Foundations Of Mental Health Care 4th Edition by Morrison-Valfre – Test Bank
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Morrison-Valfre: Foundations of Mental Health Care, 4th Edition
Test Bank
Chapter 3: Ethical and Legal Issues
MULTIPLE CHOICE
1. A
male teenage client tells the nurse that his friends like to drink alcohol
occasionally to get drunk. The client’s friends see nothing wrong with their
drinking habits. The client states that he was taught by his parents and agrees
that underage drinking is not acceptable. Also, he has never seen his parents
drunk; therefore, he refuses to drink with his friends. Which mode of
transmission best describes how this client’s particular value was formed?
|
a. |
Moralizing |
|
b. |
Modeling |
|
c. |
Reward-punishment |
|
d. |
Laissez-faire |
ANS: B
Modeling best describes how the teenage client developed this
value because his parents not only discussed this issue but behaved in a way
for the teen to copy. Moralizing sets standards of right and wrong with no
choices allowed; the reward-punishment model rewards valued behavior and
punishes undesired behavior; and the laissez-faire model imposes no restriction
or direction on choices.
DIF: Cognitive Level:
Application
REF: Page 20
OBJ: 1
TOP: Acquiring
Values
KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity
2. A
female client becomes combative when the nurse attempts to administer routine
medications. The nurse would like to ignore the client but chooses to talk with
the client to calm her. The nurse is successful in calming the client, and the
client takes her medications. What process best describes how the nurse decided
on the course of action taken?
|
a. |
Values clarification |
|
b. |
Nurse’s rights |
|
c. |
Beliefs |
|
d. |
Morals |
ANS: A
Values clarification consists of the steps of choosing, prizing,
and acting. This most accurately describes how the nurse made the proper
decision. The nurse chose the best action, reaffirmed the choice, and then
enacted the choice. The nurse’s rights were not violated, and beliefs and
morals do not describe the entire decision-making process that occurred.
DIF: Cognitive Level:
Application
REF: Page 20
OBJ: 1
TOP: Values Clarification
KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment
3. Which
patient right may clients with mental health disorders lose during treatment?
|
a. |
Confidentiality of records |
|
b. |
Freedom from restraint or
seclusion |
|
c. |
Humane treatment
environment |
|
d. |
Referral to other mental
health providers on discharge |
ANS: B
A client could lose the right of freedom from restraint or
seclusion in emergency situations, such as being a threat to himself or others.
The other rights must be upheld at all times.
DIF: Cognitive Level:
Knowledge
REF: Page 21
OBJ: 2
TOP: Client
Rights
KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment
4. Twenty
three states have enacted mental health parity laws. The most accurate
description of these laws is that they require insurance companies to:
|
a. |
Include coverage for mental
illness |
|
b. |
Include coverage for
substance abuse treatment |
|
c. |
Include coverage for mental
illness that is equal to coverage for physical illness |
|
d. |
Include coverage for
outpatient therapy for individuals with substance abuse |
ANS: C
The mental health parity laws require insurance companies to
include coverage for mental illness that is equal to coverage for physical
illness. Only nine states include treatment for substance abuse in their parity
laws.
DIF: Cognitive Level:
Knowledge
REF: Page 21
OBJ: 2
TOP: Client
Rights
KEY: Nursing Process Step: Assessment
MSC: Client Needs: Safe and Effective Care Environment
5. The
rights of the care provider include the right to:
|
a. |
Fair pay |
|
b. |
Fair benefits from
employers |
|
c. |
Refuse to care for
individuals who may cause harm to the care provider |
|
d. |
Respect as individuals |
ANS: D
In addition to the right to respect as individuals, the rights
of the care provider include the rights to safety, competent assistance, set
standards for quality and development of policies that affect client care, and
full and equal participation as a member of the health care team. Fair
pay and benefits are not addressed by care provider rights. A care provider has
the right to safety but cannot refuse to care for an individual because he may
fear harm from the client. Proper safety measures must be implemented.
