1. This document provides a guarantee for passing the HCA340 final exam with all questions answered correctly. It then lists 31 multiple choice questions covering topics related to cultural competence in healthcare, including considerations for different ethnic groups, immigrants, definitions of health, and social determinants of health. 2. Key concepts covered in the questions include how healthcare organizations can provide culturally and linguistically appropriate services, celebrations developed for specific ethnic groups, parish nursing being based on the premise of how faith impacts health, and health status and determinants being used to measure the health of a nation. 3. The questions also address challenges immigrants face in a new country, the rising number of undocumented immigrants impacting healthcare resources, and

1. HCA340 FINAL EXAM (A++++++) GUARANTEE
QUESTIONJAN 15, 2017HCA340 FINAL EXAM (A++++++) GUARANTEEQuestion1. One of
the results of the 2005 Hurricanes Katrina and Rita in Louisiana has been an increase in the
influx of Spanish-speaking workers. Incorporating cultural and linguistic competence to
meet the health needs of this population would includea. 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 strategic plan for culturally and linguistically
appropriate services includesa. 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
specifica. 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
thata. 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 ofa. 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 questiona. ”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 ethica. of employer loyalty.b. seeking to fit their
lifestyle.c. seeking maximum financial gain.d. loyal to one’s skills in the marketplace.8. The
best outcome for health care facilities incorporating cultural care into their practices isa.
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

2. 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
ofa. time orientation.b. environmental control.c. biological variation.d. social
organization.11. Touch is an important component of nursing, but using it without
understanding the client’s cultural background can be a violation of theira. 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 understands any health teaching is bya. 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 population 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
labeleda. White.b. Asian.c. Black or African American.d. Hispanic or Latino.15. While shifts in
the population profile 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.616. With the percentage of the 65+ population greatest among White non-
Hispanics in the 2000 Census, health planning needs would indicatea. 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 includea. 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 isa. rejecting their old customs in favor of new customs.b. having their children
learn the customs of the new country.c. finding 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 froma. 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 carda.
confers automatic U.S. citizenship.b. legally restricts the holder from becoming a citizen.c.
defines the person as being in the country unlawfully.d. allows the person legal permanent

3. residency.21. When seeking permanent U.S. citizenship, legal permanent residents take a
naturalization exam that questions them ona. 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 attacks.d. Health insurance is being given to
all people in the country ensuring universal coverage.23. One recognized deterrent to
poverty isa. 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 througha. 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 definitions of
health, but the most widely used definition is that froma. Nightingale.b. Rogers.c. Murray
and Zenter.d. WHO (World Health Organization26. As people progress through a health
profession education program, definitions of health becomea. 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 define health, what can occur?a. Listing categories of
health will enable understanding of health.b. Ambiguity is resolved when health definitions
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 toa. 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 representsa. 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
definitions of health, illness also has many meanings. Illness and the sick role assigned to it
are legitimized bya. 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.31. Among the sick role components is thea. 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 thata. 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
identified.d. the person shifts into the role as it is determined by society.33. Assuming the
sick role according to Suchman means the persona. is aware that something is wrong and
responds emotionally.b. seeks scientific confirrmation that something is wrong.c. seeks help
and shares the problem with family and friends.d. goes under the control of a physician who

4. 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
isa. cognitively and physically aware that something is wrong.b. under medical control and
following a prescribed treatment protocol.c. seeking scientific c rather than lay diagnosis in
order to interpret what it all means.d. seeking help and information from family and friends.
1036. While HEALTH is considered a balance of the person, ILLNESS would be considereda.
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 bya. men.b. those who have never been hospitalized.c. people with rudimentary
education.d. women.38. Alternative medical traditions are considereda. 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 defined differently by different populations. Evil is
thought to be cast in the Philippines through thea. 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 bya. 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.
affirming the belief in the power of onions to prevent disease.41. Religion has an important
role in HEALTH, and ILLNESS can be considereda. 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 fora. nasal congestion and sore throat.b. infant colic.c. toothache pain.d. fever.43.
Allopathic medicine terms alternative treatments as complementary or alternative. An
alternative therapy for rehabilitation might include ________ as treatment.a. macrobioticsb.
Santeriac. Voodood. biofeedback44. The difference between complementary and alternative
medicine is that complementary medicinea. 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 isa. allopathic treatments may cause
adverse effects that a person can’t tolerate.b. training for alternative care practitioners is
closely regulated and licensed.c. insurance reimburses alternative care treatments at the
same rate or better than allopathic treatments.d. it has a better empirical basis than do
allopathic treatments.46. Many people of Catholic faith pray to ________ for the grace of a
happy death.a. St. Teresa of Avilab. St. John of Godc. St. Rochd. St. Joseph47. While shrines
that attract pilgrims can be religious or secular in nature, an essential component to all of
them is thea. 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

