Chapter 23

a. Communities that are “food deserts” lack grocery stores and available transportation. Moreover, residents may not have the financial resources to afford healthy food and may rely on fast food and convenience stores. These conditions place residents at risk for obesity, diabetes, and heart disease.

a. Nurses provide culturally congruent care when they use evidence-based nursing practice that recognizes and is consistent with the values, beliefs, worldviews, and practices of their clients. Culturally congruent care involves recognizing the client’s beliefs; providing care that takes into account a client’s use of a traditional healer; and creating individualized care plans that are consistent with the client’s values, beliefs, worldviews, and practices.

a. This nurse has engaged in a stereotyping behavior, ascribing certain characteristics or behaviors, such as following a kosher diet, to a person based on their membership in a particular group.

b. An organizational barrier is one that exists within an organization. It includes the provision of linguistically competent services, such as medical interpreters. Structural inequities are systemic barriers and disparities in a health care system that block individuals or groups from receiving high-quality care, such as an insufficient number of primary care providers and the inability of individuals to afford health care or obtain health care insurance.

c. Cultural awareness occurs when nurses reflect on their own cultural backgrounds, beliefs, and biases.

d. The nurse demonstrates valuing of diversity by volunteering at a clinic that provides free care to immigrants. This practice allows the nurse to learn about the culture of the immigrant group and to establish relationships within the community. Discussing diversity with individuals from the same cultural background, comparing other cultures to one’s own culture, and treating everyone from the same culture in a like manner do not demonstrate that the nurse values diversity.

c. Observing how the client uses eye contact demonstrates the nurse’s awareness that clients may have different, culture-related perceptions of eye contact. Some clients consider it rude to make eye contact with a health care professional, whereas others consider eye contact a sign of attention or respect. Following this observation, the nurse may use another method to ensure the client understands the preoperative instruction, such as the teach-back method.

c. The nurse should pay attention to and use the terms the client uses to describe illness or body parts, rather than using medical terminology. Speaking in a louder voice than normal will not help a client understand what the nurse is saying, and the client may construe this behavior as condescending. The nurse should reinforce verbal instruction with the use of pictures, models, or demonstrations.

a. Best practice is to use a trained medical translator who not only knows the client’s language but also understands cultural sensitivity.

c. The nurse should ask members of the community to review the written materials to ensure appropriateness and to enhance community buy-in. Because various colors can convey different meanings in diverse cultural groups, the nurse should determine the cultural significance of the chosen colors. All commuinity members may not understand medical terminology; therefore, the nurse should use terminology the target group will understand, and the material should be written at a reading level appropriate for most group members. A high school reading level may be too difficult for many clients.