Cultural Diversity in Health and Illness Questions and Answers (Newly Updated)

Cultural Diversity in Health and Illness Questions and Answers Cultural Diversity in Health and Illness Questions and Answers Chapter 1 1) Which action would a hospital administrator take to meet the cultural and linguistic needs of Spanish-speaking community members? 1. Hire professional staff from different Spanish-speaking countries. 2. Ensure that all health care workers speak Spanish. 3. Ensure that all signage is posted in Spanish as well as English. 4. Ensure health services are in varying locations. Answer: 1 Explanation: 1. Hiring professional staff from different Spanish-speaking countries would create a foundation for the variations in the language and culture of the different countries, and aid in providing cultural and linguistic competence to meet the health needs of this population. 2. Ensuring all health care workers speak Spanish would benefit this population, but does not necessarily guarantee that cultural and linguistic competence would result. 3. Spanish signage would aid with patient understanding, but this action also assumes that all of the patient population is literate. 4. Ensuring health services are in varying locations meets the needs of many populations, but is not necessarily a component of linguistic and cultural competence. Cognitive Level: Applying Patient Need: Psychosocial Integrity Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: LO02 - Describe the National Standards for Culturally and Linguistically Appropriate Services in Health Care.2) On which criterion would the Human Resources manager focus when identifying interpreters to support the care of patients with limited English proficiency? 1. Proficient in health language terminology 2. Availability of family members 3. Be of the same ethnic background of the patients 4. Be on 24-hour call Answer: 1 Explanation: 1. Interpreters providing language assistance must be proficient in health language terminology in order to provide accurate information to a patient in their own language. 2. Family members are not to be used for language assistance or interpretation unless absolutely necessary, or on request by the patient, as they may not be able to provide objective impartial information. 3. While it is helpful to have the same ethnic background of the patients for whom language assistance is provided, it is not necessary. 4. An interpreter may not be able to be on 24-hour call, but back-up mechanisms should be in place to provide language assistance when a designated interpreter is not available. Cognitive Level: Applying Patient Need: Safe and Effective Care Environment Patient Need Sub: Management of Care Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: LO02 - Describe the National Standards for Culturally and Linguistically Appropriate Services in Health Care. 3) A health care organization is incorporating culturally and linguistically appropriate services into the strategic plan. In which areas of the plan will these services be reflected? Select all that apply: 1. Goals 2. Policies 3. Operational plans 4. Management accountability 5. Internal audits Answer: 1, 2, 3, 4 Explanation: 1. To support cultural and linguistically appropriate services, a health care organization needs to outline clear goals in the strategic plan. 2. To support cultural and linguistically appropriate services, a health care organization needs to outline policies within the strategic plan. 3. A health care organization needs to outline operational plans to support cultural and linguistically appropriate services within the strategic plan. 4. A health care organization needs to identify management accountability for cultural and linguistically appropriate services within the strategic plan. 5. Internal audits are used to evaluate culturally and linguistically appropriate services within a health care organization. Cognitive Level: Applying Patient Need: Health Promotion and Maintenance Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: LO02 - Describe the National Standards for Culturally and Linguistically Appropriate Services in Health Care.4) Why does a health care organization maintain a current demographic, cultural, and epidemiological profile of the patients receiving care in the hospital? 1. Ensure grievances are resolved. 2. Plan and implement culturally and linguistically appropriate services. 3. Plan for culturally appropriate continuing education for the staff. 4. Develop partnerships with community members. Answer: 2 Explanation: 1. Maintaining a current demographic, cultural, and epidemiological profile of the patients receiving care in the hospital does not ensure that grievances are resolved. The health care organization must ensure that the grievance process is culturally and linguistically sensitive and capable of resolving cross-cultural conflicts. 2. Healthcare organizations should maintain a current demographic, cultural, and epidemiological profile of the community to accurately plan for and implement services that respond to the cultural and linguistic characteristics of the service area. 3. Maintaining a current demographic, cultural, and epidemiological profile of the patients receiving care in the hospital is not done to plan for culturally appropriate continuing education for staff. Planning for ongoing education and training in culturally and linguistically appropriate services would be based on the patient demographic, but not on the epidemiological profile of the community. 4. Maintaining a current demographic, cultural, and epidemiological profile of the patients receiving care in the hospital is not done to develop partnerships with community members. Partnerships with communities are used to facilitate community and patient involvement when designing and implementing culturally and linguistically appropriate service-related activities. Cognitive Level: Analyzing Patient Need: Health Promotion and Maintenance Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: LO02 - Describe the National Standards for Culturally and Linguistically Appropriate Services in Health Care. 5) Which behavior of a health care provider exemplifies culturally competent care? 1. Delivering care that demonstrates understanding and application to the patient's situation 2. Speaking the patient's language 3. Understanding some health traditions of the patient 4. Knowledgeable of the patient's cultural background Answer: 1 Explanation: 1. When delivering culturally competent care, the provider demonstrates understanding and attends to the total context of the patient's situation. 2. Speaking the patient's language is being language-proficient. However, this does not ensure culturally competent care. Interpreters can be used to ensure linguistic competence. 3. Understanding some traditions of the patient is being culturally sensitive.4. Being knowledgeable of the patient's cultural background is one aspect of being culturally appropriate. Cognitive Level: Applying Patient Need: Safe and Effective Care Environment Patient Need Sub: Management of Care Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: LO04 - Articulate the attributes of CULTURALCOMPETENCY and CULTURALCARE. 6) When a healthcare provider takes the time to learn the underlying background of a patient to provide the best possible healthcare, which type of cultural care is being provided? 1. Competent 2. Sensitive 3. Designated 4. Appropriate Answer: 4 Explanation: 1. Culturally competent care implies that within the delivered care, the provider understands and attends to the total context of the patient's situation. 2. Culturally sensitive care implies the provider possesses some basic knowledge of, and constructive attitudes toward, health traditions observed among the different cultural groups in the practice setting. 