DIF: Cognitive Level:
Knowledge
REF: Page 21
OBJ: 1
TOP: Care Provider
Rights
KEY: Nursing Process Step: Evaluation
MSC: Client Needs: Safe and Effective Care Environment
6. The
Nurse’s Code of Ethics includes the main concepts of autonomy, beneficence,
justice, and:
|
a. |
Rights |
|
b. |
Morals |
|
c. |
Nonmaleficence |
|
d. |
Prudence |
ANS: C
Nonmaleficence is the fourth main concept of the Nurse’s Code of
Ethics. The concept is that the nurse must do no harm to the client. Rights are
a power or privilege that a person has just claim to, morals are a person’s
belief regarding what is right or wrong, and prudence refers to the ability to
judge between virtuous and vicious actions.
DIF: Cognitive Level:
Knowledge
REF: Page 21
OBJ: 3
TOP: Ethical Principles
KEY: Nursing Process Step: Assessment
MSC: Client Needs: Safe and Effective Care Environment
7. The
client is feeling very anxious and has requested that a p.r.n. antianxiety
medication be ordered. The nurse informs the client that the medication can be
administered only every 4 hours and was given 3 hours ago. The nurse promises
to give the client the medication as soon as it is due, but the nurse goes to
lunch 1 hour later without giving the client the medication. Which ethical
principle did the nurse violate?
|
a. |
Fidelity |
|
b. |
Veracity |
|
c. |
Confidentiality |
|
d. |
Justice |
ANS: A
Fidelity refers to the obligation to keep one’s word. The nurse
violated this principle in this situation, which leads to mistrust from the
client. Veracity is the duty to tell the truth, confidentiality is the duty of
keeping the client’s information private, and justice indicates that all
clients must be treated fairly, equally, and respectfully.
DIF: Cognitive Level:
Application
REF: Page 22
OBJ: 3
TOP: Ethical
Principles
KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment
8. A
male client is seeking help in a mental health clinic for anger management
problems. He voices that he is fearful that his wife may divorce him
because of his anger problem, and he is willing to do “whatever it takes” to
control his anger. Later in the week, the client’s wife also seeks assistance
because she is going to divorce her husband. The nurse who is caring for both
of these clients tries to decide the correct action to take. The nurse is
experiencing:
|
a. |
A moral dilemma |
|
b. |
Value clarification |
|
c. |
An ethical conflict |
|
d. |
A breach of confidentiality |
ANS: C
This is an example of an ethical conflict or ethical dilemma.
The nurse wants to help both clients but must maintain confidentiality for
each. Use of guidelines for ethical decision making can assist the nurse in
making an ethical decision. A moral dilemma is simply a dilemma associated with
making a decision between right and wrong. Value clarification is a process
that helps to identify an individual’s values.
DIF: Cognitive Level:
Application
REF: Page 22 | Page 23
OBJ: 3
TOP: Ethical Conflict
KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment
9. The
psychiatrist asks the nurse to perform a procedure that she is not familiar
with, and the nurse is unsure whether this is something within the scope of
practice. Where can the nurse find the answer to her question?
|
a. |
National nurse practice act |
|
b. |
State nurse practice act |
|
c. |
Regional nurse practice act |
|
d. |
Community nurse practice
act |
ANS: B
Each state’s board of nursing determines the scope of practice
in that state through a series of regulations that are called nurse practice
acts. It is the nurse’s responsibility to know his or her scope of practice.
The other options do not exist.
DIF: Cognitive Level:
Comprehension REF: Page
23 OBJ: 4
TOP: Legal Concepts in Health
Care KEY: Nursing Process Step:
Intervention
MSC: Client Needs: Safe and Effective Care Environment
10. An
order written by a physician is reviewed by the nursing staff, and no one is
familiar with the treatment instructions. A nurse who was recently hired knows
that this treatment is covered by the state’s nurse practice act. What is the
nurse’s best course of action?
|
a. |
Call the physician to ask
for clarification |
|
b. |
Check the state’s nurse
practice act again |
|
c. |
Contact the nursing
supervisor for approval to carry out the treatment |
|
d. |
Refer to the facility’s
policy and procedure to determine the course of action |
ANS: D
Because this treatment is covered under the state nurse practice
act, the next step is to refer to the facility’s policy and procedure manual to
determine whether the ordered treatment is allowed by the facility. Calling the
physician is not necessary because there was no question about how the order
was written, and the state’s nurse practice act has already been checked.
Contacting the nursing supervisor would be acceptable only after the facility’s
policy has been checked.
