Dental Hygiene Theory and Practice, 4th edition by Michele Leonardi Darby

Dental Hygiene Theory and Practice, 4th edition by Michele Leonardi Darby

Chapter 06: Cultural Competence
Darby & Walsh: Dental Hygiene: Theory and Practice, 4th Edition

MULTIPLE CHOICE

1. Statement 1: Symbols can play an important role in culture. Statement 2: Culture is set by historical developments and will not change.
a. Statement 1 is correct; statement 2 is incorrect.
b. Statement 1 is incorrect; statement 2 is correct.
c. Statements 1 and 2 are both correct.
d. Statements 1 and 2 are both incorrect.

ANS: A
Symbols, rituals, and practices are prominent features of cultures. Cultures are complex and their basic characteristics quite often are historically determined, but cultures are developing and changing continuously.

REF: Culture, Cultural Competence, and Cultural Sensitivity | 71

2. Statement 1: Ethnic identity describes the common cultural, historic, and geographic experiences of a group. Statement 2: Individuals of a group who share an ethnic identity also share the same attitude, interests, and dialects.
a. Statement 1 is correct; statement 2 is incorrect.
b. Statement 1 is incorrect; statement 2 is correct.
c. Statements 1 and 2 are both correct.
d. Statements 1 and 2 are both incorrect.

ANS: A
A larger group may share common cultural, historic and geographic experiences (ethnic identity), but the individuals within the primary culture may belong to various different subcultures. Within any group, heterogeneity is more likely than homogeneity.

REF: Culture, Cultural Competence, and Cultural Sensitivity | 71

3. Statement 1: Complex societies are homogenous. Statement 2: Immigrants of the first generation share the same culture as the second or third generation of immigrants.
a. Statement 1 is correct; statement 2 is incorrect.
b. Statement 1 is incorrect; statement 2 is correct.
c. Statements 1 and 2 are both correct.
d. Statements 1 and 2 are both incorrect.

ANS: D
Complex societies are never homogenous; people will almost always form separate subgroups with their own features. Culture is a dynamic process, and traditional cultures (first immigrants) can differ from newly acquired cultures of the second or third generation of immigrants).

REF: Culture, Cultural Competence, and Cultural Sensitivity | 71

4. Statement 1: Beliefs and practices within a culture do not influence the access to healthcare services. Statement 2: The way people make sense of illness is in part culturally determined.
a. Statement 1 is correct; statement 2 is incorrect.
b. Statement 1 is incorrect; statement 2 is correct.
c. Statements 1 and 2 are both correct.
d. Statements 1 and 2 are both incorrect.

ANS: B
Health and illness are not only physical conditions. Culture can contribute to how members of a specific group determine how causes of illness can be explained and to whom they turn to if they become ill. These beliefs can facilitate or act as barriers to accessing healthcare services.

REF: Culture and Health | 71

5. At the first oral care visit, the culturally sensitive oral health professional should:
a. first assess the core values of the group to which the client belongs.
b. base his or her judgment on the characteristics of the specific culture to which the client belongs.
c. assesses the core cultural values for each client individually rather than focusing on the group to which the client belongs.
d. apply stereotyping as a tool to determine the possible core values of the client.

ANS: C
It is important to assess the core values for each individual client to identify the areas of potential cultural differences with the clients and not just those who appear to belong to different groups. It is the opposite of stereotyping.

REF: Box 6-2: Guidelines for Cross-Cultural Dental Hygiene | 77

6. Stereotyping:
a. is effective in a strange environment with new people to ascertain the characteristics of a member of a particular group.
b. can be described as an inaccurate, biased assessment of another human being based on group characteristics.
c. is an essential step in analyzing cultural differences.
d. recognizes the uniqueness of the individual and allows an accurate perception of the individual.

ANS: B
Stereotyping fails to recognize the uniqueness of the individual and prevents an accurate perception of those who appear different. It is a biased opinion. Stereotyping should not be promoted as a strategy.

REF: Culture and Health | 72

7. Cultural competence starts with:
a. awareness of the client’s background and cultural beliefs and values.
b. understanding the client’s perspective and social context.
c. applying a variety of communication skills to appeal to the client’s identity.
d. awareness of one’s own cultural beliefs and practices.