3. Culturally designated care is not a correct cultural term. 4. Culturally appropriate care implies the provider applies the underlying background knowledge that he or she must possess in order to give a patient the best possible care Cognitive Level: Analyzing Patient Need: Health Promotion and Maintenance Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: LO04 - Articulate the attributes of CULTURALCOMPETENCY and CULTURALCARE. 7) The health care organization has made a conscious effort to provide linguistically appropriate services to its predominantly Hispanic population, incorporating within its staff members from different Spanish-speaking countries of Latin America. Which cultural care concept is this organization implementing? 1. Language proficiency 2. Cultural competence 3. Cultural sensitivity 4. Cultural appropriateness Answer: 1 Explanation: 1. Language proficiency is the provision of linguistically appropriate services and implementation of competent interpreter services when the patient or family does not understand, speak, or read English.2. Cultural competence means the provider understands and attends to the total context of the patient's situation when delivering care. 3. Cultural sensitivity implies the provider possesses some basic knowledge of, and constructive attitudes toward, the health traditions observed among diverse cultural groups. 4. Cultural appropriateness implies the provider applies the underlying background knowledge ofthe patient to provide the best possible care. Cognitive Level: Applying Patient Need: Safe and Effective Care Environment Patient Need Sub: Management of Care Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: LO04 - Articulate the attributes of CULTURALCOMPETENCY and CULTURALCARE. 8) The staff development instructor is planning a seminar that focuses on the variables leading to generational conflict. What will the instructor include in this content? Select all that apply: 1. Decade of birth 2. Generation in the United States 3. Class 4. Language Answer: 1, 2, 3, 4 Explanation: 1. People's life experiences vary and depend upon the events of the decades in which they were born, and the cultural values and norms of those times. 2. Worldviews differ between the immigrant generation and subsequent generations who have resided in the United States for many years. 3. Social class includes education, economics, and background. There are differences among people predicated on class. 4. There are conflicts between those with limited English-speaking skills and those who do not understand English, and those who provide care from English speakers. Cognitive Level: Applying Patient Need: Psychosocial Integrity Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: LO01 - Discuss the critical need for cultural and linguistic competence. 9) The nurse practitioner is ensuring an adequate amount of educational materials are printed in languages that reflect the patient population. What are the reasons for this healthcare provider treating a more diverse patient population? Select all that apply: 1. Demographic changes 2. Participation in insurance programs 3. Reflects the nurse practitioner's cultural background 4. The nurse practitioner is from a minority group. 5. The educational materials will teach the patient how to be healthy or ill.Answer: 1, 2 Explanation: 1. The mainstream healthcare provider is treating a more diverse patient population as a result of demographic changes. 2. The mainstream healthcare provider is treating a more diverse patient population as a result of participation in insurance programs. 3. One's personal cultural background impacts how patients access and respond to care services. 4. One's personal cultural background impacts how patients access and respond to care services.5. Health and illness can be interpreted in terms of personal experience and expectations. We learn from our own culture how to be healthy or ill. Cognitive Level: Analyzing Patient Need: Health Promotion and Maintenance Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: LO01 - Discuss the critical need for cultural and linguistic competence. 10) The nurse is planning care for a group of patients from different cultural backgrounds. What aspects of the nurse will impact how the patients access and respond to healthcare services? Select all that apply: 1. Cultural background 2. Heritage 3. Language 4. Role 5. Age Answer: 1, 2, 3 Explanation: 1. One's personal cultural background has a considerable impact on how he or she will access and respond to healthcare services. 2. One's heritage has a considerable impact on how he or she will access and respond to healthcare services. 3. One's language has a considerable impact on how he or she will access and respond to healthcare services. 4. One's role does not impact how he or she will access and respond to healthcare services. 5. One's age does not impact how he or she will access and respond to healthcare services. Cognitive Level: Analyzing Patient Need: Psychosocial Integrity Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: LO01 - Discuss the critical need for cultural and linguistic competence. 11) The nurse is reviewing the steps needed to develop cultural competency. In which order will the nurse complete the steps of this process? 1. Personal heritage 2. Heritage of others3. Health and health beliefs and practices 4. Health care culture and system 5. Traditional health care systems Answer: 1, 2, 3, 4, 5 Explanation: The first step to cultural competency is personal heritage. The nurse will analyze answers to the following questions: “Who are you?”, “What is your heritage?”, and “What are your health beliefs?” The second step to cultural competency is the heritage of others. Here, the nurse will determine who the family is, and community is, to the patient. The third step to cultural competency is health and health beliefs and practices. The nurse will analyze competing philosophies in this step. The fourth step to cultural competency is healthcare culture and system. In this step, the nurse analyzes all of the issues and problems within the healthcare culture and system. The fifth step to cultural competency is traditional healthcare systems. At this step, the nurse analyzes the way that health was for most, and the way health still is for many. Cognitive Level: Applying Patient Need: Psychosocial Integrity Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: LO01 - Discuss the critical need for cultural and linguistic competence. 12) The nurse is planning the care for a patient from a non-English-speaking culture. Which terms would the nurse use that reflect cultural care? Select all that apply: 1. Literacy 2. Refugee 3. Silence 4. Sacred times 5. Surgery Answer: 1, 2, 3, 4 Explanation: 1. Literacy is a term that would reflect cultural care. 2. Refugee is a term that would reflect cultural care. 3. Silence is a term that would reflect cultural care. 4. Sacred times is a phrase that would reflect cultural care. 5. Surgery is not a phrase that would reflect cultural care. Cognitive Level: Applying Patient Need: Psychosocial Integrity Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: LO01 - Discuss the critical need for cultural and linguistic competence. 13) A health care organization provides care to patients that are of Hispanic, Asian, and Eastern European heritage. What will the organization do to ensure the staff represents the demographics of the service area? Select all that apply: 1. Hire nurses that speak Spanish.2. Promote a staff member from Asian and Hispanic backgrounds. 3. Provide language assistance services. 4. Post signage in the languages of the different groups. 