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Chapter 2: The Purnell Model for Cultural Competence
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____
1. Categorically imperative concepts of timeliness (being on time for appointments) are not shared by all
cultures. What should the health-care provider do to help ensure that the client is on time for appointments?
1. Ignore the issue; some people will never be timely.
2. Explain the importance of timeliness to treatments.
3. Inform them that they will not be seen if they are late.
4. Accept that they will be late and move on.
____
2. The nurse is using an interpreter to interview the parents of a 3-year-old with an earache. The nurse should
direct questions to
1. The father.
2. The mother.
3. The interpreter.
4. Both parents.
____
3. Techniques to determine oxygenation needs in dark-skinned people include
1. Examining the skin using indirect lighting.
2. Examining the palms of the hands.
3. Comparing darker and lighter parts of the body.
4. Pressing the skin and looking for blanching.
____
4. A taboo practice for pregnant women among many cultures is that they should not reach their hands over their
head while pregnant. This practice is believed to
1. Cause a miscarriage.
2. Make the delivery more difficult.
3. Cause the cord to wrap around the babyโs neck.
4. Decrease oxygenation to the fetus.
____
5. A 4-year-old boy was brought to the emergency department by the paramedics. The nurse notices that he has
a thin red cord tied around his wrist. The nurse should
1. Place it with the rest of his clothes.
2. Tape it in place.
3. Give it to the parents when they arrive.
4. Leave it in place or put it in the pocket of his pants.
____
6. Some individuals, regardless of cultural heritage, prefer traditional practitioners over Western allopathic
practitioners. The most likely explanation for this is
1. Traditional practitioners are usually known by the individual and more trusted.
2. Most individuals who prefer traditional practitioners cannot afford allopathic practitioners.
3. Traditional practitioners specialize in specific health conditions.
4. Traditional practitioners stress wellness and health promotion.
____
7. Which if the following is not one of the metaparadigm concepts in the Purnell Model for Cultural
Competence?
1. Family
2. Global society
3. Spirituality
4. Person
____
8. In a low-context language
1. Most of the message is implied.
2. Many words are used to express a thought.
3. Words are more important than nonverbal communication.
4. Voice volume and tone are low.
____
9. Discord occurs in the workforce in every culture. However, in a multicultural workforce discord can be
intensified because of issues related to all of the following except
1. Country of origin.
2. Differences in assertiveness.
3. Language differences.
4. Homogeneity.
____ 10. Cultural, ethnic, and racial diseases and illnesses can be grouped into three categories, which include all of the
following except
1. Environment.
2. Educational level of providers.
3. Genetics.
4. Lifestyle.
____ 11. In the more developed countries, which one has the highest rates of obesity?
1. United States
2. Canada
3. Sweden
4. Saudi Arabia
____ 12. Of the following statements regarding lactose intolerance, which is true?
1. White-skinned people are more likely to have lactose intolerance.
2. Dark-skinned people are more likely to have lactose intolerance.
3. There is no difference in lactose intolerance between white- and dark-skinned people.
4. Only people of Asian and American Indian descent have lactose intolerance.
____ 13. A taboo belief among many cultures is that a pregnant should not
1. Exercise.
2. Give in to cravings.
3. Reach over her head.
4. Engage in intercourse after the first trimester.
____ 14. An enlightened perspective in individualistic cultures is
1. Educational level of providers.
2. Access to care.
3. Affordability.
4. Patient autonomy.
____ 15. The difference between a translation and an interpretation is
1. Interpretation is verbal.
2. Translation is verbal.
3. There are no differences between translation and interpretation.
4. Interpretation is a higher level than translation.
Chapter 2: The Purnell Model for Cultural Competence
Answer Section
MULTIPLE CHOICE
1. ANS: 2
Feedback
1
2
3
4
Incorrect. Ignoring the lack of timeliness may continue to cause concerns for future
situations in which timeliness is important.
Correct. The importance of timeliness should be explained if timeliness is important.
Incorrect. Not seeing them if they are late demonstrates a lack of sensitivity and lacks
respect.
Incorrect. Ignoring the lack of timeliness may continue to cause concerns for future
situations in which timeliness is important. Given that some people are chronically late,
the importance of timeliness should still be explained if timeliness is important.
PTS: 1
2. ANS: 4
Feedback
1
2
3
4
Incorrect. Addressing questions only to the father shows a lack of respect for the
mother.
Incorrect. Addressing questions only to the mother shows a lack of respect for the
father.
Incorrect. The nurse should address the question to both parents, not the interpreter.
Correct. The nurse should address the question to both parents.