ANS: D
Cultural competence begins with the awareness of one’s own cultural beliefs and practices, and the recognition that others believe in different truths/realities than one’s own. Cultural competence starts with self-exploration, as well as awareness and elimination of one’s own biases.

REF: Developing Cultural Competence | 72

8. Statement 1: Patients are usually willing to share their ideas and customs with those who express a willingness to understand them. Statement 2: The clinician should assume the presence of cultural differences, and therefore, the clinician needs extensive knowledge of every cultural practice and belief.
a. Statement 1 is correct; statement 2 is incorrect.
b. Statement 1 is incorrect; statement 2 is correct.
c. Statements 1 and 2 are both correct.
d. Statements 1 and 2 are both incorrect.

ANS: A
“If you don’t ask, you won’t know.” By displaying genuine interest in the client and by asking a client to share beliefs, clinicians can increase their cultural knowledge as they practice. Extensive knowledge is not needed. It is most important to develop the understanding that each client’s preferences and values are unique.

REF: Culture and Health | 72

9. An equitable, culturally sensitive environment is characterized by:
a. the care provider initiating a cultural encounter.
b. reciprocal inquiry between the client and care provider.
c. the client initiating sharing information about his or her cultural beliefs.
d. the care provider tailoring the information to the mindset of the client.

ANS: B
The goal of effective communication is to maximize the understanding between the communicators. To communicate effectively, both parties have to move beyond cultural biases that could create barriers in care. In the most ideal situation, cross-cultural communication is a means of reciprocal inquiry. This means that both the care provider and client inform each other about their beliefs and expectations.

REF: Maximizing Effectiveness of Cross-Cultural Communication | 74

10. A client from a collectivist environment:
a. makes decisions about the proposed treatment on his or her own.
b. likes to discuss the treatment options with the healthcare provider alone.
c. prefers a “doctor-centered” approach.
d. might not display the characteristics of the group and therefore might make a decision on his or her own.

ANS: D
It is important to realize that individual clients from both collectivist and individualist cultures might have different point of views. It is the responsibility of the clinician to identify the client’s preference for shared decision making and to incorporate those preferences into the care provided.

REF: Shared Decision Making in Cross-Cultural Settings | 75

11. Ignoring or devaluing the models and practices embedded in other cultures can be described as:
a. evidence-based practice.
b. ethnocentrism.
c. stereotyping.
d. bias.

ANS: B
Demonstrating willingness to cooperate with alternative healers or incorporate traditional treatments can be important. Ignoring or devaluing the models and practices embedded in other cultures can be described as ethnocentrism and leads away from best practices in healthcare.

REF: Culture and Health | 72

12. A mother is standing beside her child in the dental office. The child is experiencing a terrible toothache. The mother is crying. She wants to know why God is doing this to her child. What would be the best response of the care provider?
a. Explain to her that God has nothing to do with the cause of this toothache.
b. Explain to her that she is making the child anxious.
c. Listen actively and allow her to express her feelings.
d. Do not pay too much attention to her crying, but focus on the child and try to examine the cause of the toothache.

ANS: C
By allowing the client to express her feelings, the oral health professional learns more about the client’s perspective and beliefs. This allows respectful communication and a suitable explanation of the possible causes. Culturally sensitive care is based on mutual respect and understanding. The other alternatives do not display respect to the cultural beliefs of the mother.

REF: Building Relationships | 74

13. Nonverbal communication is important in a culturally sensitive environment. The clinician should be sensitive to:
a. gestures.
b. eye contact.
c. personal space.
d. all of the above.

ANS: D
Cultural differences might be experienced in relation to various forms of nonverbal communication including gestures, handshakes, eye contact, or physical proximity. Follow the client’s lead and explore his or her expectations and beliefs.

REF: Nonverbal Communciation | 74-75

14. If a client does not speak the language of the care provider, the best strategy to interact would be to:
a. use a medical interpreter with no relationship to the client.
b. speak slowly and ask client if he or she understands the instructions.
c. ask a family member to translate.
d. use body language to communicate you care.

ANS: A
When language is a barrier, it is most appropriate to use a medical interpreter with no relationship to the client.

REF: Verbal Communication | 70

15. Statement 1: Health care literacy is the ability to understand health or disease. Statement 2: Poverty is not a barrier to access healthcare.
a. Statement 1 is correct; statement 2 is incorrect.
b. Statement 1 is incorrect; statement 2 is correct.
c. Statements 1 and 2 are both correct.
d. Statements 1 and 2 are both incorrect.