DIF: Cognitive Level: Application
REF: Page 23 | Page 24
OBJ:
4
TOP: Legal Concepts in Health Care
KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment
11. Standards
of nursing practice for mental health can best be described as helping to
ensure:
|
a. |
That certain clients
receive care |
|
b. |
Quality and effectiveness
of care |
|
c. |
Proper documentation |
|
d. |
Proper medication
administration |
ANS: B
Most health care disciplines have standards of practice documented
as guidelines with measurable criteria that can be used to evaluate the quality
and effectiveness of care provided. All clients have the right to receive care,
so standards of nursing practice would not address who receives care. Although
proper documentation and proper medication administration might be part of the
evaluation process, they do not provide complete evaluation of quality and
effectiveness of care.
DIF: Cognitive Level:
Comprehension REF: Page
24 OBJ: 4
TOP: Legal Concepts in Health
Care KEY: Nursing Process Step:
Evaluation
MSC: Client Needs: Safe and Effective Care Environment
12. If a
client is involuntarily committed to a mental health care facility
indefinitely, the law requires that the case must be reviewed every:
|
a. |
3 months |
|
b. |
6 months |
|
c. |
12 months |
|
d. |
15 months |
ANS: C
Although the case is being reviewed constantly by the mental
health care team, the court must review the indefinite commitment on a yearly
basis.
DIF: Cognitive Level:
Knowledge
REF: Page 25
OBJ: 5
TOP: Adult Psychiatric
Admissions KEY: Nursing
Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment
13. While
dining in a restaurant, the nurse overhears two co-workers in the next booth
discussing a client who is being cared for on the mental health unit in which
they work. What action have the nurse’s co-workers committed for which
they could be held liable?
|
a. |
Libel |
|
b. |
Slander |
|
c. |
Invasion of privacy |
|
d. |
Assault |
ANS: C
Confidentiality is included in a client’s right to privacy, and
a breach in confidentiality is considered a liability issue. Invasion of
privacy can result in a criminal case and/or job termination. Libel
refers to written defamation, and slander is verbal defamation of character.
Assault is an act that threatens another individual.
DIF: Cognitive Level:
Application
REF: Page 25
OBJ: 6
TOP: Areas of Potential
Liability
KEY: Nursing Process Step: Evaluation
MSC: Client Needs: Safe and Effective Care Environment
14. A
male client is being argumentative during a group therapy session. The male
psychiatric technician warns the client that if he does not cooperate with the
nurse, he will physically restrain him and take the client to his room for the
remainder of the day. For which action could the technician be held
liable?
|
a. |
Assault |
|
b. |
Battery |
|
c. |
Privacy |
|
d. |
Fraud |
ANS: A
The technician is engaging in assault, which is any act that
threatens a client. Battery of a client occurs when any physical act of
touching occurs without the client’s permission. Privacy refers to issues
related to the body and confidentiality, and fraud is giving false information.
DIF: Cognitive Level:
Application
REF: Page 25
OBJ: 6
TOP: Areas of Potential
Liability
KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment
15. Which
of the following circumstances when it occurs on an inpatient mental health
unit would be considered false imprisonment?
|
a. |
An alert and oriented
client is confined to his room after repeatedly being loud and argumentative
with another client in the recreation area. |
|
b. |
Restraints are placed on a
client who has been admitted in a lethargic state because of misuse of
medications and who has fallen three times since admission. |
|
c. |
A client is housed in a
private room with visual monitors after attempting suicide at home on the
previous day. |
|
d. |
An alert and oriented
client who was admitted for a 72-hour involuntary commitment is prevented
from leaving the facility 2 days after admission. |
ANS: A
The client cannot be confined to his room if he did not pose a
threat to himself or others, or if no contract was made with the client
regarding consequences for inappropriate behavior. All of the other options are
appropriate because they follow guidelines for client safety.
DIF: Cognitive Level:
Analysis
REF: Page 25
OBJ: 6
TOP: Areas of Potential
Liability
KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment
16. When
using physical restraints for client safety, the nurse must follow the guidelines
of observing, assessing, and monitoring the client every __________ minutes;
the restraint must be removed from one limb at a time, and each limb must be
exercised every __________ hours.
|
a. |
5; 2 |
|
b. |
15; 2 |
|
c. |
5; 4 |
|
d. |
15; 4 |
ANS: B
Appropriate guidelines include monitoring every 15 minutes and
exercising every 2 hours to prevent circulatory, muscle, and nerve impairment.
