California Coast HCA 340 Final Exam

1. One of the results of the 2005 Hurricanes Katrina and
Rita in Louisiana has

been an increase in
the in? ux of Spanish-speaking workers. Incorporating

cultural and
linguistic competence to meet the health needs of this popula-

tion would include

a. having health care
professional staff from different Spanish-speaking

countries at health care facilities.

b. ensuring health
services are in varying locations.

c. ensuring that all
signage is posted completely in Spanish.

d. having all health
care workers speak Spanish.

2. A mechanism health care organizations need to incorporate
into their strate-

gic plan for
culturally and linguistically appropriate services includes

a. goals, policies,
accountability and oversight mechanisms addressing these

services.

b. partnerships with
community agencies.

c. mechanisms for
client service reimbursement.

d. staff con? ict
resolution policies.

3. Kwanzaa was created in the 1960s to raise awareness and
pride for the

African- American
community. While its tenets can be applied to all people,

this particular
celebration was developed to celebrate a speci? c

a. social class.

b. religion.

c. ethnicity.

d. cultural group.

4. Parish Nursing is an aspect of nursing that is becoming
more utilized. One of

the bases of parish
nursing is the premise that

a. it is easier to
provide health services to a de? ned religious community.

b. a faith community has an
impact on the health of its members.

c. illness is
prevented through parish nursing.

d. members of a
religion follow de? ned health practices.

5. After the Vietnam War, many Vietnamese immigrated to the
United States

and settled in areas
where they could maintain many of the cultural customs

and traditions of
Vietnam, including festivals, Saturday schools to educate

the children in the
Vietnamese language and planting communal gardens.

This is an example of

a. heritage consistency.

b. acculturation.

c. socialization.

d. religious preference.

6. A seminal event in the boomer generation that can still
elicit comment today

is the question

a. ”How did the
Challenger tragedy affect you?”

b. ”Where were you when John F.
Kennedy was shot?”

c. ”Do you remember
Pearl Harbor?”

d. ”What were you
doing on September 11, 2001?”

7. A complaint of the boomer generation about the following
generations

regards work ethic.
The “nester” generation born between 1979 and 1984 is

more likely to
embrace an ethic

a. of employer
loyalty.

b. seeking to ? t their
lifestyle.

c. seeking maximum ?
nancial gain.

d. loyal to one’s
skills in the marketplace.

8. The best outcome for health care facilities incorporating
cultural care into

their practices is

a. increased numbers
of clients seeking care at these facilities.

b. improved health outcomes for
the clients at these facilities.

c. better health care
provided by the facility’s staff.

d. increased
reimbursement by insurance companies for provided health

services.

9. An important consideration when making a home health
visit to a client is to:

a. give a general
idea of when the visit will be made.

b. bring a gift to
the client’s home on the initial visit.

c. just show up at
the client’s home.

d. inform the client the
approximate time the visit will be made.

10. Certain cultures place emphasis on eating speci? c foods
during pregnancy

and after childbirth
to ensure a healthy mother and infant. This cultural

phenomena is an
example of

a. time orientation.

b. environmental
control.

c. biological
variation.

d. social organization.

11. Touch is an important component of nursing, but using it
without under-

standing the client’s
cultural background can be a violation of their

a. social
organization.

b. environmental
control.

c. space and territoriality.

d. time orientation.

12. Before doing any teaching it is important the client
understands what is

being taught. The
most effective method to determine if the client under-

stands any health teaching
is by

a. ask the client if
they understand what was said in the teaching.

b. speaking slowly
and carefully to the client.

c. having the client repeat back
what was said in his/her own words.

d. interpreting the
client’s facial gestures.

13. Native Americans have a higher susceptibility to
diabetes than other popula-

tion groups within
the United States. This is considered a(n)

a. biological variation.

b. component of
heritage consistency.

c. social
organization pattern.

d. environmental
control.

14. While the Census Bureau has placed race as a
sociopolitical construct,

placing oneself into
a racial category can still present a challenge. Those

who consider
themselves “Creole” would be more likely to place themselves

into the category
labeled

a. White.

b. Asian.

c. Black or African American.

d. Hispanic or
Latino.