ANS: A
Health care literacy refers to understanding of the ability to understand how the healthcare system works. Poverty is a major barrier to healthcare access and prevents individuals from meeting their basic human needs for systemic and oral health.

REF: Healthcare Literacy | 77

16. Statement 1: Poverty is associated with poor oral health. Statement 2: Being part of an ethnic majority group leads a person to have poor oral health.
a. Statement 1 is correct; statement 2 is incorrect.
b. Statement 1 is incorrect; statement 2 is correct.
c. Statements 1 and 2 are both correct.
d. Statements 1 and 2 are both incorrect.

ANS: A
Children with the most advanced oral disease are found within minority, poor, homeless, and immigrant populations. Therefore, poverty has a strong association with poor oral health. It is important to realize that within all racial/ethnic groups that there are substantial differences in beliefs and behaviors. This inevitably leads to varying degrees of health status.

REF: Healthcare Literacy | 77

17. When adapting behavioral interventions for minorities, it is important to:
a. use community recourses to publish the intervention and to increase accessibility.
b. identify barriers to access and participation.
c. couple the initiatives with culturally accepted values or respected figures.
d. do both a and c.
e. do a, b, and c.

ANS: E
It is very important to identify barriers to access and participation before implementing behavioral interventions using community resources. When possible, coupling initiatives with culturally accepted values and respected figures maximizes uptake and efficacy. All alternatives are correct.

REF: Implementation Phase | 77

18. Statement 1: Culturally sensitive care starts with the care provider exploring the cultural beliefs of the client. Statement 2: Cultural differences occur in every clinical encounter.
a. Statement 1 is correct; statement 2 is incorrect.
b. Statement 1 is incorrect; statement 2 is correct.
c. Statements 1 and 2 are both correct.
d. Statements 1 and 2 are both incorrect.

ANS: B
The care provider should become aware of her or his own bias and perceptions before the clinical encounter with a client. Since oral health professionals have their own professional culture, it is expected that there will always be some sort of cultural difference between the care provider and the client.

REF: Developing Cultural Competence | 72-73

19. A 42-year-old female client brought her 14-year-old son to a first appointment with an oral health professional. The oral health professional plans to obtain a medical history, but the client and the clinician do not speak the same language. The client’s son offers to be the interpreter. Which answer is the most appropriate solution?
a. The clinician agrees with the proposal and is happy with this efficient solution.
b. The clinician prefers an official interpreter, which can be arranged by phone.
c. The clinician uses a medical history in the language of the client and asks the client to complete the questionnaire.
d. The clinician refers the client to a different dental office at the other side of the city, where the oral health professional speaks the language of the client.

ANS: B
A family member as interpreter can be unreliable due to personal and confidentiality issues. In some cases, the client or the family member in the role of interpreter can be embarrassed with the information provided. Misinterpretation of the information by family members can also occur, which can lead to incorrect diagnoses.

REF: Verbal Communication | 74

Chapter 06: Cultural Competence
Darby & Walsh: Dental Hygiene: Theory and Practice, 4th Edition

MULTIPLE CHOICE

1. Statement 1: Symbols can play an important role in culture. Statement 2: Culture is set by historical developments and will not change.
a. Statement 1 is correct; statement 2 is incorrect.
b. Statement 1 is incorrect; statement 2 is correct.
c. Statements 1 and 2 are both correct.
d. Statements 1 and 2 are both incorrect.

ANS: A
Symbols, rituals, and practices are prominent features of cultures. Cultures are complex and their basic characteristics quite often are historically determined, but cultures are developing and changing continuously.

REF: Culture, Cultural Competence, and Cultural Sensitivity | 71

2. Statement 1: Ethnic identity describes the common cultural, historic, and geographic experiences of a group. Statement 2: Individuals of a group who share an ethnic identity also share the same attitude, interests, and dialects.
a. Statement 1 is correct; statement 2 is incorrect.
b. Statement 1 is incorrect; statement 2 is correct.
c. Statements 1 and 2 are both correct.
d. Statements 1 and 2 are both incorrect.