5. Incorporate internal audits for culturally appropriate services. Answer: 1, 2 Explanation: 1. Healthcare organizations should implement strategies to recruit a diverse staff that are representatives of the demographic characteristic of the service area. 2. Healthcare organizations should implement strategies to promote a diverse staff that are representatives of the demographic characteristic of the service area. 3. Providing language assistance services does not ensure that staff represents the demographic characteristics of the service area. This action ensures that communication can be made with the patients from the different cultural groups. 4. Posting signage in the languages of the different groups does not ensure the staff represents demographic characteristics of the service area. This action ensures communication can be done with patients from different cultural groups. 5. Incorporating internal audits for culturally appropriate services does not ensure the staff represents demographic characteristics of the service area. This action is a step when structuring culturally competent care. Cognitive Level: Applying Patient Need: Psychosocial Integrity Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: LO02 - Describe the National Standards for Culturally and Linguistically Appropriate Services in Health Care. 14) The staff nurse is identifying ways to communicate care needs for a patient from a nonEnglish-speaking culture. How will the nurse use the tool within the Joint Commission monograph roadmap for hospitals to help with this need? Select all that apply: 1. Access a checklist to use during the admission process. 2. Follow the steps in the assessment checklist. 3. Review the points during the phases of treatment. 4. Identify all of the steps needed for discharge. 5. Recognize ways to adapt to the patient's culture. Answer: 1, 2, 3, 4 Explanation: 1. The Joint Commission monograph is a roadmap for hospitals that provides checklists to improve effective communication during the admission process. 2. The Joint Commission monograph is a roadmap for hospitals that provides checklists to improve effective communication during the assessment process. 3. The Joint Commission monograph is a roadmap for hospitals that provides checklists to improve effective communication during the treatment process. 4. The Joint Commission monograph is a roadmap for hospitals that provides checklists to improve effective communication during the discharge process. 5. The Joint Commission identifies adapting to diversity as a way to demonstrate cultural competency, but not as a specific checklist to improve communication with individuals from different cultures. Cognitive Level: Applying Patient Need: Physiological Integrity Patient Need Sub: Basic Care and Comfort Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: LO03 - Describe institutional mandates regarding cultural and linguistic competence. 15) The Department of Nursing with a healthcare organization is planning steps that reflect the Joint Commission's recommendations for cultural competence. What will the nursing department include in these steps? Select all that apply: 1. Value diversity. 2. Assess themselves. 3. Manage differences. 4. Acquire cultural knowledge. 5. Hire staff from different cultures. Answer: 1, 2, 3, 4 Explanation: 1. Valuing diversity is a recommendation from the Joint Commission to gain cultural competence. 2. Assessing themselves is a recommendation from the Joint Commission to gain cultural competence. 3. Managing difference is a recommendation from the Joint Commission to gain cultural competence. 4. Acquiring cultural knowledge is a recommendation from the Joint Commission to gain culturalcompetence. 5. Hiring staff from different cultures is not a recommendation from the Joint Commission to gain cultural competence. This is a recommendation to achieve culturally and linguistically appropriate services in health care. Cognitive Level: Applying Patient Need: Psychosocial Integrity Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: LO03 - Describe institutional mandates regarding cultural and linguistic competence. 16) The Shared Governance committee is planning strategies for cultural competency when providing patient care. Which facets will the committee include when planning these strategies? Select all that apply: 1. Health disparities 2. Spatial factors 3. Manners4. Dietary practices 5. Insurance Answer: 1, 2, 3, 4 Explanation: 1. Health disparities are a facet of the philosophy of cultural competency. 2. Spatial factors are a facet of the philosophy of cultural competency. 3. Manners are a facet of the philosophy of cultural competency. 4. Dietary practices are a facet of the philosophy of cultural competency. 5. Insurance is not a facet of the philosophy of cultural competency. Cognitive Level: Applying Patient Need: Psychosocial Integrity Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: LO04 - Articulate the attributes of CULTURALCOMPETENCY and CULTURALCARE. 17) A healthcare organization provides care to individuals of whom 75% are from nonEnglishspeaking cultures. When determining the languages to represent within the organization, on which will the organization focus? Select all that apply: 1. Spanish 2. Chinese3. French 4. German 5. Arabic Answer: 1, 2, 3, 4, 5 Explanation: 1. The most common non-English languages spoken by people over age 5 at home include Spanish. 2. The most common non-English languages spoken by people over age 5 at home include Chinese. 3. The most common non-English languages spoken by people over age 5 at home include French. 4. The most common non-English languages spoken by people over age 5 at home include German. 5. Arabic is not one of the most common non-English languages spoken by people over age at 5 at home, but the numbers are rising. Cognitive Level: Analyzing Patient Need: Psychosocial Integrity Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: LO04 - Articulate the attributes of CULTURALCOMPETENCY and CULTURALCARE. 18) During an assessment, the nurse asks the patient to describe her current health status. How will the patient most likely explain her health? 1. Personal experience 2. Impact on family3. Cost 4. DiagnosisAnswer: 1 Explanation: 1. Health and illness can be interpreted and explained in terms of personal experience and expectations. 2. Health and illness can be interpreted and explained in terms of personal experience and expectations. A patient's current health status is not likely to be explained according to the impact on the family. 3. Health and illness can be interpreted and explained in terms of personal experience and expectations. A patient's current health status is not likely to be explained according to cost. 4. Health and illness can be interpreted and explained in terms of personal experience and expectations. A patient's current health status is not likely to be explained according to diagnosis. Cognitive Level: Analyzing Patient Need: Health Promotion and Maintenance Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: LO01 - Discuss the underpinnings of the need for cultural and linguistic competence. 19) The nurse desires to become more culturally competent when providing care to patients from non-English- speaking cultures. Which action would the nurse take to achieve this selfexpectation? 1. Commit to a time-consuming journey. 2. Find a seminar on cultural competence. 3. Talk to people from different cultures. 4. Attend several festivals from different cultures. Answer: 4 Explanation: 1. The reality of becoming culturally competent is a time-consuming process. 2. The development of cultural competency does not occur within a short encounter with a program on cultural diversity. 3. Developing cultural competency involves more than talking to people from different cultures. 