NURS456-COMMUNITY HEALTH EXAM QUESTIONS
WITH ANSWERS AND EXPLANATIONS
Chapter 13 – Social Determinants of Health
1. An unidentified patient was injured in a hit-and-run accident and was now conscious.
When asked how he felt, the patient looked very confused and responded in a
language the nurse didn't recognize. What should the nurse do?
a. Use gestures and pantomime until the nurse is able to determine what
language the patient is speaking
Explanation: The nurse can report the problem and request a translator, but in the meantime
the nurse should pantomime words and simple actions while verbalizing them until
communication can be established using a translator
2. A woman, who spoke English, was an immigrant from the Middle East, attending the
clinic for the first time with two female friends. When a male nurse attempted to get a
health history, the woman refused to respond to his questions. What can the nurse
do?
a. Ask a female nurse to talk with the client
Explanation: Many culture groups have strong norms regarding appropriate gender behavior.
3. A nurse was explaining a problem to the client so the client could make an informed
decision from alternative treatment approaches. The client responded, "The doctor
will choose the best treatment. Do whatever the doctor says." What should the nurse
do next?
a. Nothing; simply accept that some fatalistic-oriented clients literally don't
know how to choose
Explanation: One of the three ways people are oriented is destiny, in which people must endure
and accept whatever comes in a fatalistic, inevitable manner, as destiny cannot be changed.
4. The nurse made a follow-up appointment for a client at the clinic, but the client didn't
come. Two days later the client presented at the clinic explaining that a temporary
job had come up and he couldn't come back until he'd finished and been paid for that
job. What should the nurse do?
a. Understand that some clients are present oriented, and fit the client in so
care can be given
Explanation: Setting up an appointment would possibly be useless because the client may not
attend the future appointment either. Poverty-stricken persons would be wise to accept
employment when it becomes available.
5. When a nurse visited a client's home, it was apparent that the client had not begun to
implement the needed exercise program. Rather, the client had been drawing about
his illness experience. What should the nurse do?
a. Suggest his drawing might be more forceful after exercising
,NURS456-COMMUNITY HEALTH EXAM QUESTIONS
WITH ANSWERS AND EXPLANATIONS
Explanation: The dominant cultural value is action oriented, so the client would be expected to
have begun to exercise. Dominant cultural values include an emphasis on productivity and being
busy. However, some persons are not action oriented but being oriented, with a focus on
expression of impulses and desires.
6. A nurse reviewed the treatment the surgeon recommended for a woman's breast
lump. When the nurse asked the woman if she could be admitted to the hospital for
immediate surgery, the husband thanked the nurse for her time and said they would
get back in touch. What should the nurse do?
a. Recognize that the husband and other family members may need to have
input into this decision
Explanation: We typically focus on the individual as the central figure in decisions about the
self. However, in other cultures female clients may seek assistance from other members of
the family and allow male relatives to make decisions.
7. When one woman asked her friend to stay while a painful procedure was done, it
was explained that only one immediate family member could be in the room. The
woman asked, "How do you define family?" In the clinic, what would be the best
response?
a. Whoever you tell us is your family
Explanation: Families are changing from the norm of husband, wife, and children to
single parents, blended, extended, committed, or cohabitation with domestic partners.
8. A nurse felt very good about an Asian man who had responded positively to the
instructions given to him. Later, the nurse heard him tell his wife that there was no
way he could implement the suggestions. What could be the problem?
a. His culture may value harmonious relationships over expressing disagreement.
Explanation: Asian clients may provide the nurse with the answers they think the nurse
wants to hear.
9. In a client's culture it was exceedingly rude to ask any question about income or
wealth. How might the nurse draw conclusions about the client's socioeconomic status
(SES) or ability to pay?
a. Ask about the client's education or employment position
Explanation: SES may be determined by examining income, occupation, and educational level.
If that is not possible, age, gender, possessions, location of residence, religion, and race may
also be considered.
10. A nurse was responsible for setting up a 1-day-long health fair with free pizza
being served during lunch. The nurse observed quite a few people who didn't eat
but just talked quietly during lunch. What, if anything, should the nurse do?
a. Talk to the group, and ask what foods might have been more acceptable
Explanation: Many ethnic groups prefer certain foods as part of their cultural identity. The
nurse should take this opportunity to learn foods preferred by the community.
