1. Which action would a hospital administrator take to meet the cultural and linguistic needs of Spanish-speaking community members?
a. Hire health care professionals from different Spanish-speaking countries.
b. Ensure that all health care workers speak Spanish.
c. Ensure that all signage is posted in Spanish as well as English.
d. Ensure health services are in varying locations.
2. On which criterion would the Human Resources manager focus when identifying interpreters to support the care of patients with limited English proficiency?
a. Be of the same ethnic background of the patients
b. Availability of family members
c. Proficient in health language terminology
d. Be on 24-hour call
3. a. Ensure grievances are resolved
b. Plan and implement culturally and linguistically appropriate services
c. Plan for culturally appropriate continuing education for the staff
d. Develop partnerships with community members
4. During an assessment, the nurse asks the patient to describe her current health status. In what context will the patient most likely explain her health?
a. Diagnosis
b. Personal experience
c. Cost
d. Impact on family
5. 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 self-
expectation?
a. Attend a festival from a different culture.
b. Find a seminar on cultural competence.
c. Talk to people from different cultures.
d. Commit to a time-consuming journey.

6. The staff development educator is analyzing ways to incorporate cultural competency concepts in continuing education programs. How will the educator explain the concept of cultural competency to staff?
a. Philosophy
b. Condition
c. Theory
d. Fad
7. A patient from a non-English-speaking culture comes into the health clinic seeking care. The
nurse is unable to determine the patient’s primary language. What should the nurse do?
a. Ask for help to determine the patient’s€primary language.
b. Encourage the patient to seek care elsewhere.
c. Notify Security.
d. Contact a homeless shelter.
8. 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?
a. Nursing textbook
b. Standardized care plan
c. Checklist
d. Care map
9. A patient’s parish priest arrives to the care area to visit the patient and provide communion.
What impact does the priest’s visit have on the patient’s health?
a. Reinforces distinctiveness
b. Reinforces acculturation
c. Offers support and provides positive expectation
d. Reinforce assimilation
10. An older patient tells the nurse about being born in a different country and having visited the
home country many times throughout the years. The nurse realizes that the patient is explaining which aspect of culture?
a. Acculturation
b. Religious preference
c. Socialization
d. Heritage consistency
11. A group of nurses talking are overheard using jargon that is consistent with the nursing
profession. Which behavior are the nurses demonstrating?
a. Heritage consistency
b. Ethnicity
c. Acculturation
d. Socialization
12. A seminal event in the boomer generation that can still elicit comments today is the
question:
a. “Do you remember Pearl Harbor?”
b. “Where were you when John F. Kennedy was shot?”€
c. “What were you doing on September 11, 2001?”
d. “How did the Challenger tragedy affect you?”
13. A patient from a different culture tells the nurse about eating specific foods during
pregnancy and after childbirth to ensure a healthy mother and infant. Which cultural
phenomena does this behavior exemplify?
a. Environmental control
b. Social organization
c. Time orientation
d. Biological variation
14. Why does the nurse stop and think before implementing touch when providing care to a
patient from a different culture?
a. Impacts time orientation
b. Influences environmental control
c. Influences the patient’s personal space
d. Alters social organization
15. Prior to caring for a Native American patient, the nurse reviews the diseases that are more
prevalent in this culture. What is the nurse taking into consideration when caring for this
patient?
a. Biological variation
b. Environmental control
c. Social organization pattern
d. Component of heritage consistency
16. The nurse learns that a patient from a different culture does not know the names of the
people who are candidates running in the next general election. What assumption can be
made about this assessment finding?
a. The patient cannot read.
b. The patient is heritage consistent.
c. The patient is hard of hearing.
d. The patient does not have a high school education.
17. While completing demographics for a new admission, the nurse notes that there are separate
categories for race and Hispanic origin. What influenced this change to occur in demographic data reporting?
a. Better differentiates categories within the African-American group
b. The number of people identified as non-White was increasing out of proportion to the
population.
c. Identifies which health plans the patient is eligible to enroll in
d. Federal guidelines written in 1997 separated race and Hispanic origin as two separate
concepts.