4. Developing cultural competency involves initially attending festivals and meeting people fromthe given communities who are from a different culture. Cognitive Level: Applying Patient Need: Psychosocial Integrity Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: LO01 - Discuss the underpinnings of the need for cultural and linguistic competence. 20) The staff development educator is analyzing ways to incorporate cultural competency concepts in continuing education programs. How will the educator explain the concept of CULTURALCOMPETENCY to staff? 1. Philosophy2. Condition 3. Theory 4. Fad Answer: 1 Explanation: 1. CULTURALCOMPETENCY is a philosophy whereby one develops the skills to understand from where a person from a cultural background other than his or her own is coming. 2. CULTURALCOMPETENCY is not a condition. It is a philosophy whereby one develops the skills to understand where a person from where a different cultural background other than his or her own is coming. 3. CULTURALCOMPETENCY is not a theory. It is a philosophy whereby one develops the skills to understand where a person from where a different cultural background other than his or her own is coming. 4. CULTURALCOMPETENCY is not a fad. It is a philosophy whereby one develops the skills to understand where a person from where a different cultural background other than his or her own is coming. Cognitive Level: Applying Patient Need: Psychosocial Integrity Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: LO01 - Discuss the underpinnings of the need for cultural and linguistic competence. 21) A healthcare organization is planning continuing education for all staff on culturally and linguistically appropriate service delivery. Which category of culturally and linguistically appropriate services in healthcare will this action support? 1. Fundamentals of culturally competent care 2. Speaking of culturally competent care 3. Structuring culturally competent care 4. Manage the dynamics of difference Answer: 1, 2, 3 Explanation: 1. Ensuring that staff receives ongoing education and training in culturally and linguistically appropriate service delivery is a part of the fundamentals of culturally competent care. 2. Ensuring that staff receives ongoing education and training in culturally and linguistically appropriate service delivery is a part of the fundamentals of culturally competent care. Speaking of culturally competent care focuses on language services and printed materials. 3. Ensuring that staff receives ongoing education and training in culturally and linguistically appropriate service delivery is a part of the fundamentals of culturally competent care. Structuring culturally competent care focuses on organizational assessments, community profiles, and conflict and grievance resolution processes. 4. Managing the dynamics of difference is a recommendation by the Joint Commission for cultural competency. Cognitive Level: AnalyzingPatient Need: Psychosocial Integrity Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: LO02 - Describe the National Standards for Culturally and Linguistically Appropriate Services in Health Care. 22) Why would a healthcare organization maintain a current demographic, cultural, and epidemiological profile of the community? 1. Plan for services. 2. Correlate with health records. 3. Facilitate community involvement. 4. Advertise services. Answer: 1 Explanation: 1. Healthcare organizations would maintain a current demographic, cultural, and epidemiological profile of the community to accurately plan for services that respond to the cultural and linguistic characteristics of the service area. 2. Healthcare organizations would maintain a current demographic, cultural, and epidemiologicalprofile of the community to accurately plan for services that respond to the cultural and linguistic characteristics of the service area. Health records should include patients' race, ethnicity, and language for integration into the organization's management information system. 3. Healthcare organizations would maintain a current demographic, cultural, and epidemiologicalprofile of the community to accurately plan for services that respond to the cultural and linguistic characteristics of the service area. Partnerships facilitate community involvement. 4. Healthcare organizations would maintain a current demographic, cultural, and epidemiologicalprofile of the community to accurately plan for services that respond to the cultural and linguistic characteristics of the service area. Public notices would be used to share information about progress and innovations when implementing culturally and linguistically appropriate services in healthcare. Cognitive Level: Analyzing Patient Need: Psychosocial Integrity Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: LO02 - Describe the National Standards for Culturally and Linguistically Appropriate Services in Health Care. 23) The nurse is unable to locate an interpreter to support a patient from a non-Englishspeaking background. The patient asks a family member to interpret for the staff. What would the nurse do to ensure culturally and linguistically appropriate services for this patient? 1. Use the family member as an interpreter until a non-family member can be located. 2. Write the questions down for the patient to answer. 3. Do nothing until an interpreter can be located.4. Use sign language. Answer: 1 Explanation: 1. Family and friends should not be used to provide interpretation services except on request by the patient or consumer. 2. The patient is from a non-English-speaking culture and most likely would not understand the written questions. 3. The patient's health status could be in jeopardy if nothing is done until an interpreter is located. 4. Using sign language is not an appropriate method to communicate with the patient. Hand gestures mean different things to different people. Cognitive Level: Applying Patient Need: Psychosocial Integrity Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: LO02 - Describe the National Standards for Culturally and Linguistically Appropriate Services in Health Care. 24) A patient from a non-English-speaking background comes into the health clinic seeking care. The nurse is unable to determine the patient's primary language. What should the nurse do? 1. Ask for help to determine the patient's primary language. 2. Encourage the patient to seek care elsewhere. 3. Notify Security. 4. Contact a homeless shelter. Answer: 1 Explanation: 1. To avoid discrimination based on national origin, Title VI of the Civil Rights Act of 1964 requires that reasonable steps be taken to provide meaningful access to people with limited English proficiency. 2. To avoid discrimination based on national origin, Title VI of the Civil Rights Act of 1964 requires that reasonable steps be taken to provide meaningful access to people with limited English proficiency. Therefore, services cannot be denied. 3. To avoid discrimination based on national origin, Title VI of the Civil Rights Act of 1964 requires that reasonable steps be taken to provide meaningful access to people with limited English proficiency. Therefore, services cannot be denied. There is no reason to notify Security. 4. To avoid discrimination based on national origin, Title VI of the Civil Rights Act of 1964 requires that reasonable steps be taken to provide meaningful access to people with limited English proficiency. Therefore, services cannot be denied. There is no reason to contact a homeless shelter. Cognitive Level: Applying Patient Need: Psychosocial Integrity Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: LO03 - Describe institutional mandates regarding cultural and linguistic competence.25) In a non-English-speaking patient's medical records, it is indicated that he has no family. However, several people arrived in the critical care unit and stated that they are the patient's family. What impact does this miscommunication have on the patient's care? 1. Poor decision-making 2. Increase the cost 3. Improve the outcomes 4. Enhance therapeutic communication Answer: 3 Explanation: 1. Language barriers can cause poor, abbreviated, or erroneous communication and poor decision making on the part of both the provider and patient. 