15. While shifts in the population pro? le are occurring,
what is an important

consideration to
address in health care?

a. More physicians
need to be trained to deliver health care.

b. Cultural health needs of
varying groups must be considered.

c. Health care
providers need to be younger to care for an aging population.

d. Health care needs
to be streamlined for consistent care delivery.6

16. With the percentage of the 65+ population greatest among
White non-His-

panics in the 2000
Census, health planning needs would indicate

a. there is no need
to increase manufacture of childhood immunizations.

b. cultural
accommodations for other minority groups can be decreased.

c. planning needs for
other segments of the population can be revised

downwards.

d. this population will have
greater demands on the health care system as

they age.

17. Twelve percent of the population in 2000 was age 65 or
over. Long-term

implications for
health for this group include

a. developing systems
to provide health care only to those older citizens who

remain healthy.

b. providing health care that is
focused on gerontological needs.

c. providing health
insurance for all age groups.

d. developing
medications to prolong life at any cost.

18. A hurdle immigrants face coming to a new country is

a. rejecting their
old customs in favor of new customs.

b. having their
children learn the customs of the new country.

c. ? nding their own
cultural group in the new country.

d. learning a new way of life
that differs from their former way of life.

19. In 1970, the highest percentage of foreign-born legal
permanent residents

becoming citizens
came from Europe. What is true today? The majority of

foreign-born legal
permanent residents are from

a. Asia.

b. Mexico, China, and the
Philippines.

c. Europe.

d. South America.

20. Many people who come to the United States to live seek to
get a “green

card.” The green card

a. confers automatic
U.S. citizenship.

b. legally restricts
the holder from becoming a citizen.

c. de? nes the person
as being in the country unlawfully.

d. allows the person legal
permanent residency.Final Examination

HCA 340 Cultural Diversity in Health and Illness

7

21. When seeking permanent U.S. citizenship, legal permanent
residents take a

naturalization exam
that questions them on

a. knowing the Pledge
of Allegiance.

b. being able to
recite or sing the national anthem.

c. elements of the U.S.
government.

d. the Congressional
district they live in.

22. Among the very real concerns for all residents of the
United States, citizens

and legal permanent
residents, is the rise in undocumented people entering

the country. What
impact is this having on health care?

a. Increased numbers of
undocumented people are straining health care

resources.

b. The rise in
undocumented people is contributing to the rise in exotic and

rare diseases in the
country.

c. There is a concern
that undocumented people will lead to bioterrorist at-

tacks.

d. Health insurance
is being given to all people in the country ensuring uni-

versal coverage.

23. One recognized deterrent to poverty is

a. the presence of two parents
in a family structure.

b. not needing to
have housing assistance.

c. not needing to
utilize food stamps.

d. living in a
household of a male income earner.

24. While income is not a restrictor for engaging in
health-promoting behaviors,

higher income
improves them through

a. living in better
housing.

b. membership in
health clubs in suburban areas.

c. increasing opportunities
through nutrition and access to facilities.

d. access to better
jobs.

25. Many people and groups have provided de?nitions of
health, but the most

widely used de?
nition is that from

a. Nightingale.

b. Rogers.

c. Murray and Zenter.

d. WHO (World Health
Organization

26. As people progress through a health profession education
program, de? ni-

tions of health
become

a. easier to explain
to others.

b. aligned with the
client seeking care.

c. more abstract and technical.

d. well articulated
and understandable.

27. In attempting to de?ne health, what can occur?

a. Listing categories
of health will enable understanding of health.

b. Ambiguity is
resolved when health de? nitions are discussed.

c. Terms and meanings can be
challenged by others.

d. A full acceptance
can be achieved by all parties.

28. Health status and determinants are used to

a. account for health
care expenditures.

b. enforce
legislation pertaining to health.

c. determine federal
dietary guidelines.

d. measure the health of a
nation.

29. Healthy People 2010 represents

a. health policies
providing monetary incentives to states who reach the

benchmark goals by
2010.

b. a plan to improve the health
of everyone in the United States in the ? rst

decade of this
century.

c. mandated
legislation that will result in a healthier population by 2010.

d. a monitoring
system evaluating the health of all citizens.

