the hand is the most common form of divination among the Navajo
and the form often practiced by women.
2. Listening is a form of divination practiced by men and women.
3. Singing is a form of treatment and not a form of divination.
4. Stargazing is a form of divination and is practiced by women, but not the most prevalent.
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19) What is the purpose of sand paintings when diagnosing ILLNESS in the Navajo American
Indian heritage?
1. Determines the cause and treatment of the ILLNESS
2. Ensures appropriate payment is made by the family
3. Provides an atmosphere of calm for the medicine man
4. Creates symbolic representations of the patient and family
Answer: 1
Explanation: 1. Sand paintings may be incorporated as part of the practice of motion in the hand.
The shape of the painting using the symbolic colors of white, blue, yellow, and black determines
the cause and the treatment of the ILLNESS.
2. Chanting as part of motion in the hand is determined by the amount the family is able to pay.
3. The use of sand paintings is part of the overall process of motion in the hand, but aids the
medicine man in diagnosis, not in providing calm.
4. The symbolic colors help to determine the shape and provide cause of the ILLNESS, but are
not symbolic representations of the patient and family.
20) What purpose does singing and chanting serve during the Navajo American Indian tradition
of HEALING?
1. The psychological effects of the singing help the patient feel cared for in a deeply personal
way, which aids HEALING.
2. The patient enters a trance, which aids HEALING.
3. The singer accurately predicts the trajectory of the ILLNESS and recovery.
4. The singer brings the family of the affected patient back into harmony with the universe that
ultimately heals the patient.
Answer: 1
Explanation: 1. The main effects of chant and the singer are psychological, allowing the patient
to feel cared for in a deeply personal way, as the focus of the singer is on the patient, who is the
reason for the singer's presence.
2. The patient does not enter a trance when the singer is chanting.
3. The singer can tell the patient that recovery will occur, but is not able to predict a trajectory of
illness and recovery.
4. The focus of the singer and chant is on the affected patient, not the family.
10
21) The nurse is conducting a medication history with a patient from the Oneida American
Indian heritage. Which remedies would the nurse include as part of this history? Select all that
apply.
1. Witch hazel
2. Comfrey
3. Skunk oil
4. Dried raspberry leaves
Answer: 1, 2, 3, 4
Explanation: 1. In the Oneida American Indian heritage, witch hazel is used for colds.
2. In the Oneida American Indian heritage, comfrey is used for a sore throat.
3. In the Oneida American Indian heritage, skunk oil is used for an ear infection.
4. In the Oneida American Indian heritage, dried raspberry leaves are used for mouth sores.
22) Why would a patient from the American Indian heritage be prone to developing diseases of
the poor, such as tuberculosis and malnutrition?
1. Living in abject poverty
2. Living in areas not accessible to the general population
3. Genetic predisposition to these illnesses and conditions
4. Health practices are conducive to these conditions
Answer: 1
Explanation: 1. American Indians have a higher proportion of diseases of the poor due to
poverty. Their poor socioeconomic status predisposes the development of the diseases of the
poor.
2. Living on reservations can exacerbate the conditions that lead to diseases of the poor, but not
all reservations are the same.
3. Tuberculosis and malnutrition are not conditions or diseases for which there is a genetic
predisposition.
4. Health practices among American Indians are not conducive to diseases of the poor.
Learning Outcome: LO05 - Describe current healthcare problems of the American Indian and
Alaska Native populations.
11
23) The nurse is obtaining a health history from a patient of the American Indian heritage. Which
problems would cause the nurse to be concerned about the patient's health? Select all that apply.
1. Heart disease
2. Diabetes mellitus
3. Cancer of the prostate
4. Gastric ulcers
Answer: 1, 2, 3
Explanation: 1. Diseases of the heart are the leading cause of death for American Indians.
2. Diabetes mellitus is the fifth leading cause of death for American Indians.
3. Malignant neoplasms are the second leading cause of death for American Indians.
4. Gastric ulcers are not identified as being a leading cause of death for people of the American
Indian heritage.
24) A patient of the American Indian heritage is diagnosed with liver cirrhosis caused by chronic
alcoholism. For which problems would the nurse focus when discussing the patient's care with
the spouse? Select all that apply.
1. Domestic violence
2. Sexual abuse
3. Battering of women
4. Unplanned pregnancy
Answer: 1, 2, 3
Explanation: 1. A problem related to alcohol abuse in the American Indian people is domestic
violence.
2. A problem related to alcohol abuse in the American Indian people is sexual abuse.
3. A problem related to alcohol abuse in the American Indian people is battering of women.
4. Unplanned pregnancy is not a problem related to alcohol abuse in the American Indian people.
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25) What is a goal of the Indian Health Service?
1. Ensure that comprehensive, culturally acceptable personal care is available and accessible to
all American Indian people
2. Provide healthcare to the American Indian and Alaska Native
3. Provide American Indian medical providers to deliver medical care to the American Indian
and Alaska Native population
4. Educate the American Indian and Alaska Native in preventive health care practices
Answer: 1
Explanation: 1. The goal of the Indian Health Service is to ensure that comprehensive, culturally
