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Nurse Practitioner:
doi: 10.1097/01.NPR.0000441909.94029.16
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Cultural considerations at the end of life

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INSTRUCTIONS Cultural considerations at the end of life

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Cultural considerations at the end of life

General Purpose: The purpose of this learning activity is to provide information about cultural considerations related to end-of-life care. Learning Objectives: After reading this article and taking this test, you should be able to: 1. Identify cultural considerations related to end-of-life patient care. 2. Select culturally sensitive interventions related to end-of-life patient care.

  1. Cultural competency indicates the provider understands that illness
    1. may not be viewed in a negative way.
    2. must be diagnosed in terms of the patient's belief structure.
    3. occurs in a biopsychosocial context in response to health beliefs and practices.
    4. requires a specific treatment protocol regardless of the patient's belief system.
  2. The ANA position statement notes that knowledge of cultural diversity is vital to
    1. understand how cultural groups define health and wellness.
    2. explain to the patient the role of medication in managing illness.
    3. determine which family members to include in the decision-making process.
    4. decide on treatment for a specific illness.
  3. The Joint Commission developed new standards for culturally competent care in response to
    1. the ANA's position statement on cultural diversity.
    2. changes in Medicare regulations.
    3. the WHO's palliative care definition.
    4. the diverse needs of hospitalized patients.
  4. Which cultural group has a documented mistrust of the American healthcare system?
    1. Hispanics
    2. American Indians
    3. Black Americans
    4. Muslims
  5. Which cultural group islesslikely to formally prepare for the end of life?
    1. American Indians
    2. Eastern Europeans
    3. Muslims
    4. Black Americans
  6. What type of decision-making model is common in the Hispanic culture?
    1. The patient is the primary decision-maker.
    2. Decisions are made by immediate and extended family as a group.
    3. The family will defer to the physician for end-of-life decisions.
    4. The mother or matriarch is the primary decision-maker.
  7. Hispanics believe that planning for death
    1. will lead to its occurrence.
    2. is the best way to prevent an early death.
    3. is the responsibility of the entire family.
    4. should be done before illness occurs.
  8. Many Hispanics prefer to die
    1. privately, protecting their families from witnessing death.
    2. at home surrounded by family.
    3. in the hospital with medical care available.
    4. in the hospital with a clergyman in attendance.
  9. In the Chinese culture, the discussion of death
    1. occurs early in the treatment process.
    2. is usually considered forbidden and offensive.
    3. is designed to maintain hope and alleviate stress.
    4. must be directed by the head of the household.
  10. In traditional Chinese culture, who is responsible to provide care for the parents?
    1. eldest son
    2. youngest son
    3. eldest daughter
    4. youngest daughter
  11. Which of the following statements reflects the Muslim culture's view of death?
    1. Discussions about dying hasten death.
    2. Discussions of death and dying are forbidden.
    3. The decision for death comes from God.
    4. God determines death and therefore there is no need to seek medical attention when ill.
  12. Before discussing quality of life with the patient, the NP must first
    1. communicate with the patient's family.
    2. study the patient's culture.
    3. ask if he or she wishes to have the discussion.
    4. be self-aware.
  13. An interview with the patient about palliative care begins with questions about
    1. the meaning of life.
    2. the stage of the disease process.
    3. cultural influences.
    4. the patient's preferences for treatment.
  14. The goal of the palliative care interview is to
    1. establish trust, safety, and control.
    2. develop a treatment plan.
    3. support what the patient wants when the family is in opposition.
    4. help the patient accept that death is near.
  15. When discussing end-of-life care with the patient, the NP should always ask
    1. if an advance directive has been prepared.
    2. if the patient is ready to die.
    3. what the NP can do to help the patient achieve desired outcomes.
    4. if family and friends are supportive.
  16. In managing the patient's end-of-life care, the NP understands that
    1. the family knows what is best for the patient.
    2. the patient knows what is best for himself or herself.
    3. the physician makes the final care decisions.
    4. managing pain is the primary objective.
  17. Recommended communication techniques about end-of-life care include allexcept
    1. restructuring narratives.
    2. using metaphors.
    3. listening to meanings emerge.
    4. expecting culturally consistent responses.
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