18. While shifts in the population profile are occurring, what is an important consideration to
address in health care?
a. Cultural health needs of varying groups must be considered.
b. Health care needs to be streamlined for consistent care delivery.
c. More physicians need to be trained to deliver health care.
d. Health care providers need to be younger to care for an aging population.
19. Between the 2000 Census and 2010 Census, what is the most notable statistic about the
total United States population?
a. The population age shift moved towards 18 years and younger.
b. The Asian population increased to become the second-largest minority group in the United States.
c. The U.S. population was over 308 million in 2010.
d. The population shift went from a White majority to White minority status.
20. According to the 2010 Census, 40.3 million people are aged 65 and over. What are the
long-term implications for the health of this group?
a. Providing health care that is focused on gerontological needs
b. Developing medications to prolong life at any cost
c. Providing health insurance for all age groups
d. Developing systems to provide health care only to those older citizens who remain healthy
21. Which criterion limits access to health care?
a. Employment opportunities
b. No public transportation
c. Transition programs for newly arrived legal residents
d. Advocacy groups for immigrants
22. Why would a patient who has a higher income generally have better health outcomes?
a. Have better access to health care
b. Have better job skills
c. Can afford private transportation
d. Can afford private insurance
23. A patient tells the nurse that she lives in Section 8 housing. The nurse realizes that
eligibility for this program is determined by:
a. Employment history
b. Family size
c. Geographic address
d. Low-income guidelines
24. Which definition of health would the nurse most likely use when assessing a patient’s thinking about health?
a. Having a harmonious, balanced relationship with nature
b. Not having any discernible illness or disease
c. Being in a state of physical, mental, and social well-being
d. The ability to get up and go to work each day
25. Which statement exemplifies how a nursing student views health?
a. Must share the client’s views of health and illness
b. Forces clients to accept the medical definitions of health
c. Entered the health care profession with a culturally based concept of health
d. Accepts the prevailing definition of health and applies it to individual clients
26. A group of health care providers are attempting to define health. What can occur during this
discussion?
a. Terms and meanings may be challenged
b. Categories of health will be listed
c. Ambiguity will be resolved
d. Achieves a full acceptance by all parties
27. For many people, health and illness are opposites which can make them view health as
which of the following:
a. A state of physical fitness
b. Freedom from evil that causes illness
c. A state of emotional ambiguity
d. The reward for a productive life
28. Why would health care providers refer to Healthy People 2020 when providing patient care?
a. It is mandated legislation that will result in a healthier population by 2020.
b. It supports health policies that provide monetary incentives to states who reach the
benchmark goals.
c. It serves as a monitoring system that evaluates the health of all citizens.
d. It provides a plan to continue to improve the health of everyone in the United States.
29. A patient has a family history of cardiac disease and has maintained lifestyle changes as a
preventive measure. Within the overall perspective of perceived susceptibility, what is this
patient demonstrating?
a. Perceived benefits
b. Perceived seriousness
c. Taking action
d. Changing modifying factors
30. The nurse determines that a patient is in the onset stage of an illness. What did the nurse
observe in the patient?
a. The first symptoms of a given problem are experienced.
b. There is a gradual resumption of normal roles and activities.
c. The sick role becomes that of being a patient.
d. The disease is identified and socially sanctioned.
31. Which action do most people take when experiencing a mild illness?
a. Rely on self-treatment or do nothing.
b. Ingest herbs specific to how they are feeling.
c. Consult a local faith healer.
d. Immediately seek medical attention.