30. As with the many variant de?nitions of health, illness
also has many mean-

ings. Illness and the
sick role assigned to it are legitimized by

a. the insurance
company that pays for the illness treatment.

b. the person having
the illness.

c. the health care profession
that diagnoses the illness.

d. society’s view of
the illness.Final Examination

HCA 340 Cultural Diversity in Health and Illness

9

31. Among the sick role components is the

a. mandate of
appearing ill and suffering from the illness.

b. necessity of
taking medications and staying in bed.

c. exemption from performance of
certain normal social obligations.

d. refusal to look to
other sources of health care treatments beyond those

prescribed.

32. During the stage of patient status, it is expected that

a. symptoms are being
experienced, leading to a diagnosis.

b. the patient do all
they can do to recover from their illness.

c. the illness is now
socially recognized and identi? ed.

d. the person shifts into the
role as it is determined by society.

33. Assuming the sick role according to Suchman means the
person

a. is aware that
something is wrong and responds emotionally.

b. seeks scienti? c
con? rmation that something is wrong.

c. seeks help and shares the
problem with family and friends.

d. goes under the
control of a physician who plans a treatment of care.

34. A person who has cancer may have followed this illness
trajectory:

a. presenting
symptoms, followed by treatment and recovery.

b. acute illness, unstable
status, deterioration, and recovery.

c. diagnosis,
treatment, unstable status, death.

d. presenting
symptoms, followed by diagnosis and treatment.

35. When Suchman divides the illness experience into its
various stages, the

medical care contact
stage implies the person is

a. cognitively and
physically aware that something is wrong.

b. under medical
control and following a prescribed treatment protocol.

c. seeking scienti? c rather
than lay diagnosis in order to interpret what it all

means.

d. seeking help and
information from family and friends. 10

Final Examination

HCA 340 Cultural Diversity in Health and Illness

36. While HEALTH is considered a balance of the person,
ILLNESS would be

considered

a. the imbalance of one’s being
in and outside the world.

b. actual
symptomatology physically manifested.

c. part of the human
condition that all must experience.

d. the absence of
elements that contribute to health.

37. While complementary alternative medical (CAM) treatments
are used by

people of all
backgrounds, recent research indicates CAM use is greater by

a. men.

b. those who have
never been hospitalized.

c. people with
rudimentary education.

d. women.

38. Alternative medical traditions are considered

a. an essential
component of a cultural heritage medical tradition.

b. for use in concert
with other aspects of health care.

c. out of the realm of a
person’s cultural heritage medical tradition.

d. traditional
methods of health care.

39. The evil eye is de? ned differently by different
populations. Evil is thought to

be cast in the
Philippines through the

a. mouth or eye.

b. eye or touch.

c. foot.

d. breath.

40. The saying, “An apple a day keeps the doctor away, an
onion a day keeps

everyone away,” is
thought to protect HEALTH by

a. recognizing the
special antibiotic properties contained within onions.

b. advertising that
onions have special healing abilities.

c. protecting the person from
coming in contact with those who might be ill.

d. af? rming the
belief in the power of onions to prevent disease.Final Examination

HCA 340 Cultural Diversity in Health and Illness

11

41. Religion has an important role in HEALTH, and ILLNESS
can be considered

a. violating dietary
practices.

b. failure to wear
special amulets to ward it off.

c. a necessary part
of religious culture.

d. punishment for breaking a
religious code.

42. Eucalyptus is a folk herbal remedy that has applications
today. It is used for

a. nasal congestion and sore
throat.

b. infant colic.

c. toothache pain.

d. fever.

43. Allopathic medicine terms alternative treatments as
complementary or alter-

native. An
alternative therapy for rehabilitation might include ________ as

treatment.

a. macrobiotics

b. Santeria

c. Voodoo

d. biofeedback

44. The difference between complementary and alternative
medicine is that

complementary
medicine

a. can be used together with
allopathic medicine.

b. is never used with
allopathic medicine.

c. lessens a
patient’s discomfort with allopathic treatments.

d. replaces
allopathic medicine as a primary form of treatment.