Either the nurse or a delegate of the nurse must perform these interventions,
and the nurse is responsible for ensuring proper implementation of the
interventions.
DIF: Cognitive Level:
Knowledge
REF: Page 26
OBJ: 6
TOP: Areas of Potential
Liability
KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment
17. The
nurse often assists in the process of obtaining informed consent from the
client for treatment and/or procedures. Who has the responsibility of providing
information to the client so he can give informed consent?
|
a. |
Social worker |
|
b. |
Nurse |
|
c. |
Physician |
|
d. |
Facility’s legal
representative |
ANS: C
The physician is responsible for providing the client with the
information necessary to give informed consent, including expectations and
risks involved. The nurse can assist by obtaining the written documentation
necessary for informed consent.
DIF: Cognitive Level:
Knowledge
REF: Page 26
OBJ: 8
TOP: Care Providers’
Responsibilities KEY: Nursing Process Step:
Intervention
MSC: Client Needs: Safe and Effective Care Environment
18. An
important responsibility of the nurse in a mental health facility is to ensure
that clients do not __________ from the facility without a discharge order, by
carefully supervising and accurately documenting client behaviors and
therapeutic actions.
|
a. |
Escape |
|
b. |
Abandon |
|
c. |
Flee |
|
d. |
Elope |
ANS: D
The appropriate terminology for when a client runs away from a
facility without a discharge order is elopement. In the event of elopement, the
caregiver can be held liable if a client becomes injured.
DIF: Cognitive Level:
Knowledge
REF: Page 26
OBJ: 8
TOP: Care Providers’
Responsibilities KEY: Nursing Process Step:
Intervention
MSC: Client Needs: Safe and Effective Care Environment
19. If a
female client tells the nurse of extensive plans she has to harm the girlfriend
of her ex-husband, what is the nurse’s best action?
|
a. |
Try to talk with the client
to convince her not to harm the girlfriend |
|
b. |
Have the client sign a contract
with you stating that she will not harm the girlfriend |
|
c. |
Inform the ex-husband of
the intentions of the client |
|
d. |
Inform the girlfriend of
the intentions of the client |
ANS: D
Health care providers have a duty to warn others when serious harm
may occur as the result of actions taken by the client. This does not breach
confidentiality because providers have an obligation to protect the public as
well as the client. In addition to warning the client, the nurse should inform
the client’s physician and the nursing supervisor and must document the
situation and actions taken. The other options are not adequate to meet the
duty to warn or to prevent harm to the girlfriend.
DIF: Cognitive Level:
Application
REF: Page 26
OBJ: 8
TOP: Care Providers’
Responsibilities KEY: Nursing Process Step:
Intervention
MSC: Client Needs: Safe and Effective Care Environment
20. A
female client asks the nurse if the medication risperidone (Risperdal), an
antipsychotic medication for schizophrenia, has any side effects. Which
response by the nurse would violate the ethical concept of veracity?
|
a. |
“I am not sure, but I will
find out.” |
|
b. |
“Risperdal has no
documented side effects” |
|
c. |
“Risperdal does have some
side effects.” |
|
d. |
“Let’s talk to your
physician about potential side effects.” |
ANS: B
The ethical concept of veracity refers to the duty of being
truthful with the client, within the scope of one’s practice. Stating that the
drug has no side effects is not a truthful statement because the medication
does have side effects.
DIF: Cognitive Level:
Application
REF: Page 22
OBJ: 2
TOP: Ethical
Principles
KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment
MULTIPLE RESPONSE
1. If a
person is perceived to be a threat to himself or others, who can implement an
involuntary commitment to a mental health facility? Select all that apply.
|
a. |
Family members |
|
b. |
Police |
|
c. |
Physicians |
|
d. |
Social workers |
|
e. |
Representatives of a county
administrator |
ANS: B, C, E
Police, physicians, and representatives of a county
administrator are the only individuals who can implement an involuntary
admission to a mental health facility. An involuntary admission can last from
days to years, depending on the need. A court order is necessary for extended
involuntary admissions.