32. How would the nurse explain alternative medical traditions to a patient?
a. For use in concert with other aspects of health care
b. Outside of the realm of a person’s cultural heritage medical tradition
c. An essential component of a cultural heritage medical tradition
d. Traditional methods of health care
33. Which actions would the nurse categorize as traditional mental health maintenance?
a. Wearing head covering in the cold to preserve head warmth
b. Avoiding physically demanding hobbies
c. Using medications to preserve chemical balance in the brain
d. Activities to concentrate and stimulate the mind
34. While assessing a patient from the Jewish culture, the nurse learns that the patient believes
that an illness is being caused by another soul. What is this health belief considered?
a. Dybbuk
b. Kayn aynhoreh
c. Szatan
d. Aberglobin
35. During an assessment, a patient tells the nurse, “An onion a day keeps everyone away.”€ How does this philosophy protect health?
a. Recognizes the special antibiotic properties contained within onions
b. Affirms the belief in the power of onions to prevent disease
c. Protects the person from coming in contact with those who might be ill
d. Advertises that onions have special healing abilities
36. Which patient statement reflects a spiritual belief that defines illness?
a. “It is a necessary part of my religious culture.”
b. “I am being punished for breaking a religious code.”
c. “I failed to wear special amulets to ward it off.”
d. “I am sick because I violated dietary practices.”
37. What is an advantage of using complementary medicine for treatment of an illness?
a. Complementary medicine is never used with allopathic medicine.
b. Complementary medicine replaces allopathic medicine as a primary form of treatment.
c. Complementary medicine lessens a patient’s discomfort with allopathic treatments.
d. Complementary medicine can be used with allopathic medicine.
38. Why would the nurse assess a patient’s religion when completing the health history process?
a. Religion plays a role in the perception of health and illness
b. Helps explain recreational habits
c. Provides information about the patient’s geographic location
d. Explains nutritional preferences
39. Which action would the nurse take when assessing the impact of religion, culture, and
ethnicity on a patient’s illness?
a. Recognize that certain ethnic groups practice the same religion.
b. Recognize that all members of an ethnic group will follow the same dietary practices.
c. Recognize that religious preferences may differ between members of an ethnic group.
d. Recognize that certain ethnic groups always practice the same cultural rituals.
40. The nurse overhears a patient ask a family member to bring the Lourdes water to the
hospital. The nurse recalls that this water is believed to cure which health problem?
a. Being bedridden
b. Blindness
c. Bodily ills
d. Deafness
41. A family member tells a patient with terminal cancer not to worry since special prayers have
been said in church. To which saint is prayed for help with cancer?
a. St. Peregrine
b. St. Odilia
c. St. Francis de Sales
d. St. Raymond Nonnatus
42. What would be alternative treatment modalities used during an illness?
a. Strict adherence to the prescribed medical regimen
b. Willingness to seek a second medical opinion
c. Refusal to allow any medical treatment to be performed
d. Consultation of a healer outside the medical establishment
43. A patient follows the teachings of Christian Science and will not take any medications, but
for which health problem will medications be used by members of this religion?
a. Chemotherapy to treat cancer
b. Immunizations to comply with civil law
c. Antibiotics
d. Narcotics for pain relief
44. Which type of healing is most appropriate for a person who is possessed by external evil?
a. Deliverance
b. Physical healing
c. Inner healing
d. Spiritual healing
45. Why is understanding family heritage important?
a. New traditions can be discovered to be incorporated into daily life.
b. It provides answers to questions regarding why family members behaved as they did.
c. Knowing the methods of socialization that were passed down among families can explain social behaviors today.
d. Health practices can be altered as a result of understanding heritage.
46. Why is it important to examine individual familial health/health practices?
a. Rejects those health traditions if they differ from those of the same ethnocultural group
b. Identifies what healing practices need to be used when one is ill
c. Helps a person become sensitized to understand the role that ethnocultural and religious heritage has played within a family
d. Generalizes to all members of the same ethnocultural group the various health practices that are done
47. What is the value of sharing family health practices among people?
a. Encourages feelings of nostalgia for past times with family
b. Supports the rejection of all types of family health practices
c. Recognizes autonomy for the efficacy of the health practices
d. Provides an awareness of the differences between various groups
48. Which health protection action would the nurse assess in a patient who is of Black American
Baptist heritage?