2. Language barriers can cause poor, abbreviated, or erroneous communication and poor decisionmaking on the part of the provider and patient. It has not been documented that language barriers increase the cost for health care. 3. Language barriers can cause poor, abbreviated, or erroneous communication and poor decisionmaking on the part of the provider and patient. Language barriers will improve the patient's outcomes once overcome. 4. Language barriers can cause poor, abbreviated, or erroneous communication and poor decisionmaking on the part of the provider and patient. Language barriers do not enhance therapeutic communication. Cognitive Level: Analyzing Patient Need: Psychosocial Integrity Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: LO03 - Describe institutional mandates regarding cultural and linguistic competence. 26) The nurse working in a Joint Commission—accredited organization is admitting a patient from a non-English-speaking background. Which action supports the Joint Commission principle of effective communication? 1. Assess communication needs 2. Value diversity 3. Manage the dynamics of difference 4. Adapt to diversity Answer: 1 Explanation: 1. Assessing communication needs is a Joint Commission principle to support cultural competency in health care. 2. Valuing diversity is an organizational action to ensure cultural competence. 3. Managing the dynamics of difference is an organizational action to ensure cultural competence. 4. Adapting to diversity is an organizational action to ensure cultural competence. Cognitive Level: Applying Patient Need: Psychosocial IntegrityNursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: LO03 - Describe institutional mandates regarding cultural and linguistic competence. 27) The nurse is completing a survey that includes questions about different aspects of cultural competence. What is the purpose of this survey? 1. Assessment of cultural competence 2. Manage the dynamics of difference 3. Value diversity 4. Institutionalize cultural knowledge Answer: 1 Explanation: 1. The Joint Commission recognizes that cultural competence requires organizations and personnel to assess themselves with regards to cultural competence. 2. The Joint Commission recognizes that cultural competence requires organizations and personnel to assess themselves with regards to cultural competence. Managing the dynamics of difference would be achieved through a different strategy. 3. The Joint Commission recognizes that cultural competence requires organizations and personnel to assess themselves with regards to cultural competence. Valuing diversity would be achieved through a different strategy. 4. The Joint Commission recognizes that cultural competence requires organizations and personnel to assess themselves with regards to cultural competence. Institutionalizing cultural knowledge would be achieved through a different strategy. Cognitive Level: Analyzing Patient Need: Psychosocial Integrity Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: LO03 - Describe institutional mandates regarding cultural and linguistic competence. 28) The nurse is planning care to address health care needs for a non-English-speaking patient and family. What would the nurse use as a guide for this care? 1. Checklist 2. Standardized care plan 3. Nursing textbook 4. Care mapAnswer: 1 Explanation: 1. The Joint Commission has created checklists for activities to address patientand family-centered care. 2. A standardized care plan may or may not address the cultural needs of the patient and family. 3. A nursing textbook may or may not address the cultural needs of the patient and family. 4. A care map may or may not address the cultural needs of the patient and family. Cognitive Level: ApplyingPatient Need: Psychosocial Integrity Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: LO03 - Describe institutional mandates regarding cultural and linguistic competence. 29) Unlicensed assistive personnel (UAP) ask the nurse to explain the difference between CULTURALCARE and other types of care. What would the nurse say in response to the UAP? 1. It is holistic. 2. It is a fad. 3. It focuses on scientific theory. 4. It is a belief system. Answer: 1 Explanation: 1. CULTURALCARE is holistic care. 2. CULTURALCARE is not a fad. 3. CULTURALCARE does not focus on scientific theory. 4. CULTURALCARE is not a belief system. Cognitive Level: Applying Patient Need: Psychosocial Integrity Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: LO04 - Articulate the attributes of CULTURALCOMPETENCY and CULTURALCARE. 30) The nurse is struggling with providing culturally competent care to non-English-speaking patients because the organization does not have any resources to support the patients' care needs. What is this nurse experiencing? 1. Dissonance 2. Compromise 3. Confusion 4. Distress Answer: 1 Explanation: 1. Dissonance is when a practitioner provides culturally and linguistically competent care that is not in harmony with the organization's beliefs and practices. 2. Dissonance is when a practitioner provides culturally and linguistically competent care that is not in harmony with the organization's beliefs and practices. Compromise is not a term used to describe culturally competent care. 3. Dissonance is when a practitioner provides culturally and linguistically competent care that is not in harmony with the organization's beliefs and practices. Confusion is not a term used to describe culturally competent care. 4. Dissonance is when a practitioner provides culturally and linguistically competent care that is not in harmony with the organization's beliefs and practices. Distress is not a term used to describe culturally competent care. Cognitive Level: AnalyzingPatient Need: Psychosocial Integrity Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: LO04 - Articulate the attributes of CULTURALCOMPETENCY and CULTURALCARE. 31) The nurse is disappointed with not being able to provide educational materials in a nonEnglish-speaking patient's primary language. What can the nurse do to serve as an advocate when providing culturally competent care? 1. Find or create materials to meet the patients' needs. 2. Teach the patient in English. 3. Provide educational materials written in English. 4. Ask the physician to talk with the patient. Answer: 1 Explanation: 1. Cultural competence is a learning process. Healthcare providers need to serve as patient advocates, and not advocates of the organization or modern health care. 2. Cultural competence is a learning process. Healthcare providers need to serve as patient advocates, and not advocates of the organization or modern health care. Teaching the patient in English is not providing culturally competent care. 3. Cultural competence is a learning process. Healthcare providers need to serve as patient advocates, and not advocates of the organization or modern health care. Providing educational materials written in English is not providing culturally competent care. 4. Cultural competence is a learning process. Healthcare providers need to serve as patient advocates, and not advocates of the organization or modern health care. Asking the physician to talk with the patient is not providing culturally competent care. Cognitive Level: Applying Patient Need: Psychosocial Integrity Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: LO04 - Articulate the attributes of CULTURALCOMPETENCY and CULTURALCARE. Chapter 3 Diversity 1) The nurse is comparing the patient population at a healthcare organization with the US Bureau of the Census population statistics. Which statement would the nurse use to make this comparison? 