DIF: Cognitive Level:
Knowledge
REF: Page 24
OBJ: 5
TOP: Adult Psychiatric Admissions
KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment
2. For a
nurse or health care provider to be found negligent, what requirements must the
provider’s misconduct meet? Select all that apply.
|
a. |
The provider owed a duty to
the client. |
|
b. |
The provider breached a
duty to the client. |
|
c. |
The provider had intent to
harm the client. |
|
d. |
The provider caused injury
to the client by action or inaction. |
|
e. |
The provider caused loss or
damage through his or her actions. |
ANS: A, B, D, E
These four criteria must be present for an act of a health care
provider to be considered negligent. Intent to harm would be considered a
criminal action rather than an action of negligence.
DIF: Cognitive Level:
Comprehension REF: Page
26 OBJ: 7
TOP: Areas of Potential
Liability
KEY: Nursing Process Step: Evaluation
MSC: Client Needs: Safe and Effective Care Environment
COMPLETION
1. What
term describes an individual’s attitudes, beliefs, and values and helps a
person distinguish between what is considered right and wrong behavior?
ANS:
Morals
Morals are developed through learned behavior, teachings of
others, and experience.
DIF: Cognitive Level: Knowledge
REF: Page 19
OBJ: 1
TOP: Values and
Morals
KEY: Nursing Process Step: Assessment
MSC: Client Needs: Safe and Effective Care Environment
2. The
nurse documents on the medication administration record that a medication has
been given as ordered on a daily basis, but the medication actually has been
out of stock for a week. This nurse is guilty of __________.
ANS:
Fraud
This nurse is committing fraud by giving false information. Not
only is this illegal, but it could bring harm to the client in several ways.
DIF: Cognitive Level:
Comprehension REF: Page
25 OBJ: 6
TOP: Areas of Potential
Liability
KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment
3. __________
is either omitting or committing a duty that a reasonable and prudent person
would or would not do that brings harm to an individual.
ANS:
Negligence
Negligence on the part of a professional is called malpractice.
DIF: Cognitive Level:
Knowledge
REF: Page 26
OBJ: 7
TOP: Areas of Potential
Liability
KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment
Morrison-Valfre: Foundations of Mental Health Care, 4th Edition
Test Bank
Chapter 4: Sociocultural Issues
MULTIPLE CHOICE
1. An
older Asian female with a diagnosis of depression is cared for by her
granddaughter. Her granddaughter is very attentive to the client’s needs, attends
every therapy session, and is active in the planning and implementing of the
treatment plan. The granddaughter’s valuing of her grandmother is most
likely due to her:
|
a. |
Ethnicity |
|
b. |
Cultural beliefs |
|
c. |
Religion |
|
d. |
Stereotype |
ANS: B
Cultural beliefs develop over many generations and are a learned
set of values, beliefs, and behaviors. Asian cultures commonly value their
elderly family members. Ethnicity and religion do not explain the
granddaughter’s behavior in that ethnicity describes customs and socialization
patterns, and religion refers to an organized form of worship.
Stereotyping is a pre-conceived belief about another cultural group, so it does
not apply to this situation.
DIF: Cognitive Level:
Application
REF: Page 29
OBJ: 1
TOP: Characteristics of
Culture
KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity
2. A
traditional Arab female client is brought to the emergency room by her
husband. She complains of feeling very anxious and short of breath and
has chest pain. What would likely be a hindrance to the care of this client?
|
a. |
The emergency room
physician is female. |
|
b. |
Her husband asks if he can
stay with his wife. |
|
c. |
One of the emergency room nurses
is of Arab descent. |
|
d. |
The only caregivers
available in the emergency room are male. |
ANS: D
In some traditional Arab cultures, a woman will not make eye
contact with any man except her husband and may not be touched by another man. Having
only male staff in the emergency room on this shift would block necessary care.
Arrangements would have to be made to have a female staff member come to the
emergency room to assist in client care. The other options should not cause a
problem.
DIF: Cognitive Level:
Application
REF: Page 30
OBJ: 3
TOP: Characteristics of
Culture
KEY: Nursing Process Step: Intervention
MSC: Client Needs: Psychosocial Integrity
3. On
what is Western medicine primarily based?
|
a. |
Empirical knowledge |
|
b. |
Religious customs |
|
c. |
Scientific research |
|
d. |
Folk treatments |
ANS: C
Western medicine typically disregards what cannot be explained
by scientific research. Empirical knowledge serves as the basis for folk medicine
and refers to knowledge that comes from observation. It encompasses cause and
effect without knowledge of why something happens. Religious customs do not
form the basis of Western medicine.