a. Eating fresh lemons
b. Wearing camphor around the neck in the winter
c. Taking a daily shot of whiskey
d. Drinking blackstrap molasses
49. Which health restoration practice for a cold would the nurse assess in a patient of English
Catholic heritage?
a. Drinking honey and vinegar
b. Rubbing the chest with Vicks
c. Gargling with water and vinegar
d. Drinking brandy with warm milk
50. A patient of Swedish-American Protestant descent wants a specific health protection intervention to maintain throat health. Which action will the patient most likely request?
a. Gargling with salt and taking honey with milk
b. Having the throat blessed on St. Blaise Day
c. Ingesting baking soda
d. Staying in a steamy bathroom when the throat is sore
51. Which action would a patient from Italian-American Catholic heritage perform to protect
health?
a. Never washing hair before going outdoors
b. Keeping a kitchen warm
c. Drinking water with meals
d. Taking regular vitamin tonics
52. What is an assumption about socialization into the health care culture?
a. Interventions for health events must follow a prescribed protocol.
b. The more technological the intervention, the greater benefit it yields.
c. Effective treatment can only be done by educated and licensed professionals.
d. Alternative complementary treatments have validity.
53. How does the U.S. health care expenditure per person compare to other nations?
a. Expenditures rank lower than those of other nations.
b. Expenditures are equal with other nations.
c. Expenditures are a fraction of the gross domestic product.
d. Expenditures exceed those of other nations.
54. What impact did social and health policy have on the health care system in the latter part of
the twentieth century?
a. Exploding health care costs and the challenges to reform and control them
b. The majority of health care being paid for through government subsidies
c. Affordable health care for all citizens
d. Health care costs decreasing as a result of social and health policy
55. What would be a reason why a person with sickle cell disease does not receive adequate care
and pain control during a crisis?
a. Physicians are not familiar with the trajectory of a pain crisis.
b. There may be subtle racism exhibited toward those with sickle cell disease.
c. The person isn’t aware that appropriate care for a pain crisis exists.
d. The person may not explain their symptoms appropriately.
56. What would be a barrier to health care for a person who lives in a rural area?
a. Transportation
b. Education
c. Insurance
d. Technology
57. How would the nurse practicing cultural care define health?
a. Experience of well-being and integrity of the mind and body
b. Absence of illness and disease
c. Balance of the person both within and in the outside world
d. Use of science and technology to cure diseases
58. During a health history, the patient describes health restoration activities that are synonymous with cultural care. Which activity would the patient practice to restore health?
a. Participate in human experimentation
b. Complete recommended diagnostic tests
c. Agree to radical treatments
d. Use herbal preparations
59. Which is a characteristic of health insurance usage by the American Indian and Alaska
Native population?
a. Less than among the general population
b. Dependent on federal monies
c. Subsidized by tribal income
d. Greater than among the general population
60. The nurse practitioner desires to provide health care to American Indians. In what part of the
United States would the nurse find the largest concentration of American Indians to provide
care?
a. West
b. North
c. South
d. East
61. What might a patient from the American Indian culture use to prevent disease?
a. Wear certain objects or charms as a preventive measure
b. Perform specific daily rituals against disease
c. Deny that disease or illness can harm a person
d. Accept that disease is a part of life
62. Which American Indian tribe associates illness with evil spirits?
a. Sioux
b. Passamaquoddy
c. Hopi
d. Cherokee
63. Which action is considered to be a traditional practice among American Indians to maintain
their harmony with nature?
a. Eating ritual foods
b. Lunar cycle agriculture
c. Purification
d. Divination
64. In which American Indian tribe are meditation and herbs used to create a trance to provide
the vision of the evil that causes an illness?
a. Cherokee
b. Sioux
c. Navajo
d. Hopi
65. A patient that is of the American Indian culture is waiting to be seen in a non-Indian Health
Service facility. What concern might this patient have about receiving health care through
this route?