1. The percentage of U.S. White alone people in the 2014 estimates was 61.9 % of the population. 2. The percentage of Black Americans dropped considerably between 2000 and the 2014 estimates. 3. People of color are the majority population within the United States. 4. People of color as a percentage of the overall U.S. population are decreasing. Answer: 1Explanation: 1. In 2014, the U.S. Bureau of the Census estimated that 61.9% of the population was comprised of people who were White alone. 2. The percentage of Black Americans experienced a modest growth from 12.3% in 2000 to 12.7% in 2014 estimates. 3. While the proportional population is increasing, people of color are not the majority population in the United States. 4. Census statistics indicate an increase in people of color as a population group within the United States, not a decrease. Cognitive Level: Applying Patient Need: Health Promotion and Maintenance Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: LO01 – Describe the total population characteristics of the United States as presented in Census 2010. 2) While completing demographics for a new admission, the nurse notices there are separate categories for race and Hispanic origin. What influenced this change to occur in demographic data reporting? 1. Federal guidelines written in 1997 separated race and Hispanic origin as two separate concepts. 2. The number of people identified as non-White was increasing out of proportion to the population. 3. Identifies in which health plans the patient is eligible to enroll 4. Better differentiates categories within the African-American group Answer: 1 Explanation: 1. Previously, the Census Bureau had classified Hispanic as a race, but this became two separate categories in response to the 1997 guidelines. The 2010 Census adhered to these guidelines. 2. A separate category for race and Hispanic origin was not done to better classify the number of White population members. 3. Separate categories for race and Hispanic origin do not help identify health plans for patient enrollment. 4. A separate category for race and Hispanic origin was not done to differentiate categories within the African-American group. Cognitive Level: Understanding Patient Need: Psychosocial Integrity Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: LO01 – Describe the total population characteristics of the United States as presented in Census 2010. 3) The healthcare organization is analyzing the demographics of its current patient population, andnotes many patients are classifying themselves as members of many different groups. What is the challenge with comparing this data with previous years’ information? 1. There is a considerable amount of data to review 2. This data cannot be compared to the data before 2000.. 3. The data does not clearly identify the patient’s health care needs. 4. Does not help predict the length of stay for the average hospitalization Answer: 2 Explanation: 1. The challenge with comparing this data with previous years’ information is because the Census Bureau changed the reporting of race and Hispanic origin in 2000. It is unknown how much data needs to be reviewed.2. In 2000, the Census Bureau changed the reporting of race and Hispanic origin. Data collected prior to 2000 does not contain this information. This organization will have difficulty comparing recent data with that collected before 2000. 3. Demographic information is not used to identify health care needs. 4. Demographic information is not used to help predict the length of stay for the average hospitalization. Cognitive Level: Analyzing Patient Need: Psychosocial Integrity Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: LO01 – Describe the total population characteristics of the United States as presented in Census 2010. 4) A patient whose ancestry is European, but was born in Puerto Rico, is deciding how to classify race and Hispanic origin while completing demographics prior to having a medical procedure. How would the patient complete this classification? Select all that apply: 1. White 2. Hispanic 3. Asian 4. Black 5. Other Answer: 1 Explanation: 1. A person is categorized as being White if they have origins among any of the original people of Europe. 2. A person who was born in Puerto Rico would be categorized as Hispanic. 3. An Asian is a person who has origins among any of the original people of the Far East. 4. A person who has roots among any of the original black racial groups of Africa would be categorized as Black. 5. The patient can be categorized as being White and Hispanic. The category of other would not apply for this patient. Cognitive Level: Applying Patient Need: Psychosocial Integrity Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: LO01 – Describe the total population characteristics of the United States as presented in Census 2010. 5) While shifts in the population profile are occurring, what is an important consideration to address in health care? 1. Healthcare providers need to be younger to care for an aging population. 2. Healthcare needs to be streamlined for consistent care delivery. 3. More physicians need to be trained to deliver healthcare. 4. Cultural health needs of varying groups must be considered. Answer: 4 Explanation: 1. While the needs of an aging population will require additional healthcare providers, age is not a requisite to providing appropriate health care to population groups. 2. Consistent care delivery is a goal for all healthcare, but streamlining for “one size fits all” will not meet the healthcare needs of different population groups. 3. Additional physicians alone are not the answer to providing culturally sensitive healthcare.4. In order to provide appropriate care to different groups, healthcare workers must show sensitivity to, and understanding of, various cultural differences and needs as population shifts occur. Cognitive Level: Understanding Patient Need: Psychosocial Integrity Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: LO02 – Compare the population characteristics of the United States in 2000, 2010, and 2014. 6) The healthcare administrator is comparing the 2014 Census Bureau estimates with patient demographic data. Which cultural group represented 17.3% of the population in 2000? 1. American Indian and Alaskan Native 2. Asian 3. African American 4. Hispanic or Latino Answer: 4 Explanation: 1. American Indian and Alaskan Native heritage represented 0.8% of the population counted in the 2014 Estimates Census Bureau data. 2. Asian heritage represented 5.2% of the 2014 Census Bureau estimates. 3. African-American heritage represented 12.7% of the population counted in the 2014 Census Bureau estimates. 4. Hispanic or Latino heritage represented 17.3% of the population counted in the 2014 Census Bureau estimates. Cognitive Level: Analyzing Patient Need: Psychosocial Integrity Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: LO02 – Compare the population characteristics of the United States in 2000, 2010, and 2014. 7) When determining healthcare needs for a patient population, the healthcare organization analyzes the percentage of races represented within the organization with those of the U.S. Census. What was the change in the White population between the 2000 Census data and 2014 Census Bureau estimates? 1. 7.2% 2. 1.2% 3. 0.3% 4. 3.8% Answer: 1 Explanation: 1. The White-alone population decreased by approximately 7.2% from the 2000 Census to the 2014 Census Bureau estimates. 2. The Asian population increased approximately 1.6% from 2000 Census to the 2014 Census Bureau estimates. 3. The Black or African-American population increased approximately 0.4% from 2000 Census to the 2014 Census Bureau estimates. 