DIF: Cognitive Level:
Knowledge
REF: Page 29
OBJ: 4
TOP: Health and Illness
Beliefs
KEY: Nursing Process Step: Evaluation
MSC: Client Needs: Psychosocial Integrity
4. The
nurse is performing an admission assessment on a Greek couple seeking care from
a family counseling center. Although the couple is talking, the wife states
that she wants to work as a teaching assistant at their daughter’s school, but
her husband adamantly objects to the idea. If the wife were to work outside the
home, she most likely would be seen in their culture as:
|
a. |
Eccentric |
|
b. |
Strong-willed |
|
c. |
Self-sufficient |
|
d. |
Dependent |
ANS: A
Traditional Greek cultural beliefs see the husband as the head
of the household, and it is a dishonor if the wife works outside the home. The
behavior is deemed eccentric or deviant. Strong-willed, self-sufficient, and
dependent would not be adjectives that would describe feelings about the wife
in this cultural situation.
DIF: Cognitive Level:
Comprehension REF: Page
30 OBJ: 3
TOP: Characteristics of
Culture
KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity
5. Disease
is defined as:
|
a. |
Social dysfunction |
|
b. |
Emotional dysfunction |
|
c. |
Physical dysfunction |
|
d. |
Intellectual dysfunction |
ANS: C
Disease differs from illness in that disease is an abnormal
physical function, whereas illness refers to social, emotional, and
intellectual dysfunction. Illness is affected by culture, but disease is not.
DIF: Cognitive Level:
Knowledge
REF: Page 30
OBJ: 4
TOP: Health and Illness
Beliefs
KEY: Nursing Process Step: Evaluation
MSC: Client Needs: Physiological Integrity
6. The
nurse is caring for a 20-year-old woman from Puerto Rico. The client speaks
English, but she is accompanied by her mother, who does not. The client has a
history of mental illness, and through the interpreter, the nurse learns that
the mother, who has traditional Puerto Rican cultural beliefs, believes that
the client’s mental illness is caused by:
|
a. |
Witchcraft |
|
b. |
Stress |
|
c. |
Chemical imbalances |
|
d. |
A trance |
ANS: A
It is a common traditional Puerto Rican cultural belief that
mental illness is caused by witchcraft, magic, or evil spells, as opposed to
more traditional Western medicine, which believes that stress and chemical
imbalances play a role in mental illness. A trance is considered a state of
consciousness in some cultures.
DIF: Cognitive Level:
Comprehension REF: Page
31 OBJ: 4
TOP: Health and Illness
Beliefs
KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity
7. A
mental health care provider who is aware of her cultural views and attitudes
toward other cultures and who strives to understand, communicate, and
effectively work with clients of other cultures is considered to be:
|
a. |
Prejudiced |
|
b. |
Culturally competent |
|
c. |
Stereotypical |
|
d. |
Proficient |
ANS: B
Culturally competent providers of mental health care are more
likely to be effective in the treatment of individuals with disorders.
Stereotyping and prejudice will block therapeutic interventions. Proficient
simply means knowledgeable.
DIF: Cognitive Level:
Comprehension REF: Page
32 OBJ: 5
TOP: Cultural Assessment
KEY: Nursing Process Step: Intervention
MSC: Client Needs: Psychosocial Integrity
8. When
a cultural assessment of communication is performed, which of the following is
considered nonverbal communication?
|
a. |
Silence |
|
b. |
Volume of speech |
|
c. |
Pronunciation |
|
d. |
Music |
ANS: A
Silence is considered nonverbal communication that is important
in determination of cultural practices and meaning, as are forms of verbal
communication such as volume of speech, pronunciation, and music.
DIF: Cognitive Level:
Comprehension REF: Page
32 OBJ: 5
TOP: Communication in Cultural Assessment
KEY: Nursing Process Step: Assessment MSC:
Client Needs: Psychosocial Integrity
9. A
client is continually late for his appointment at the mental health clinic.
What is a likely reason for his lack of punctuality?
|
a. |
Need for environmental
control |
|
b. |
Time orientation |
|
c. |
Space comfort zone |
|
d. |
Territorial needs |
ANS: B
Mental dysfunction can lead to incorrect perception of time,
causing the client to be continually late. In addition, some cultures do not
see schedules and specific appointment times as important, causing the client
to be continually late in the eyes of the caregiver. Environmental control
refers to an individual’s need to control his or her perception of the
environment. Comfort zones are highly culture based, meaning that individual
interpretation of personal space varies among cultures. Territorial needs
provide a sense of identity and security for some clients.