45. A reason why people seek alternative care treatments is

a. allopathic treatments may
cause adverse effects that a person can’t toler-

ate.

b. training for
alternative care practitioners is closely regulated and licensed.

c. insurance
reimburses alternative care treatments at the same rate or bet-

ter than allopathic
treatments.

d. it has a better
empirical basis than do allopathic treatments.12

Final Examination

HCA 340 Cultural Diversity in Health and Illness

46. Many people of Catholic faith pray to ________ for the
grace of a happy

death.

a. St. Teresa of
Avila

b. St. John of God

c. St. Roch

d. St. Joseph

47. While shrines that attract pilgrims can be religious or
secular in nature, an

essential component
to all of them is the

a. feeling of peace and serenity
that is conducive to healing.

b. location of the
shrine.

c. presence of water
so pilgrims can take samples home.

d. numbers of people
who are attracted to that site.

48. Lourdes, France, is the site of a revered Roman Catholic
shrine. Many people

with illnesses visit
the shrine with the hope of

a. becoming more
prosperous.

b. gaining a better
job.

c. receiving a cure through a
miracle.

d. being able to live
a long life.

49. Historically, early forms of HEALING for illness were
equated with

a. performing set
rituals to prevent illness.

b. ? nding the person
causing the illness.

c. sacri? cial
offerings.

d. removing the evil causing the
illness.

50. Among alternative treatment modalities utilized during
an illness may be the

a. consultation of a healer
outside the medical establishment.

b. strict adherence
to the prescribed medical regimen.

c. willingness to
seek a second medical opinion.

d. refusal to allow
any medical treatment to be performed.

51. A potential explanation for healers being used in
addition to or instead of

traditional medical
personnel is their

a. unique language
that is characteristic of their calling.

b. exclusive dialogue
with the person who is ill.

c. formal
relationship with the client.

d. willingness to be available
at any time.Final Examination

HCA 340 Cultural Diversity in Health and Illness

13

52. An illness of the spirit is treated through repentance and
is considered

a. physical healing.

b. spiritual healing.

c. inner healing.

d. deliverance.

53. The six-week postpartum check that women have after
having a baby closely

matches the crucial
________ day practice of ancient times.

a. seventh

b. fortieth

c. third

d. tenth

54. Baptism dates for children have signi?cance within
various religions. Water

is the common element
in baptism as water signi?es

a. protecting the
child from illness.

b. cleansing the child either
from evil or other maladies.

c. the relation of
the child to God.

d. dedication of the
child to a family group.

55. Wearing white clothes in the Buddhist tradition
indicates

a. mourning the death of a
relative.

b. recognition of a
religious holiday.

c. joy for the birth
of an infant.

d. celebration for a
marriage.

56. The decline in the use of patent medicine utilization in
the United States

began with

a. the passage of the Food and
Drug Act.

b. increased
popularity of over-the-counter medicines.

c. the rise in
alternative health care practitioners.

d. Medicare
reimbursement for prescription medications.

57. An important health protection practice among Black
American Baptists is

a. drinking blackstrap molasses.

b. eating fresh
lemons.

c. wearing camphor
around the neck in the winter.

d. taking a daily
shot of whiskey. 14

Final Examination

HCA 340 Cultural Diversity in Health and Illness

58. Chicken soup is considered a universal HEALTH
restoration intervention in

which tradition?

a. French

b. Paci? c Islander

c. Eastern European Jewish

d. Italian

59. As a HEALTH maintenance practice, the use of cod liver
oil is advocated by

those of the

a. German Catholic
tradition.

b. Italian Catholic
tradition.

c. Iranian (U.S.)
Islamic tradition.

d. English Episcopal tradition.

60. A HEALTH protection practice among Irish-American
Catholics is drinking

a. senna tea.

b. yeast.

c. hot peppermint
tea.

d. wine daily.

61. Fr. John’s medicine is suggested as a HEALTH protection
practice from No-

vember to May for

a. English American
Episcopalians.

b. Canadian Catholics.

c. Native American
Baptists.

d. Italian American
Catholics.

62. Among the HEALTH restoration practices for menstrual
cramps for Irish–

American Catholics is

a. applying Vicks on
the abdomen.

b. drinking cod liver
oil in orange juice.

c. applying warm oil
to the stomach.

d. drinking hot milk sprinkled
with ginger.