PTS: 1
3. ANS: 2
Feedback
1
2
3
4
Incorrect. This will not help to determine oxygenation needs. Direct lighting is
recommended.
Correct. This is the recommended technique for determining oxygenation needs in
dark-skinned people.
Incorrect. Comparing darker and lighter parts of the body will not help determine
oxygenation.
Incorrect. Pressing the skin and looking for blanching will not help determine
oxygenation.
PTS: 1
4. ANS: 3
Feedback
1
2
3
Incorrect. This is not a common belief.
Incorrect. This is not a common belief.
Correct. This is a common belief.
4
Incorrect. This is not a common belief.
PTS: 1
5. ANS: 2
Feedback
1
2
3
4
Incorrect. Amulets provide solace and should not be removed unless absolutely
necessary.
Correct. Amulets provide solace and should not be removed unless absolutely
necessary, so taping it in place to ensure that it is not lost is best.
Incorrect. Amulets provide solace and should not be removed unless absolutely
necessary.
Incorrect. Amulets provide solace and should not be removed unless absolutely
necessary.
PTS: 1
6. ANS: 1
Feedback
1
2
3
4
Correct. Traditional practitioners are usually known by the individual and more trusted.
Incorrect. The use of traditional practitioners is not correlated with socioeconomic
status.
Incorrect. Traditional healers do not generally specialize in specific health conditions.
Incorrect. Traditional healers treat conditions after they have occurred.
PTS: 1
7. ANS: 3
Feedback
1
2
3
4
Incorrect: Family is a metaparadigm concept.
Incorrect: Global society is a metaparadigm concept.
Correct. Spirituality is a domain.
Incorrect: Person is a metaparadigm concept.
PTS: 1
8. ANS: 1
Feedback
1
2
3
4
Correct. Low-context means most of the message is implied.
Incorrect. Low-context means few words are used to express a thought.
Incorrect. Low-context means that nonverbal is as important if not more important than
words.
Incorrect. Low-context communication may have loud or soft voice volume.
PTS: 1
9. ANS: 4
Feedback
1
Incorrect. Country of origin may cause discord.
2
3
4
Incorrect. Differences in assertiveness may cause discord.
Incorrect. Differences in language may cause discord.
Correct. Homogeneity does not cause discord.
PTS: 1
10. ANS: 2
Feedback
1
2
3
4
Incorrect. Environment can be a cause of illness and disease.
Correct. Educational level is not a cause of illness or disease.
Incorrect. Genetics can be a cause of illness or disease.
Incorrect. Lifestyle can be a cause of illness or disease.
PTS: 1
11. ANS: 1
Feedback
1
2
3
4
Correct. Of the countries listed, the United States has the highest rates of obesity.
Incorrect. Of the countries listed, the United States has the highest rates of obesity.
Incorrect. Of the countries listed, the United States has the highest rates of obesity.
Incorrect. Of the countries listed, the United States has the highest rates of obesity.
PTS: 1
12. ANS: 2
Feedback
1
2
3
4
Incorrect. Anyone can have lactose intolerance, but the incidence is lower in
white-skinned people.
Correct. African Americans, blacks, and American Indians have high rates of lactose
intolerance.
Incorrect. Anyone can have lactose intolerance, but the incidence is lower in
white-skinned people.
Black populations and people of Asian American and American Indian descent have
high levels of lactose intolerance.
PTS: 1
13. ANS: 3
Feedback
1
2
3
4
Incorrect. Whereas certain types of exercise might be discouraged in some cultures,
there is no taboo against exercise in general for a pregnant woman.
Incorrect. Many believe that the woman should give in to the craving; otherwise the
infant might be marked.
Correct. Several cultures believe that if the woman reaches over her head while
pregnant, it will cause the umbilical cord to wrap around the neck of the fetus.
Incorrect. Not engaging in intercourse after the first trimester is not a common taboo
belief.
PTS: 1
14. ANS: 4
Feedback
1
2
3
4
Incorrect. This is not an enlightened perspective of individualistic cultures.
Incorrect. Access to care is a desire of both collectivistic and individualistic culture.
Incorrect. Affordability of care is a desire of both collectivistic and individualistic
cultures.
Correct. Patient autonomy is a hallmark of individualistic cultures.
PTS: 1
15. ANS: 1
Feedback
1
2
3
4
Correct. Interpretation is verbal and translation is written.
Incorrect. Interpretation is verbal and translation is written.
Incorrect. Interpretation is verbal and translation is written.
Incorrect. Interpretation is verbal and translation is written.
PTS: 1
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