ANS: A
A larger group may share common cultural, historic and geographic experiences (ethnic identity), but the individuals within the primary culture may belong to various different subcultures. Within any group, heterogeneity is more likely than homogeneity.

REF: Culture, Cultural Competence, and Cultural Sensitivity | 71

3. Statement 1: Complex societies are homogenous. Statement 2: Immigrants of the first generation share the same culture as the second or third generation of immigrants.
a. Statement 1 is correct; statement 2 is incorrect.
b. Statement 1 is incorrect; statement 2 is correct.
c. Statements 1 and 2 are both correct.
d. Statements 1 and 2 are both incorrect.

ANS: D
Complex societies are never homogenous; people will almost always form separate subgroups with their own features. Culture is a dynamic process, and traditional cultures (first immigrants) can differ from newly acquired cultures of the second or third generation of immigrants).

REF: Culture, Cultural Competence, and Cultural Sensitivity | 71

4. Statement 1: Beliefs and practices within a culture do not influence the access to healthcare services. Statement 2: The way people make sense of illness is in part culturally determined.
a. Statement 1 is correct; statement 2 is incorrect.
b. Statement 1 is incorrect; statement 2 is correct.
c. Statements 1 and 2 are both correct.
d. Statements 1 and 2 are both incorrect.

ANS: B
Health and illness are not only physical conditions. Culture can contribute to how members of a specific group determine how causes of illness can be explained and to whom they turn to if they become ill. These beliefs can facilitate or act as barriers to accessing healthcare services.

REF: Culture and Health | 71

5. At the first oral care visit, the culturally sensitive oral health professional should:
a. first assess the core values of the group to which the client belongs.
b. base his or her judgment on the characteristics of the specific culture to which the client belongs.
c. assesses the core cultural values for each client individually rather than focusing on the group to which the client belongs.
d. apply stereotyping as a tool to determine the possible core values of the client.

ANS: C
It is important to assess the core values for each individual client to identify the areas of potential cultural differences with the clients and not just those who appear to belong to different groups. It is the opposite of stereotyping.

REF: Box 6-2: Guidelines for Cross-Cultural Dental Hygiene | 77

6. Stereotyping:
a. is effective in a strange environment with new people to ascertain the characteristics of a member of a particular group.
b. can be described as an inaccurate, biased assessment of another human being based on group characteristics.
c. is an essential step in analyzing cultural differences.
d. recognizes the uniqueness of the individual and allows an accurate perception of the individual.

ANS: B
Stereotyping fails to recognize the uniqueness of the individual and prevents an accurate perception of those who appear different. It is a biased opinion. Stereotyping should not be promoted as a strategy.

REF: Culture and Health | 72

7. Cultural competence starts with:
a. awareness of the client’s background and cultural beliefs and values.
b. understanding the client’s perspective and social context.
c. applying a variety of communication skills to appeal to the client’s identity.
d. awareness of one’s own cultural beliefs and practices.

ANS: D
Cultural competence begins with the awareness of one’s own cultural beliefs and practices, and the recognition that others believe in different truths/realities than one’s own. Cultural competence starts with self-exploration, as well as awareness and elimination of one’s own biases.

REF: Developing Cultural Competence | 72

8. Statement 1: Patients are usually willing to share their ideas and customs with those who express a willingness to understand them. Statement 2: The clinician should assume the presence of cultural differences, and therefore, the clinician needs extensive knowledge of every cultural practice and belief.
a. Statement 1 is correct; statement 2 is incorrect.
b. Statement 1 is incorrect; statement 2 is correct.
c. Statements 1 and 2 are both correct.
d. Statements 1 and 2 are both incorrect.

ANS: A
“If you don’t ask, you won’t know.” By displaying genuine interest in the client and by asking a client to share beliefs, clinicians can increase their cultural knowledge as they practice. Extensive knowledge is not needed. It is most important to develop the understanding that each client’s preferences and values are unique.

REF: Culture and Health | 72

9. An equitable, culturally sensitive environment is characterized by:
a. the care provider initiating a cultural encounter.
b. reciprocal inquiry between the client and care provider.
c. the client initiating sharing information about his or her cultural beliefs.
d. the care provider tailoring the information to the mindset of the client.