5. 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 ofa. 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 witha. performing set rituals
to prevent illness.b. finding the person causing the illness.c. sacrificial offerings.d. removing
the evil causing the illness.50. Among alternative treatment modalities utilized during an
illness may be thea. 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 theira. 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.52. An illness of the spirit is treated through repentance and is considereda. 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. seventhb. fortiethc. thirdd. tenth54. Baptism dates for children have
significance within various religions. Water is the common element in baptism as water
signifiesa. 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 indicatesa. 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 witha. 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 isa. drinking blackstrap molasses.b. eating fresh lemons.c.
wearing camphor around the neck in the winter.d. taking a daily shot of whiskey.58.
Chicken soup is considered a universal HEALTH restoration intervention in which
tradition?a. Frenchb. Pacific Islanderc. Eastern European Jewishd. Italian59. As a HEALTH
maintenance practice, the use of cod liver oil is advocated by those of thea. 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 drinkinga.
senna tea.b. yeast.c. hot peppermint tea.d. wine daily.61. Fr. John’s medicine is suggested as
a HEALTH protection practice from November to May fora. 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 isa. 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 includea. 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.64. While dressing
properly for season and weather is an important HEALTH protection practice for Iranian-
American Moslems, it is also important toa. keep onions under the bed to keep nasal

6. 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 thea. 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 thata. effective treatment can only be done by educated
and licensed professionals.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 toa. 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.
Specified government efforts for health insurance have resulted ina. 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 18.69. Technology and scientific
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 diseaseb.
Conditions resulting in transplantationc. Diabetes cared. Pulmonary disease70. In the early
part of the twentieth century, health care efforts focused on controlling infectious diseases
and improvinga. 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 agriculture industry. Health care can be offered for this
population but faces a potential barrier ofa. language.b. access.c. racism.d. homelessness.72.
What differentiates CULTURALCARE from modern medical care in philosophy is thata.
sufficient 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 maintenance.73. HEALTH for
American Indians has a basis in thea. 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 thea. Sioux.b. Cherokee.c. Passamaquoddy.d. Hopi.75. In determining the cause for
illness, medicine men and women look for thea. 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 toa. 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 ina. 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 meansa. 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

7. 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 isa. Chinese.b. Filipino.c. Indian.d. Indonesian.80. The initial impetus for Asian
immigration to the United States, specifically with the Chinese population, resulted from
thea. 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 thata. 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 ita. can help refine a diagnosis.b. is
only felt on the wrist.c. indicates a specific treatment.d. is considered the storehouse of the
blood.84. In acupuncture, needles are inserted at predetermined points called meridians
becausea. puncturing the meridians helps to restore yin and yang balance.b. the best
anesthetic response is done through meridian puncture.c. meridians represent specific yin
and yang points.d. only specific 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 approximatelya. thirty percent.b. twenty percent.c. fifty percent.d. twenty-five
percent.86. Speaking a language other than English at home is highest among immigrants
froma. Nigeria.b. Somalia.c. Sudan.d. Niger.87. A diabetic Muslim may refuse insulina.
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 figure within
the Black familial structure is thea. oldest adult child.b. female.c. male.d. minister.89. When
a Black person is being examined, skin pallor can be recognized bya. 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 area. melasma.b.
pseudofolliculitis.c. keloids.d. a pigmentary disorder.91. Educational comparisons of high
school graduation and college attendance between Hispanics and non-Hispanic whites
indicatea. Hispanics have a lower rate of graduation and attendance than theirnon-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 reflecting 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 seekinga. 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 nervousness. Its English name isa. spearmint.b.

8. basil.c. orange leaves.d. chamomile.95. The percentage of live births to women receiving
third-trimester or no prenatal care is higher for Hispanics than the general population. This
would imply thata. 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 general population.d. live birth rates would be comparable if all
women received appropriate prenatal care.96. In examining the median age of population
groups, the oldest group isa. African Americans.b. Hispanics.c. Whites.d. Native
Americans.97. While German Americans believe in the germ theory of infection, another
potential cause of ILLNESS can bea. stress-related occurrences.b. envy by others toward
that person.c. a voodoo curse.d. unholy actions done in life.98. Treating a cough in the
German tradition may includea. eating chicken soup.b. putting wet warm compresses on the
chest.c. drinking lemon juice and whiskey.d. rubbing goose grease on the chest.99. To treat a
cough, a traditional Polish remedy isa. taking garlic oil.b. a mustard plaster on the chest.c.
drinking hot lemonade with whiskey.d. goose grease rubbed on the throat.100. When
compared to all races, the White population has a highera. percentage of low birth-weight
infants.b. percentage of women receiving prenatal care.c. infant mortality rate.d. crude birth
rate.