, NURS456-COMMUNITY HEALTH EXAM QUESTIONS
WITH ANSWERS AND EXPLANATIONS
11. A nurse set up a clinic appointment for Friday of the following week. An Arab patient
asked to come earlier in the week. As those days were heavily booked, the nurse left
the appointment on Friday. The patient was a "no show." What might have been the
problem?
a. Muslims' holy day is from sunset Thursday to sunset Friday.
Explanation: The nurse should know the days of religious worship. Protestants usually worship
on Sundays; Muslims' day of worship is from sunset Thursday to sunset on Friday; and Jews
and Seventh-Day Adventists' holy day is from sunset on Friday to sunset on Saturday
12. What is the most important first step before interviewing a Hispanic family?
a. Establish rapport, and gain trust and confidence
Explanation: Regardless of the culture of the client family, it is crucial to establish rapport and
gain trust and confidence before attempting to gather data.
13. A woman stood very close to the nurse and asked a question about her husband's
condition. The nurse took a step back and shared the requested information. No
other questions were asked. Was this a successful interaction?
a. No, because the woman and the nurse had different perceptions of
personal space
Explanation: Sense of spatial distance is significant because culturally appropriate distance
zones vary widely. Many cultures stand closer for important conversations, whereas the
nurse stepped back because being so close made the nurse uncomfortable.
14. A nurse became frustrated because after each interview question there was a long
pause before the client responded. What should the nurse do?
a. Ask the client what silence after a question means
Explanation: Wide cultural variation exists when interpreting silence. Because the nurse is
uncomfortable, action should be taken. The only way to know the meaning of the silence is to
ask.
15. A client, accompanied by her son, spoke only Spanish while the nurse did not.
What should the nurse do to meet the client's need?
a. Call until she finds a Spanish interpreter employed by the agency
Explanation: Asking the son would violate confidentiality, and gender issues may also
arise.
16. At a military base, a family from Qatar, a Muslim Arabic country, came in because
the wife believed she was pregnant. If there are no intervening variables, who
should see the family?
a. The female nurse midwife
Explanation: People from Arab Muslim countries feel even more strongly about males
touching a female.
WITH ANSWERS AND EXPLANATIONS
Chapter 13 – Social Determinants of Health
1. An unidentified patient was injured in a hit-and-run accident and was now conscious.
When asked how he felt, the patient looked very confused and responded in a
language the nurse didn't recognize. What should the nurse do?
a. Use gestures and pantomime until the nurse is able to determine what
language the patient is speaking
Explanation: The nurse can report the problem and request a translator, but in the meantime
the nurse should pantomime words and simple actions while verbalizing them until
communication can be established using a translator
2. A woman, who spoke English, was an immigrant from the Middle East, attending the
clinic for the first time with two female friends. When a male nurse attempted to get a
health history, the woman refused to respond to his questions. What can the nurse
do?
a. Ask a female nurse to talk with the client
Explanation: Many culture groups have strong norms regarding appropriate gender behavior.
3. A nurse was explaining a problem to the client so the client could make an informed
decision from alternative treatment approaches. The client responded, "The doctor
will choose the best treatment. Do whatever the doctor says." What should the nurse
do next?
a. Nothing; simply accept that some fatalistic-oriented clients literally don't
know how to choose
Explanation: One of the three ways people are oriented is destiny, in which people must endure
and accept whatever comes in a fatalistic, inevitable manner, as destiny cannot be changed.
4. The nurse made a follow-up appointment for a client at the clinic, but the client didn't
come. Two days later the client presented at the clinic explaining that a temporary
job had come up and he couldn't come back until he'd finished and been paid for that
job. What should the nurse do?
a. Understand that some clients are present oriented, and fit the client in so
care can be given
Explanation: Setting up an appointment would possibly be useless because the client may not
attend the future appointment either. Poverty-stricken persons would be wise to accept
employment when it becomes available.
5. When a nurse visited a client's home, it was apparent that the client had not begun to
implement the needed exercise program. Rather, the client had been drawing about
his illness experience. What should the nurse do?
a. Suggest his drawing might be more forceful after exercising
,NURS456-COMMUNITY HEALTH EXAM QUESTIONS
WITH ANSWERS AND EXPLANATIONS
Explanation: The dominant cultural value is action oriented, so the client would be expected to
have begun to exercise. Dominant cultural values include an emphasis on productivity and being
busy. However, some persons are not action oriented but being oriented, with a focus on
expression of impulses and desires.