ANS: B
The goal of effective communication is to maximize the understanding between the communicators. To communicate effectively, both parties have to move beyond cultural biases that could create barriers in care. In the most ideal situation, cross-cultural communication is a means of reciprocal inquiry. This means that both the care provider and client inform each other about their beliefs and expectations.

REF: Maximizing Effectiveness of Cross-Cultural Communication | 74

10. A client from a collectivist environment:
a. makes decisions about the proposed treatment on his or her own.
b. likes to discuss the treatment options with the healthcare provider alone.
c. prefers a “doctor-centered” approach.
d. might not display the characteristics of the group and therefore might make a decision on his or her own.

ANS: D
It is important to realize that individual clients from both collectivist and individualist cultures might have different point of views. It is the responsibility of the clinician to identify the client’s preference for shared decision making and to incorporate those preferences into the care provided.

REF: Shared Decision Making in Cross-Cultural Settings | 75

11. Ignoring or devaluing the models and practices embedded in other cultures can be described as:
a. evidence-based practice.
b. ethnocentrism.
c. stereotyping.
d. bias.

ANS: B
Demonstrating willingness to cooperate with alternative healers or incorporate traditional treatments can be important. Ignoring or devaluing the models and practices embedded in other cultures can be described as ethnocentrism and leads away from best practices in healthcare.

REF: Culture and Health | 72

12. A mother is standing beside her child in the dental office. The child is experiencing a terrible toothache. The mother is crying. She wants to know why God is doing this to her child. What would be the best response of the care provider?
a. Explain to her that God has nothing to do with the cause of this toothache.
b. Explain to her that she is making the child anxious.
c. Listen actively and allow her to express her feelings.
d. Do not pay too much attention to her crying, but focus on the child and try to examine the cause of the toothache.

ANS: C
By allowing the client to express her feelings, the oral health professional learns more about the client’s perspective and beliefs. This allows respectful communication and a suitable explanation of the possible causes. Culturally sensitive care is based on mutual respect and understanding. The other alternatives do not display respect to the cultural beliefs of the mother.

REF: Building Relationships | 74

13. Nonverbal communication is important in a culturally sensitive environment. The clinician should be sensitive to:
a. gestures.
b. eye contact.
c. personal space.
d. all of the above.

ANS: D
Cultural differences might be experienced in relation to various forms of nonverbal communication including gestures, handshakes, eye contact, or physical proximity. Follow the client’s lead and explore his or her expectations and beliefs.

REF: Nonverbal Communciation | 74-75

14. If a client does not speak the language of the care provider, the best strategy to interact would be to:
a. use a medical interpreter with no relationship to the client.
b. speak slowly and ask client if he or she understands the instructions.
c. ask a family member to translate.
d. use body language to communicate you care.

ANS: A
When language is a barrier, it is most appropriate to use a medical interpreter with no relationship to the client.

REF: Verbal Communication | 70

15. Statement 1: Health care literacy is the ability to understand health or disease. Statement 2: Poverty is not a barrier to access healthcare.
a. Statement 1 is correct; statement 2 is incorrect.
b. Statement 1 is incorrect; statement 2 is correct.
c. Statements 1 and 2 are both correct.
d. Statements 1 and 2 are both incorrect.

ANS: A
Health care literacy refers to understanding of the ability to understand how the healthcare system works. Poverty is a major barrier to healthcare access and prevents individuals from meeting their basic human needs for systemic and oral health.

REF: Healthcare Literacy | 77

16. Statement 1: Poverty is associated with poor oral health. Statement 2: Being part of an ethnic majority group leads a person to have poor oral health.
a. Statement 1 is correct; statement 2 is incorrect.
b. Statement 1 is incorrect; statement 2 is correct.
c. Statements 1 and 2 are both correct.
d. Statements 1 and 2 are both incorrect.

ANS: A
Children with the most advanced oral disease are found within minority, poor, homeless, and immigrant populations. Therefore, poverty has a strong association with poor oral health. It is important to realize that within all racial/ethnic groups that there are substantial differences in beliefs and behaviors. This inevitably leads to varying degrees of health status.

REF: Healthcare Literacy | 77

17. When adapting behavioral interventions for minorities, it is important to:
a. use community recourses to publish the intervention and to increase accessibility.
b. identify barriers to access and participation.
c. couple the initiatives with culturally accepted values or respected figures.
d. do both a and c.
e. do a, b, and c.