4. The Hispanic or Latino population increased approximately 4.8% from 2000 Census to the 2014 Census Bureau estimates. Cognitive Level: Remembering Patient Need: Psychosocial Integrity Nursing/Integrated Concepts: Nursing Process: AssessmentLearning Outcome: LO02 – Compare the population characteristics of the United States in 2000, 2010, and 2014. 8) Between the 2000 Census and the 2014 Census Bureau estimates, what is the most notable statistic about the total United States population? 1. The U.S. population was over 318 million in 2014. 2. The Asian population increased to become the second-largest minority group in the United States. 3. The population age shift moved towards 18 years and younger. 4. The population shift went from a White-alone majority to White-alone minority status. Answer: 1 Explanation: 1. The U.S. population, steadily increasing, went from approximately 281 million people in the 2000 Census to over 318 million by the 2014 Census Bureau estimates. 2. Asian population numbers represent the third-largest minority group, behind Hispanic and African-American groups. 3. The age group of 18 years and younger is 26.6% of the total population. 4. The population majority in the United States remains a White-alone majority. Cognitive Level: Remembering Patient Need: Psychosocial Integrity Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: LO02 – Compare the population characteristics of the United States in 2000, 2010, and 2014. 9) 2014 Census Bureau estimates indicated that 62.5% of the population was between 45 to 64 years of age. What health implications can be derived from this data? 1. There will not be a higher incidence of work-related injuries. 2. This population group will be the highest percentage over age 65. 3. There will be higher numbers of seniors receiving Medicare in five years. 4. This population will have higher rates of chronic diseases. Answer: 4 Explanation: 1. There may be a higher incidence of work-related injuries. 2. There is no indication this group will become the largest population group over age 65. 3. There is no indication Medicare numbers will rise in five years. 4. There is an expectation that chronic disease rates will increase for this age group. Cognitive Level: Applying Patient Need: Health Promotion and Maintenance Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: LO02 – Compare the population characteristics of the United States in 2000, 2010, and 2014. 10) According to the 2014 Census Bureau estimates, the percentage of the population over 65 years of age was at 14.5%. How will health planning needs be affected by this percentage? 1. This population will have greater demands on the health care system as it ages. 2. Planning needs for other segments of the population can be revised downwards. 3. There is no need to increase manufacture of childhood immunizations.4. Cultural accommodations for other minority groups can be decreased. Answer: 1 Explanation: 1. As the White-alone population over 65 years of age increases, demands on the health system will increase. 2. Planning needs for other segments of the population will need to remain at appropriate levels. 3. Manufacture of childhood immunizations is not driven by changes in this population. 4. Cultural accommodations for minority groups will need to remain and be increased in order to provide culturally appropriate care. Cognitive Level: Understanding Patient Need: Health Promotion and Maintenance Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: LO02 – Compare the population characteristics of the United States in 2000, 2010, and 2014. 11) According to the 2014 Census Bureau estimates, the population between the ages of 18 and 64 was 62.5%. What are the long-term implications for the health of this group? 1. Providing health care focused on gerontological needs 2. Developing medications to prolong life at any cost 3. Providing health insurance for all people. 4. Developing systems to provide healthcare only to those older citizens who remain healthy Answer: 3 Explanation: 1. Healthcare needs for this age group need to be focused on the unique aspects of gerontological health. The Boomer generation began turning 65 in 2011, and this age group is expected to become a dominant segment in the population. 2. Prolonging life at any cost through medication does not contribute to quality of life. 3. Providing health insurance for all groups is not specific to those 65 or older, as they have access to healthcare through Medicare. 4. Rationing healthcare to those who deserve it is against the American culture of healthcare. Cognitive Level: Applying Patient Need: Health Promotion and Maintenance Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: LO02 – Compare the population characteristics of the United States in 2000, 2010, and 2014. 12) A patient, who is an immigrant from another country, is waiting to be seen in the Emergency Department. With what difficulties is this patient dealing since coming to a new country? Select all that apply: 1. Learning a new language 2. Adapting to a new climate 3. Eating new foods 4. Fitting in with the new culture 5. Rejecting old customs in favor of new ones Answer: 1 Explanation: 1. Learning a new language can be difficult for the immigrant. 2. Adapting to a new climate can be difficult for an immigrant. 3. Eating new foods can be difficult for an immigrant.4. Fitting in with the new culture can be difficult for the immigrant. 5. Old customs are not necessarily rejected in favor of new customs when moving to a new country. Cognitive Level: Analyzing Patient Need: Psychosocial Integrity Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: LO03 – Discuss the changes in points of origin of recent and past immigrants. 13) The nurse notices a larger number of foreign-born patients are being seen in the hospital. From which countries are the majority of foreign-born legal permanent residents? Select all that apply: 1. Mexico 2. China 3. India 4. Europe 5. South America Answer: 1, 2, 3 Explanation: 1. The highest number of legal permanent residents originates from Mexico. 2. A significant number of legal permanent residents originates from China. 3. A significant number of legal permanent residents originates from India. 4. European legal permanent resident numbers have declined since 1970, and are no longer the majority; also, Europe is a continent, not a country. 5. South America is not the dominant area of birth for legal permanent residents and it is not a country—it is a continent. Cognitive Level: Remembering Patient Need: Psychosocial Integrity Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: LO03 – Discuss the changes in points of origin of recent and past immigrants. 14) Legal permanent residents tend to initially settle in urban areas. What can be inferred from this? 1. Employment may be found, but will probably be in lesser-paying jobs. 2. Unemployment will not be a concern. 3. Employment is easy to obtain in urban areas. 4. Income earning potential is higher. Answer: 1 Explanation: 1. Legal permanent residents generally have lesser-paying jobs than natives. 2. Legal permanent residents are more likely to be unemployed. 3. Employment is not necessarily easier to find in urban areas. 4. Legal permanent residents are more likely to live in poverty than natives. Cognitive Level: Applying Patient Need: Psychosocial Integrity Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: LO03 – Discuss the changes in points of origin of recent and past immigrants. 15) The nurse desires employment in a metropolitan area with a high percentage of foreign-born legal residents. In which areas would the nurse consider employment? Select all that apply: 1. New York City 2. Los Angeles3. Miami 4. Baltimore 5. Dallas Answer: 1, 2, 3, 4 Explanation: 1. The highest percentage of legal foreign-born residents is in the Northeast, specifically in the New York, Northern New Jersey, and Long Island areas. 