acceptable personal and public health services are available and accessible to all American
Indian people.
2. The purpose of the Indian Health Service is to be the federal health provider and advocate for
the Indian people.
3. The Indian Health Service strives to raise health status through many medical providers, both
Indian and non-Indian.
4. One aspect of improving the health of the Indian peoples to its highest level is to educate them
about preventive care practices, but it is not the goal.
Learning Outcome: LO06 - Summarize the services rendered by the Indian Health Service.
26) How does the Indian Health Service plan to raise the health of the American Indian people?
1. Partnering and assisting tribes in planning the best delivery of care
2. Allotting health resources based on population numbers
3. Having one master health guideline blueprint for consistency of care
4. Following prescribed federal guidelines and procedures
Answer: 1
Explanation: 1. Partnering and assisting tribes in planning health care needs and delivery of
healthcare allows the Indian Health Service to carry out its mission to improve health to its
highest level.
2. Allocating health resources based on population numbers does not take into account needs of
specific groups.
3. One master guideline will not allow for culturally unique and relevant care for this population.
4. Following only prescribed federal guidelines and procedures does not allow for culturally
acceptable care that is reflective of each unique tribe's traditions.
13
27) Even though the Indian Health Service (IHS) provides care to a wide area of the population,
what is an issue with this health service?
1. Services are predominantly given in the western part of the United States.
2. Health services can only be provided through IHS facilities.
3. Any American Indian or Alaska Native can demand care from the IHS.
4. There is a redundancy of services in all its facilities.
Answer: 1
Explanation: 1. Services provided by the IHS for American Indians are primarily located in the
western region of the United States. Those living on the East Coast have a difficult time
obtaining health services.
2. The IHS provides care through its facilities, but also through contracted facilities.
3. Any person who is a member of a federally recognized Indian tribe may be eligible for
services, but not all American Indian tribes have received federal recognition.
4. Health services in the IHS facilities are geared to providing services to meet the needs of each
area and population.
28) A patient of the American Indian heritage is waiting to be seen in a non-Indian Health
Service facility. What concern might this patient have about receiving health care through this
route?
1. Conflict between his or her perception of the illness and what the physician diagnoses
2. Easier to receive medical care through emergency departments rather than private physicians
3. Receive better healthcare from mainstream medical services
4. Concern that medical insurance won't cover all the medical costs
Answer: 1
Explanation: 1. When an American Indian is in a geographic area not covered by the Indian
Health Services, there exists the concern of whether culturally appropriate care will be given.
There may be conflict over whether the illness perceived by the American Indian is respected or
addressed by the physician.
2. Receiving medical care through emergency departments rather than private physicians may
contribute to feelings of conflict and concern, as there is no continuity of care.
3. Mainstream medicine may not address or consider the unique cultural aspects of providing
care to an American Indian population.
4. Concern over insurance coverage is not foremost when an American Indian seeks healthcare
from mainstream medicine.
14
29) Which action would the nurse take when assessing a patient of American Indian heritage?
Select all that apply.
1. Remaining quiet and recognizing the importance of nonverbal communication to seek
information
2. Asking detailed questions regarding the presenting symptoms
3. Asking indirect questions about the reason for seeking health care
4. Ensuring no one beyond the medical provider and the patient discuss what has brought the
patient to seek care
Answer: 1, 3
Explanation: 1. Nonverbal communication is an important concept to American Indians, and the
medical provider is expected to deduce the problem through instinct rather than asking detailed
questions to form a history.
2. Asking detailed questions regarding the presenting symptoms is intrusive to the individual
privacy of the American Indian.
3. Asking indirect questions about the reason for seeking healthcare may be a valuable technique.
4. Ensuring patient confidentiality is universal and not specific to the American Indian.
30) The nurse is completing a health history for a patient of the American Indian heritage. What
activity would the nurse perform while conducting this assessment?
1. Remembering what is being said to be recorded at a later date
2. Encouraging free conversation by the American Indian patient
3. Repeating back everything that is said
4. Tape-recording the responses given
Answer: 1
Explanation: 1. Note-taking is taboo when eliciting a history of an American Indian, as their
heritage is based upon verbal history. Memory skills are to be employed when taking a history.
2. Encouraging free conversation is not considered appropriate by the American Indian when
seeking healthcare.
3. Repeating back everything that has been said may be considered offensive, as it can give the
impression that close attention was not being given to what was said.
4. Tape-recording responses is considered offensive.
15

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9th Edition Spector Test Bank

2) Prior to the 1860 census, how were American Indians documented?

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