ANS: E
It is very important to identify barriers to access and participation before implementing behavioral interventions using community resources. When possible, coupling initiatives with culturally accepted values and respected figures maximizes uptake and efficacy. All alternatives are correct.

REF: Implementation Phase | 77

18. Statement 1: Culturally sensitive care starts with the care provider exploring the cultural beliefs of the client. Statement 2: Cultural differences occur in every clinical encounter.
a. Statement 1 is correct; statement 2 is incorrect.
b. Statement 1 is incorrect; statement 2 is correct.
c. Statements 1 and 2 are both correct.
d. Statements 1 and 2 are both incorrect.

ANS: B
The care provider should become aware of her or his own bias and perceptions before the clinical encounter with a client. Since oral health professionals have their own professional culture, it is expected that there will always be some sort of cultural difference between the care provider and the client.

REF: Developing Cultural Competence | 72-73

19. A 42-year-old female client brought her 14-year-old son to a first appointment with an oral health professional. The oral health professional plans to obtain a medical history, but the client and the clinician do not speak the same language. The client’s son offers to be the interpreter. Which answer is the most appropriate solution?
a. The clinician agrees with the proposal and is happy with this efficient solution.
b. The clinician prefers an official interpreter, which can be arranged by phone.
c. The clinician uses a medical history in the language of the client and asks the client to complete the questionnaire.
d. The clinician refers the client to a different dental office at the other side of the city, where the oral health professional speaks the language of the client.

ANS: B
A family member as interpreter can be unreliable due to personal and confidentiality issues. In some cases, the client or the family member in the role of interpreter can be embarrassed with the information provided. Misinterpretation of the information by family members can also occur, which can lead to incorrect diagnoses.

REF: Verbal Communication | 74

Chapter 06: Cultural Competence
Darby & Walsh: Dental Hygiene: Theory and Practice, 4th Edition

MULTIPLE CHOICE

1. Statement 1: Symbols can play an important role in culture. Statement 2: Culture is set by historical developments and will not change.
a. Statement 1 is correct; statement 2 is incorrect.
b. Statement 1 is incorrect; statement 2 is correct.
c. Statements 1 and 2 are both correct.
d. Statements 1 and 2 are both incorrect.

ANS: A
Symbols, rituals, and practices are prominent features of cultures. Cultures are complex and their basic characteristics quite often are historically determined, but cultures are developing and changing continuously.

REF: Culture, Cultural Competence, and Cultural Sensitivity | 71

2. Statement 1: Ethnic identity describes the common cultural, historic, and geographic experiences of a group. Statement 2: Individuals of a group who share an ethnic identity also share the same attitude, interests, and dialects.
a. Statement 1 is correct; statement 2 is incorrect.
b. Statement 1 is incorrect; statement 2 is correct.
c. Statements 1 and 2 are both correct.
d. Statements 1 and 2 are both incorrect.

ANS: A
A larger group may share common cultural, historic and geographic experiences (ethnic identity), but the individuals within the primary culture may belong to various different subcultures. Within any group, heterogeneity is more likely than homogeneity.

REF: Culture, Cultural Competence, and Cultural Sensitivity | 71

3. Statement 1: Complex societies are homogenous. Statement 2: Immigrants of the first generation share the same culture as the second or third generation of immigrants.
a. Statement 1 is correct; statement 2 is incorrect.
b. Statement 1 is incorrect; statement 2 is correct.
c. Statements 1 and 2 are both correct.
d. Statements 1 and 2 are both incorrect.

ANS: D
Complex societies are never homogenous; people will almost always form separate subgroups with their own features. Culture is a dynamic process, and traditional cultures (first immigrants) can differ from newly acquired cultures of the second or third generation of immigrants).

REF: Culture, Cultural Competence, and Cultural Sensitivity | 71

4. Statement 1: Beliefs and practices within a culture do not influence the access to healthcare services. Statement 2: The way people make sense of illness is in part culturally determined.
a. Statement 1 is correct; statement 2 is incorrect.
b. Statement 1 is incorrect; statement 2 is correct.
c. Statements 1 and 2 are both correct.
d. Statements 1 and 2 are both incorrect.

ANS: B
Health and illness are not only physical conditions. Culture can contribute to how members of a specific group determine how causes of illness can be explained and to whom they turn to if they become ill. These beliefs can facilitate or act as barriers to accessing healthcare services.