a. Conflict between his or her perception of the illness and what the physician diagnoses
b. Easier to receive medical care through emergency departments rather than private physicians
c. Receive better health care from mainstream medical services
d. Concern that medical insurance won’t cover all the medical costs
66. In which cities do the largest number of naturalized Asian citizens reside?
a. Washington, D.C.
b. New York
c. Houston
d. Chicago
67. What is the birthplace for the largest percentage of Asians who became naturalized in 2010?
a. India
b. Philippines
c. People’s Republic of China
d. Vietnam
68. What does Chinese medicine teach about health?
a. It is the way to ultimate reality.
b. It is based in Confucian philosophy.
c. It is the prevention of illness.
d. It is a state of spiritual and physical harmony with nature.
69. Which action would a United States health care provider need to take to understand the
Chinese philosophy of health and illness?
a. Live according to the Buddhist precepts.
b. Follow the Confucian way of life.
c. Understand the Chinese culture.
d. Examine Taoist religion and philosophy.
70. Which is a concept of holism in traditional Chinese medicine?
a. Integration of the body with the external environment
b. Energy fields that create health or disease
c. Local pathology as separate from the body
d. Harmonic balance that creates illness
71. Why does the Chinese physician focus on palpating a patient’s pulse?
a. It can help to refine a diagnosis.
b. It indicates a specific treatment.
c. It is considered the storehouse of the blood.
d. It determines the time of death.
72. While assessing the health history of a patient who is an Asian/Pacific Islander, what will the
nurse identify as a leading cause of death for people from this culture?
a. Alzheimer’s disease
b. Influenza and pneumonia
c. Malignant neoplasms
d. Chronic lower respiratory diseases
73. What is the geographic origin of the majority of African Americans?
a. West coast of Africa
b. African interior
c. Southern coast of Africa
d. East coast of Africa
74. What is a traditional Black belief regarding health?
a. The mind, body, and spirit are not separated
b. Health represents energy forces
c. Represents a process rather than a state
d. Believed to be influenced by ancestors
75. Which is considered a traditional Black belief about illness?
a. A separation of body, mind, and spirit
b. A state of disharmony
c. An alteration in the energy force
d. Evil ancestral influence on the person
76. Which health maintenance practice would a patient from the Black culture use to keep the
system’s “open”?
a. Participate in rooting and prayer
b. Have massages
c. Take laxatives
d. Wear amulets
77. Which is a preparation used in the spring of each year by individuals of the Black culture to
protect health?
a. Drinking blackstrap molasses
b. Wearing asafetida around the neck
c. Rubbing a sulfur and molasses preparation on the back
d. Drinking cod liver oil weekly
78. How would a patient from the Black culture treat poison ivy?
a. Sprinkling crushed bluestone powder on the affected area
b. Placing a mixture of garlic, onions, and parsley on the site
c. Placing clay in a dark leaf over the affected area
d. Rubbing Vicks Vaporub on the area
79. During the examination of a patient from the Black culture, how will the nurse recognize
pallor?
a. Slow blood return
b. Palpate the skin
c. Check the sclera
d. Absence of underlying red tones
80. What is important for the nurse to know about high school graduation and college attendance
for Hispanics?
a. The total percentage of Hispanic people who graduated from high school in 2010 was
62.9%.
b. Graduation from college is expected in the Hispanic population.
c. More Hispanics are applying to college than ever before in the history of the United
States.
d. Hispanics who graduate from high school are more likely to be naturalized.
81. What can be surmised regarding the combination of employment patterns and income levels
of Hispanics living in the United States?
a. Capable of remaining above the poverty line
b. Remain at the middle of the economic spectrum for employment
c. More likely to live in poverty than non-Hispanic whites
d. Remain at the lowest level for economic benefits
82. What will a patient from the Mexican culture explain to the nurse as the cause of an illness?
a. Punishment from an ancestor
b. An imbalance within the body
c. Warning from God to live a better life
d. Inevitable with no method to prevent it from occurring
83. A patient from the Mexican culture tells the nurse that an illness has been caused by mal ojo
or bad eye. How did this health problem occur?
a. Excessive admiration from someone else
b. Having a spell caused by black magic
c. Being touched improperly by a health care provider
d. Lying about the amount of food one has eaten
84. Which method will a patient of the Hispanic culture use to counteract illness caused by an
imbalance?
a. Refrain from discussing the illness with family members.
b. Eat foods that are opposite of the imbalance.
c. Seek appropriate medical care from the local healer.
d. Dress appropriately.