63. Activities for HEALTH maintenance for Swedish-American
Protestants

include

a. walking distances on a
regular basis.

b. dressing
appropriately for the weather.

c. going to a
physician twice a year whether needed or not.

d. starting each day
with prayer.Final Examination

HCA 340 Cultural Diversity in Health and Illness

15

64. While dressing properly for season and weather is an
important HEALTH

protection practice
for Iranian-American Moslems, it is also important to

a. keep onions under
the bed to keep nasal passages clear.

b. eat sorghum
molasses.

c. keep feet from getting wet in
the rain.

d. prevent evil
spirits by not looking at a mirror at night.

65. A constant for any culture is the

a. ability for it to
change quickly to adjust to new challenges.

b. requirement that
all members of the culture act the same.

c. socialization into its
traditions, language and practices.

d. necessity for its
members to be homogenous in all their decisions.

66. Socialization into the health care culture includes an assumption
that

a. effective treatment can only
be done by educated and licensed profes-

sionals.

b. the more
technological the intervention, the greater bene? t it yields.

c. interventions for
health events must follow a prescribed protocol.

d. alternative
complementary treatments have validity.

67. Contemporary per capita U.S. health care expenditures
are expected to

a. increase as part of the
overall gross domestic product.

b. decrease as health
care becomes available for all citizens.

c. match those of
other Western countries.

d. have the United
States achieve the highest health status in the world.

68. Speci?ed government efforts for health insurance have
resulted in

a. decreasing the
amount that Medicare covers for prescription medications.

b. decreasing the percentage of
uninsured children under age 18.

c. increasing
coverage for prenatal and well-baby care.

d. increasing the
percentage of uninsured children under age 18.16

Final Examination

HCA 340 Cultural Diversity in Health and Illness

69. Technology and scienti? c advances in health care have
resulted in more

conditions being
treated than in previous decades. The most expensive costs

for care are for
which conditions?

a. Cardiac disease

b. Conditions resulting in transplantation

c. Diabetes care

d. Pulmonary disease

70. In the early part of the twentieth century, health care
efforts focused on con-

trolling infectious
diseases and improving

a. maternal and child
health.

b. the requirements
of the medical profession.

c. chronic diseases.

d. health care costs.

71. The United State relies heavily on guest worker/migrant
labor for its agricul-

ture industry. Health
care can be offered for this population but faces a

potential barrier of

a. language.

b. access.

c. racism.

d. homelessness.

72. What differentiates CULTURALCARE from modern medical
care in philoso-

phy is that

a. suf? cient money,
technology and science are used to cure or remedy.

b. premature death
must be avoided.

c. holistic care is predicated
on cultural health traditions and needs.

d. disease and injury
are avoided through health promotion and mainte-

nance.

73. HEALTH for American Indians has a basis in the

a. curing of those
conditions that affect the spirit.

b. respecting of
others’ beliefs in healing traditions.

c. harmony between nature and
the ability to survive.

d. optimism that life
creates positive forces.

74. Evil spirits are associated with illness by the

a. Sioux.

b. Cherokee.

c. Passamaquoddy.

d. Hopi. Final
Examination

HCA 340 Cultural Diversity in Health and Illness

17

75. In determining the cause for illness, medicine men and
women look for the

a. dietary practices
of the person being seen.

b. past medical
history as a determinant.

c. spiritual cause of the
problem of the person seen.

d. physical symptoms
displayed.

76. Use of sand paintings as diagnosis in the Navajo
tradition helps to

a. provide an
atmosphere of calming for the medicine man.

b. determine cause and treatment
of the illness.

c. ensure that
appropriate payment is made by the family.

d. create symbolic
representations of the client and family.

77. A sequela related to alcohol abuse in American Indians
is the rise in

a. malnourishment
among children.

b. breast cancer
rates.

c. domestic violence against
women.

d. unintentional
injuries.

78. The provision of health services through the Indian
Health Service means

a. having one master
health guideline blueprint for consistency of care.

b. partnering and assisting
tribes in planning the best delivery of care.

c. allotting health
resources based on population numbers.

d. following
prescribed federal guidelines and procedures.