6. A nurse reviewed the treatment the surgeon recommended for a woman's breast
lump. When the nurse asked the woman if she could be admitted to the hospital for
immediate surgery, the husband thanked the nurse for her time and said they would
get back in touch. What should the nurse do?
a. Recognize that the husband and other family members may need to have
input into this decision
Explanation: We typically focus on the individual as the central figure in decisions about the
self. However, in other cultures female clients may seek assistance from other members of
the family and allow male relatives to make decisions.
7. When one woman asked her friend to stay while a painful procedure was done, it
was explained that only one immediate family member could be in the room. The
woman asked, "How do you define family?" In the clinic, what would be the best
response?
a. Whoever you tell us is your family
Explanation: Families are changing from the norm of husband, wife, and children to
single parents, blended, extended, committed, or cohabitation with domestic partners.
8. A nurse felt very good about an Asian man who had responded positively to the
instructions given to him. Later, the nurse heard him tell his wife that there was no
way he could implement the suggestions. What could be the problem?
a. His culture may value harmonious relationships over expressing disagreement.
Explanation: Asian clients may provide the nurse with the answers they think the nurse
wants to hear.
9. In a client's culture it was exceedingly rude to ask any question about income or
wealth. How might the nurse draw conclusions about the client's socioeconomic status
(SES) or ability to pay?
a. Ask about the client's education or employment position
Explanation: SES may be determined by examining income, occupation, and educational level.
If that is not possible, age, gender, possessions, location of residence, religion, and race may
also be considered.
10. A nurse was responsible for setting up a 1-day-long health fair with free pizza
being served during lunch. The nurse observed quite a few people who didn't eat
but just talked quietly during lunch. What, if anything, should the nurse do?
a. Talk to the group, and ask what foods might have been more acceptable
Explanation: Many ethnic groups prefer certain foods as part of their cultural identity. The
nurse should take this opportunity to learn foods preferred by the community.
, NURS456-COMMUNITY HEALTH EXAM QUESTIONS
WITH ANSWERS AND EXPLANATIONS
11. A nurse set up a clinic appointment for Friday of the following week. An Arab patient
asked to come earlier in the week. As those days were heavily booked, the nurse left
the appointment on Friday. The patient was a "no show." What might have been the
problem?
a. Muslims' holy day is from sunset Thursday to sunset Friday.
Explanation: The nurse should know the days of religious worship. Protestants usually worship
on Sundays; Muslims' day of worship is from sunset Thursday to sunset on Friday; and Jews
and Seventh-Day Adventists' holy day is from sunset on Friday to sunset on Saturday
12. What is the most important first step before interviewing a Hispanic family?
a. Establish rapport, and gain trust and confidence
Explanation: Regardless of the culture of the client family, it is crucial to establish rapport and
gain trust and confidence before attempting to gather data.
13. A woman stood very close to the nurse and asked a question about her husband's
condition. The nurse took a step back and shared the requested information. No
other questions were asked. Was this a successful interaction?
a. No, because the woman and the nurse had different perceptions of
personal space
Explanation: Sense of spatial distance is significant because culturally appropriate distance
zones vary widely. Many cultures stand closer for important conversations, whereas the
nurse stepped back because being so close made the nurse uncomfortable.
14. A nurse became frustrated because after each interview question there was a long
pause before the client responded. What should the nurse do?
a. Ask the client what silence after a question means
Explanation: Wide cultural variation exists when interpreting silence. Because the nurse is
uncomfortable, action should be taken. The only way to know the meaning of the silence is to
ask.
15. A client, accompanied by her son, spoke only Spanish while the nurse did not.
What should the nurse do to meet the client's need?
a. Call until she finds a Spanish interpreter employed by the agency
Explanation: Asking the son would violate confidentiality, and gender issues may also
arise.
16. At a military base, a family from Qatar, a Muslim Arabic country, came in because
the wife believed she was pregnant. If there are no intervening variables, who
should see the family?
a. The female nurse midwife
Explanation: People from Arab Muslim countries feel even more strongly about males
touching a female.