REF: Culture and Health | 71

5. At the first oral care visit, the culturally sensitive oral health professional should:
a. first assess the core values of the group to which the client belongs.
b. base his or her judgment on the characteristics of the specific culture to which the client belongs.
c. assesses the core cultural values for each client individually rather than focusing on the group to which the client belongs.
d. apply stereotyping as a tool to determine the possible core values of the client.

ANS: C
It is important to assess the core values for each individual client to identify the areas of potential cultural differences with the clients and not just those who appear to belong to different groups. It is the opposite of stereotyping.

REF: Box 6-2: Guidelines for Cross-Cultural Dental Hygiene | 77

6. Stereotyping:
a. is effective in a strange environment with new people to ascertain the characteristics of a member of a particular group.
b. can be described as an inaccurate, biased assessment of another human being based on group characteristics.
c. is an essential step in analyzing cultural differences.
d. recognizes the uniqueness of the individual and allows an accurate perception of the individual.

ANS: B
Stereotyping fails to recognize the uniqueness of the individual and prevents an accurate perception of those who appear different. It is a biased opinion. Stereotyping should not be promoted as a strategy.

REF: Culture and Health | 72

7. Cultural competence starts with:
a. awareness of the client’s background and cultural beliefs and values.
b. understanding the client’s perspective and social context.
c. applying a variety of communication skills to appeal to the client’s identity.
d. awareness of one’s own cultural beliefs and practices.

ANS: D
Cultural competence begins with the awareness of one’s own cultural beliefs and practices, and the recognition that others believe in different truths/realities than one’s own. Cultural competence starts with self-exploration, as well as awareness and elimination of one’s own biases.

REF: Developing Cultural Competence | 72

8. Statement 1: Patients are usually willing to share their ideas and customs with those who express a willingness to understand them. Statement 2: The clinician should assume the presence of cultural differences, and therefore, the clinician needs extensive knowledge of every cultural practice and belief.
a. Statement 1 is correct; statement 2 is incorrect.
b. Statement 1 is incorrect; statement 2 is correct.
c. Statements 1 and 2 are both correct.
d. Statements 1 and 2 are both incorrect.

ANS: A
“If you don’t ask, you won’t know.” By displaying genuine interest in the client and by asking a client to share beliefs, clinicians can increase their cultural knowledge as they practice. Extensive knowledge is not needed. It is most important to develop the understanding that each client’s preferences and values are unique.

REF: Culture and Health | 72

9. An equitable, culturally sensitive environment is characterized by:
a. the care provider initiating a cultural encounter.
b. reciprocal inquiry between the client and care provider.
c. the client initiating sharing information about his or her cultural beliefs.
d. the care provider tailoring the information to the mindset of the client.

ANS: B
The goal of effective communication is to maximize the understanding between the communicators. To communicate effectively, both parties have to move beyond cultural biases that could create barriers in care. In the most ideal situation, cross-cultural communication is a means of reciprocal inquiry. This means that both the care provider and client inform each other about their beliefs and expectations.

REF: Maximizing Effectiveness of Cross-Cultural Communication | 74

10. A client from a collectivist environment:
a. makes decisions about the proposed treatment on his or her own.
b. likes to discuss the treatment options with the healthcare provider alone.
c. prefers a “doctor-centered” approach.
d. might not display the characteristics of the group and therefore might make a decision on his or her own.

ANS: D
It is important to realize that individual clients from both collectivist and individualist cultures might have different point of views. It is the responsibility of the clinician to identify the client’s preference for shared decision making and to incorporate those preferences into the care provided.

REF: Shared Decision Making in Cross-Cultural Settings | 75

11. Ignoring or devaluing the models and practices embedded in other cultures can be described as:
a. evidence-based practice.
b. ethnocentrism.
c. stereotyping.
d. bias.

ANS: B
Demonstrating willingness to cooperate with alternative healers or incorporate traditional treatments can be important. Ignoring or devaluing the models and practices embedded in other cultures can be described as ethnocentrism and leads away from best practices in healthcare.