85. Which is a dilemma encountered by health care providers when trying to accommodate a
patient of the Mexican culture’s desire to maintain hot and cold
food preferences?
a. Ensuring that all medications are taken with specific foods
b. Avoiding all foods that contain certain spices
c. Obtaining the unusual foods native to a Mexican patient’s diet
d. Understanding which foods the patient considers hot and cold
86. What would the nurse infer about the incidence of lung cancer being lower among Hispanic
women versus that of the general population?
a. Hispanic women are less likely to smoke.
b. Hispanic women are healthier than the general population.
c. Hispanic women have better preventive health practices.
d. Hispanic women are not genetically predisposed to lung cancer.
87. In 2010, which cities in the United States had both the largest number of White alone and
multiple-race White populations?
a. Houston
b. Chicago
c. Los Angeles
d. San Diego
88.What would a patient of Italian descent tell the nurse is the cause of a less severe illness?
a. The evil eye
b. Curses
c. Anxiety
d. Failure to pray
89. Which action would a patient of German descent use to protect health?
a. Always wearing a hat to protect the head
b. Dressing properly for the season
c. Eating garlic with lunch and dinner
d. Drinking orange juice every day
90. What will the nurse assess as an important component of healing for a patient of Italian
descent?
a. Wearing black when a family member is ill
b. Use of garlic and olive oil in tonics
c. Religious faith in God
d. Eating pasta at every meal
91. For what would a patient of Polish descent tell the nurse that paregoric is used?
a. Diarrhea
b. Gas
c. Indigestion
d. Cramps
92. What would the nurse consider about the incidence of cancer when assessing a White
patient?
a. Is significantly lower than other races
b. Is lower than among the overall population
c. Is equal with other races in incidence
d. Is slightly higher than for the overall population
93. When comparing the leading causes of death for all persons, which problem ranks higher for
the White population?
a. Alzheimer’s disease
b. Influenza and pneumonia
c. Diseases of the heart
d. Septicemia
94. Which action would the nurse take to improve cultural care?
a. Expect everyone to embrace the process
b. Confront biases and stereotypes
c. Learn a foreign language
d. Study different cultures
95. The nurse is developing the ability to hears when caring for a patient from a different
culture. What is this nurse doing?
a. Understanding the patient and the patient’s culture
b. Listening to the patient talk in the native language
c. Observing patient-family interactions
d. Identifying cultural inconsistencies
96. What action would a nurse take to learn more about the different cultures represented in the
community?
a. Walk through the community.
b. Prepare a guide sheet with a list of herbs.
c. Recognize hot-cold imbalances.
d. Recognize folk diseases.
97. What is identified as an issue with using an interpreter when communicating with a non-
English-speaking patient?
a. Age of the interpreter
b. Fee for service
c. Different dialects
d. An interpreter interprets€
98. A health clinic in a socioeconomically depressed area that provides care to Hispanic patients
is being closed. Which action should the nurse take to support the patients?
a. Investigate the misappropriation of funds
b. Urge for increased funding
c. Create a list of comparable resources outside the community
d. Write directions to the nearest hospital in the patients native
language
99. The nurse is on the journey to learn cultural competence and sees an open highway
ahead. Which action should the nurse take at this time?
a. Cruise along, but not too fast
b. Stop
c. Go faster
d. Expect clear sailing ahead
100. Two nurses are overheard talking about their experiences with cultural competency.
Which experience would be considered an unexpected positive event?
a. Learning a foreign language
b. Role of a healer within a culture
c. Deep love of life and people
d. Being an advocate for funding

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