DIF: Cognitive Level:
Comprehension REF: Page
34 OBJ: 5
TOP: Space, Territory, and Time in Cultural
Assessment
KEY: Nursing Process Step: Evaluation
MSC: Client Needs: Psychosocial Integrity
10. Which
client communication problem can the nurse most easily correct?
|
a. |
Age differences |
|
b. |
Altered cognition |
|
c. |
Cultural differences |
|
d. |
Gender differences |
ANS: C
The nurse can easily correct communication problems caused by
cultural differences in a number of ways, including learning what cultural
beliefs and practices are important to the client and being accepting of those
beliefs. Communication problems due to age and gender differences and altered
cognition cannot be corrected by the nurse.
DIF: Cognitive Level:
Comprehension REF: Page
32 OBJ: 5
TOP: Communication in Cultural Assessment
KEY: Nursing Process Step: Intervention MSC: Client
Needs: Psychosocial Integrity
11. What
is the social orientation among most middle-class American families?
|
a. |
Extended |
|
b. |
Friends |
|
c. |
Significant others |
|
d. |
Nuclear |
ANS: D
The nuclear family is the social orientation of family that is
seen most frequently in this group. The extended family is seen as the social
orientation for cultures such as some Alaskan, traditional Chinese, and Mexican
cultures. Friends and significant others are not identified as a social
orientation of family.
DIF: Cognitive Level:
Knowledge
REF: Page 34
OBJ: 5
TOP: Social Organization in Cultural Assessment
KEY: Nursing Process Step: Assessment MSC:
Client Needs: Psychosocial Integrity
12. The
nurse is performing an admission assessment on a female client. She is a white
middle-class American who has recently married a male of Greek descent with
strong traditional Greek cultural beliefs. She is displaying signs and symptoms
of an eating disorder, most likely attributable to:
|
a. |
Genetics |
|
b. |
Gender role conflict |
|
c. |
Learned behavior |
|
d. |
Modeling of behavior |
ANS: B
White middle-class American women usually have cultural beliefs
that women can be outspoken and assertive, which totally conflicts with the
beliefs of traditional Greek culture. Eating disorders, as well as phobias and
depression, are commonly seen in clients who experience gender role conflict.
Genetics, learned behavior, and modeling behavior are not indicated as
causative factors in this scenario.
DIF: Cognitive Level:
Application
REF: Page 31
OBJ: 4
TOP: Health and Illness
Beliefs
KEY: Nursing Process Step: Evaluation
MSC: Client Needs: Psychosocial Integrity
13. It is
important for the nurse to be familiar with the religious practices of clients
cared for most often in a particular region because attitudes toward health and
illness, death and burial, food, and procreation have a strong impact on a
client’s beliefs and practices. The nurse knows that the religion practiced
most often around the world is:
|
a. |
Buddhism |
|
b. |
Jehovah’s Witness |
|
c. |
Christianity |
|
d. |
Ahmadiyya |
ANS: C
More than 2 billion individuals throughout the world are
practicing Christians. Although these religions are seen in large numbers
worldwide, it is important for the nurse to be familiar with the religions most
frequently seen in the client populations with whom he works within his own
area.
DIF: Cognitive Level:
Knowledge
REF: Page 35
OBJ: 6
TOP: Social Organization in Cultural Assessment
KEY: Nursing Process Step: Evaluation
MSC: Client Needs: Psychosocial Integrity
14. The
metabolism of psychotropic medications is most likely to be affected by:
|
a. |
Ethnicity |
|
b. |
Religion |
|
c. |
Culture |
|
d. |
Values |
ANS: A
A person’s genetics plays a role in how medications are
metabolized through metabolic activity and enzyme functions; therefore, it is
important for the clinician to monitor clients for effectiveness, side effects,
and adverse reactions. Ethnicity is a determining factor in a person’s genetic
makeup. Religious and cultural practices could play a role in the metabolism of
medications as a result of food or alternative treatment interactions with
medications, but the metabolism is more closely related to the genetic
makeup. Values have little to do with the metabolism of medications.
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