2. The Los Angeles, Long Beach, and Santa Ana metropolitan areas in Southern California are the second-highest metropolitan areas for legal permanent residents. 3. Miami and Fort Lauderdale rank the third-highest of metropolitan areas for legal permanent residents. 4. The mid-Atlantic areas of Washington, D.C., Maryland, and Virginia rank the fourthhighest of metropolitan areas for legal permanent residents. 5. Texas is not ranked as a leading metropolitan area for legal permanent residents. Cognitive Level: Analyzing Patient Need: Psychosocial Integrity Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: LO03 – Discuss the changes in points of origin of recent and past immigrants. 16) The nurse is trying to determine if a patient is a refugee. Which characteristics would the patient need to fulfill in order to be classified as a refugee? Select all that apply: 1. The person is outside the country of nationality. 2. The person is unable to return to the country of nationality because of persecution. 3. The person is unable to return to the country of nationality because of fear of persecution. 4. The person is outside of the country of last habitual residence. 5. The person is naturalized and owes allegiance to the United States. Answer: 1, 2, 3, 4 Explanation: 1. A refugee is a person who is outside of the country of nationality. 2. A refugee is any person who is unable to return to the country of nationality because of persecution. 3. A refugee is any person who is unable to return to the country of nationality because of a fear of persecution. 4. A refugee is a person who is outside of the country of last habitual residence. 5. A citizen is a person who is naturalized and owes allegiance to the United States. Cognitive Level: Analyzing Patient Need: Psychosocial Integrity Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: LO04 – Explain the meanings of terms related to immigration, such as citizen, refugee, legal permanent resident, and naturalization. 17) Prior to completing an admission assessment, a foreign-born patient provides the nurse with a green card. What does this green card represent? Select all that apply: 1. Proof of legal permanent residency 2. All rights of a U.S. citizen with exceptions 3. Inability to vote 4. Restrictions to become a citizen 5. Automatic U.S. citizenshipAnswer: 1, 2, 3 Explanation: 1. The green card allows the person permanent legal residency. 2. The green card allows the person to have all of the rights of a U.S. citizen with exceptions. 3. The green card allows the person to have all of the rights of a U.S. citizen except voting rights. 4. The green card allows the holder to apply for naturalization. 5. The green card does not confer automatic U.S. citizenship, but possession of a green card allows the resident to apply for naturalization. Cognitive Level: Analyzing Patient Need: Psychosocial Integrity Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: LO04 – Explain the meanings of terms related to immigration, such as citizen, refugee, legal permanent resident, and naturalization. 18) A foreign-born patient tells the nurse about preparing for the naturalization exam. What kinds of questions will be on this exam? Select all that apply: 1. Questions about the Constitution 2. Branches of the U.S. government 3. Which branch makes federal laws 4. The number of justices on the Supreme Court 5. Words of the U.S. national anthem Answer: 1, 2, 3, 4 Explanation: 1. The naturalization test includes questions about the U.S. Constitution. 2. The naturalization test includes questions about the branches of the U.S. government. 3. The naturalization test asks the question of who makes federal laws. 4. The naturalization test asks to identify the number of justices on the Supreme Court. 5. The naturalization test does not include questions about the words of the U.S. national anthem. Cognitive Level: Analyzing Patient Need: Psychosocial Integrity Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: LO04 – Explain the meanings of terms related to immigration, such as citizen, refugee, legal permanent resident, and naturalization. 19) Among the very real concerns for all residents of the United States, both citizens and legal permanent residents, is the rise in undocumented people entering the country. What impact is this having on healthcare? 1. Increased numbers of undocumented people are straining healthcare resources. 2. There is a concern that undocumented people will lead to bioterrorist attacks. 3. Health insurance is being given to all people in the country, ensuring universal coverage.The rise in undocumented people is contributing to the rise in exotic and rare diseases in the country. Answer: 1 Explanation: 1. Increased numbers of undocumented people are straining healthcare resources in the United States, because they increase the population that requires services. 2. There is no evidence the rise in undocumented people will lead to a bioterrorist attack. 3. There is no universal health insurance in the United States, so there is no universal health coverage. 4. There is no evidence the rise in undocumented people is causing a rise in rare and exotic diseases in the United States. Cognitive Level: Understanding Patient Need: Health Promotion and Maintenance Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: LO04 – Explain the meanings of terms related to immigration, such as citizen, refugee, legal permanent resident, and naturalization. 20) Which criterion limits access to health care? 1. Transition programs for newly arrived legal residents 2. Employment opportunities 3. No public transportation 4. Advocacy groups for immigrants Answer: 3 Explanation: 1. Transition programs for newly arrived legal residents can help them to access healthcare. 2. Employment opportunities can translate into better economic opportunities, including healthcare and the availability to access it. 3. When there is no public transportation, access to healthcare is limited because people with limited incomes may not have private transportation. 4. Advocacy groups for immigrants can help newly arrived legal residents find healthcare. Cognitive Level: Understanding Patient Need: Health Promotion and Maintenance Nursing/Integrated Concepts: Nursing Process: Planning Learning Outcome: LO05 – Discuss the concepts of poverty. 21) Statistics for 2014 indicated that 14.8 million people were in poverty. What health implications can be drawn from this statistic? 1. The people run a higher risk of poor overall health status. 2. Public health clinics can provide preventive care. 3. Medicaid assistance can enable people to receive healthcare. 4. Increased funding for public health has resulted from these statistics. Answer: 1, 2, 3 Explanation: 1. People living in poverty run a higher risk of having poorer overall health status because they may lack the medical care, nutritional intake, and other factors that contribute to better health. 2. Public health clinics are plentiful, and are always able to provide the preventive health care. 3. Medicaid assistance helps people in dire need receive health care. 4. Funding for public health has not increased as a result of statistics indicating people living in poverty.4. Cognitive Level: Applying Patient Need: Health Promotion and Maintenance Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: LO05 – Discuss the concepts of poverty. 22) A patient in the Emergency Department is concerned about the cost of treatment because of no financial income. What areas would the nurse include when assessing this patient? Select all that apply: 1. Preventive care 2. Nutritional status 3. Number of a