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Quality Care for Diverse Populations

Each question has only one right answer.
1. Which of the following best represents an important motivation for providing more culturally competent health care?
A. Eliminating racial and ethnic health disparities.
B. Reducing liability and malpractice claims.
C. Improving quality of services and outcomes.
D. Meeting accreditation, contract and regulatory requirements.
E. All of the above.


2. Which of the following have been recommended as "National Standards for Culturally and Linguistically Appropriate Services in Health Care" by the U.S. Department of Health and Human Services, Office of Minority Health?
A. Health care organizations should ensure that staff at all levels and across all disciplines receive ongoing education and training in culturally and linguistically appropriate service delivery.
B. Health care organizations must offer and provide language assistance services, including bilingual staff and interpreter services, at no cost to each patient/consumer with limited English proficiency at all points of contact, in a timely manner during all hours of operation.
C. Health care organizations must provide to patients/consumers in their preferred language both verbal offers and written notices informing them of their right to receive language assistance services.
D. Health care organizations must assure the competence of language assistance provided to limited English proficient patients/consumers by interpreters and bilingual staff. Family and friends should not be used to provide interpretation services (except on request by the patient/consumer).
E. All of the above.


3. Which of the following mnemonics represents an interviewing technique that can be used by the clinician to develop rapport and elicit the psychosocial context for a patient's visit?
A. ETHNIC
B. TRANSLATE
C. SIGICAPS
D. BATHE
E. LEARN


4. Which of the following interpersonal communication issues is not considered to be primarily important to most Hispanic/Latino American patients?
A. Having a personal relationship with their physician or other health care provider.
B. Sharing similar sociocultural attitudes.
C. Being treated in a respectful manner.
D. Building trust.
E. Recognizing the importance of family relationships.


5. When caring for patients with limited English proficiency, which of the following resources is not considered an appropriate language assistance option?
A. Bilingual/bicultural employees.
B. Bilingual/bicultural community health workers.
C. Children, minors or other family members.
D. Professional medical interpreters.
E. Telephonic interpreter services.


6. The combined population of African Americans, Hispanic/Latino Americans and Asian Americans is expected to comprise the majority of the U.S. population by the middle of the 21st century.
A. True
B. False


7. What percentage of African American children and adolescents are considered clinically obese?
A. 10%
B. 15%
C. 18%
D. 22%
E. 30%


8. What percentage of obese African-American children become obese adults?
A. 5% to 15%
B. 20% to 24%
C. 25% to 50%
D. 51% to 60%


9. Which of the following diagnoses does not have a higher incidence in African Americans than the general U.S. population?
A. Type 2 diabetes
B. Hypertension
C. Overweight/obesity
D. Cancer
E. Cardiovascular disease


10. All of the following are components of the LEARN mnemonic except:
A. Listen
B. Explain
C. Acknowledge
D. Respond
E. Negotiate


11. According to population-based data, which of the following statements is false regarding lesbian and bisexual women?
A. They are at increased risk for breast cancer.
B. They are at decreased risk for ovarian cancer.
C. They are less likely to receive regular Papanicolaou (PAP) testing.
D. They are less likely to receive regular mammograms.


12. Transgender individuals have an increased risk for hypertension, cardiovascular disease and certain forms of cancer.
A. True
B. False


13. Lesbian and bisexual women are just as likely as women in the general population to report a regular source of health care and to have health care insurance.
A. True
B. False


14. Domestic violence is rarely seen in gay and lesbian patients.
A. True
B. False


15. Compared with the general population, gay, lesbian, bisexual and transgender patients are at decreased risk for depression and suicide.
A. True
B. False


16. All of the following are components of the ETHNIC mnemonic except:
A. Empathy
B. Treatment
C. Healers
D. Intervention
E. Collaboration


17. Which of the following is not characteristic of most Vietnamese American families?
A. Families typically have lived in the United States for several generations.
B. Many families emigrated from areas embroiled in conflict from World War II to the fall of Saigon in 1975.
C. Multiple generations of the family commonly live in the same household.
D. Elders hold a special position of respect within the family.


18. All of the following are spiritual faiths commonly practiced in Vietnam except:
A. Buddhism
B. Confucianism
C. Islam
D. Christianity


19. The current literature indicates that rates of depression and post-traumatic stress disorder are high among Vietnamese Americans.
A. True
B. False


20. Which of the following is not part of the recommended approach to interviewing American Indian or Native Alaskan patients?
A. Assessing readiness to discuss medical problems.
B. Setting the stage for discussion.
C. Discussing diagnostic or prognostic possibilities indirectly.
D. Considering including religious or indigenous healers in the treatment plan, if requested.
E. Addressing the patient in a direct manner with focused eye contact and a firm handshake at the beginning and end of the clinical encounter.


21. Traditional Navajo medicine may include:
A. Chanting
B. Prayer
C. Sand painting
D. Herbal remedies
E. All of the above


22. Discussions about mental and physical health, deviance, familial problems, and community structure and function among Native Americans must include, in some form or another, a discussion of the influence of alcohol use and abuse.
A. True
B. False


23. Indian youth who have higher levels of identification with their native culture may demonstrate lower drug and alcohol use and other unhealthful behaviors.
A. True
B. False


24. Lactose intolerance is common among American Indians.
A. True
B. False


25. Five-year survival rates after cervical cancer are significantly lower in American Indian women than among most other ethnic groups.
A. True
B. False