79. Comparing household income levels of $150,000 or more
within the Asian

subpopulations, the
population that has the higher income level is

a. Chinese.

b. Filipino.

c. Indian.

d. Indonesian. 18

Final Examination

HCA 340 Cultural Diversity in Health and Illness

80. The initial impetus for Asian immigration to the United
States, speci?cally

with the Chinese
population, resulted from the

a. favorable
immigration status for the Chinese.

b. high unemployment
rates in China.

c. need for cheap labor building
railroads in the nineteenth century.

d. demand for menial
service jobs.

81. A second-class physician in Chinese medicine:

a. pays the patient’s
family if the patient dies.

b. has to wait for patients to
become ill before treating them.

c. consults Taoist
writings for diagnosis and prescription.

d. receives payment
only if the patient is cured.

82. The health and disease beliefs in Ayurveda teach that

a. humans are
distinct beings within the universe.

b. disease arises when a person
is out of harmony with the universe.

c. at birth, people
are not in balance and their lives are spent getting into

balance with the
universe.

d. living and
nonliving things have minor connections with one another.

83. Feeling the pulse is important for a Chinese physician
because it

a. can help re? ne a
diagnosis.

b. is only felt on
the wrist.

c. indicates a speci?
c treatment.

d. is considered the storehouse
of the blood.

84. In acupuncture, needles are inserted at predetermined
points called merid-

ians because

a. puncturing the meridians
helps to restore yin and yang balance.

b. the best
anesthetic response is done through meridian puncture.

c. meridians
represent speci? c yin and yang points.

d. only speci? c
needles can puncture the meridians.

85. While Blacks are represented in every socio-economic
group, the percentage

of those living in
poverty in 2005 was approximately

a. thirty percent.

b. twenty percent.

c. ? fty percent.

d. twenty-? ve percent.
Final Examination

HCA 340 Cultural Diversity in Health and Illness

19

86. Speaking a language other than English at home is
highest among immi-

grants from

a. Nigeria.

b. Somalia.

c. Sudan.

d. Niger.

87. A diabetic Muslim may refuse insulin

a. because it implies
the person has not led a holy life.

b. because any
injectable medication is forbidden.

c. during Ramadan.

d. if it has a pork base.

88. The leading authority ?gure within the Black familial
structure is the

a. oldest adult
child.

b. female.

c. male.

d. minister.

89. When a Black person is being examined, skin pallor can
be recognized by

a. palpation.

b. checking the
sclera.

c. the absence of underlying red
tones.

d. slow blood return.

90. Scars that form at a wound site growing beyond the
normal boundaries of the

wound are

a. melasma.

b.
pseudofolliculitis.

c. keloids.

d. a pigmentary
disorder.20

Final Examination

HCA 340 Cultural Diversity in Health and Illness

91. Educational comparisons of high school graduation and
college attendance

between Hispanics and
non-Hispanic whites indicate

a. Hispanics have a lower rate
of graduation and attendance than their

non-Hispanic counterparts.

b. similar percentages
of attendance between both groups.

c. more Hispanics
attend college than their non-Hispanic counterparts.

d. a higher
proportion of non-Hispanic whites fail to complete high school.

92. The largest Hispanic group in the United States comes from
Mexico. Which

is a true statement
re? ecting this population?

a. Employment levels
are above the national average.

b. Employment in
professional areas is stagnant.

c. Migrant farm work
is the predominant employment.

d. Most live in urban areas.

93. Visiting a curandero(a) implies a person is seeking

a. holistic care encompassing
social, physical, and psychological purposes.

b. care not offered
by the medical establishment.

c. care for spiritual
distress.

d. specialized herbal
preparations not used by the medical establishment.

94. Teas used to treat mental illnesses in the Hispanic
population are herbs

common in the United
States. Yerba buena is an herb used to treat nervous-

ness. Its English
name is

a. spearmint.

b. basil.

c. orange leaves.

d. chamomile.

95. The percentage of live births to women receiving
third-trimester or no prena-

tal care is higher
for Hispanics than the general population. This would

imply that

a. more prenatal services
are needed for the general population.

b. some prenatal care
is better than no prenatal care.

c. Hispanics possibly have
better self-care prenatal practices than the gen-

eral population.

d. live birth rates
would be comparable if all women received appropriate

prenatal care.21

Final Examination

HCA 340 Cultural Diversity in Health and Illness Explanation & Answer

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