REF: Culture and Health | 72

12. A mother is standing beside her child in the dental office. The child is experiencing a terrible toothache. The mother is crying. She wants to know why God is doing this to her child. What would be the best response of the care provider?
a. Explain to her that God has nothing to do with the cause of this toothache.
b. Explain to her that she is making the child anxious.
c. Listen actively and allow her to express her feelings.
d. Do not pay too much attention to her crying, but focus on the child and try to examine the cause of the toothache.

ANS: C
By allowing the client to express her feelings, the oral health professional learns more about the client’s perspective and beliefs. This allows respectful communication and a suitable explanation of the possible causes. Culturally sensitive care is based on mutual respect and understanding. The other alternatives do not display respect to the cultural beliefs of the mother.

REF: Building Relationships | 74

13. Nonverbal communication is important in a culturally sensitive environment. The clinician should be sensitive to:
a. gestures.
b. eye contact.
c. personal space.
d. all of the above.

ANS: D
Cultural differences might be experienced in relation to various forms of nonverbal communication including gestures, handshakes, eye contact, or physical proximity. Follow the client’s lead and explore his or her expectations and beliefs.

REF: Nonverbal Communciation | 74-75

14. If a client does not speak the language of the care provider, the best strategy to interact would be to:
a. use a medical interpreter with no relationship to the client.
b. speak slowly and ask client if he or she understands the instructions.
c. ask a family member to translate.
d. use body language to communicate you care.

ANS: A
When language is a barrier, it is most appropriate to use a medical interpreter with no relationship to the client.

REF: Verbal Communication | 70

15. Statement 1: Health care literacy is the ability to understand health or disease. Statement 2: Poverty is not a barrier to access healthcare.
a. Statement 1 is correct; statement 2 is incorrect.
b. Statement 1 is incorrect; statement 2 is correct.
c. Statements 1 and 2 are both correct.
d. Statements 1 and 2 are both incorrect.

ANS: A
Health care literacy refers to understanding of the ability to understand how the healthcare system works. Poverty is a major barrier to healthcare access and prevents individuals from meeting their basic human needs for systemic and oral health.

REF: Healthcare Literacy | 77

16. Statement 1: Poverty is associated with poor oral health. Statement 2: Being part of an ethnic majority group leads a person to have poor oral health.
a. Statement 1 is correct; statement 2 is incorrect.
b. Statement 1 is incorrect; statement 2 is correct.
c. Statements 1 and 2 are both correct.
d. Statements 1 and 2 are both incorrect.

ANS: A
Children with the most advanced oral disease are found within minority, poor, homeless, and immigrant populations. Therefore, poverty has a strong association with poor oral health. It is important to realize that within all racial/ethnic groups that there are substantial differences in beliefs and behaviors. This inevitably leads to varying degrees of health status.

REF: Healthcare Literacy | 77

17. When adapting behavioral interventions for minorities, it is important to:
a. use community recourses to publish the intervention and to increase accessibility.
b. identify barriers to access and participation.
c. couple the initiatives with culturally accepted values or respected figures.
d. do both a and c.
e. do a, b, and c.

ANS: E
It is very important to identify barriers to access and participation before implementing behavioral interventions using community resources. When possible, coupling initiatives with culturally accepted values and respected figures maximizes uptake and efficacy. All alternatives are correct.

REF: Implementation Phase | 77

18. Statement 1: Culturally sensitive care starts with the care provider exploring the cultural beliefs of the client. Statement 2: Cultural differences occur in every clinical encounter.
a. Statement 1 is correct; statement 2 is incorrect.
b. Statement 1 is incorrect; statement 2 is correct.
c. Statements 1 and 2 are both correct.
d. Statements 1 and 2 are both incorrect.

ANS: B
The care provider should become aware of her or his own bias and perceptions before the clinical encounter with a client. Since oral health professionals have their own professional culture, it is expected that there will always be some sort of cultural difference between the care provider and the client.

REF: Developing Cultural Competence | 72-73

19. A 42-year-old female client brought her 14-year-old son to a first appointment with an oral health professional. The oral health professional plans to obtain a medical history, but the client and the clinician do not speak the same language. The client’s son offers to be the interpreter. Which answer is the most appropriate solution?
a. The clinician agrees with the proposal and is happy with this efficient solution.
b. The clinician prefers an official interpreter, which can be arranged by phone.
c. The clinician uses a medical history in the language of the client and asks the client to complete the questionnaire.
d. The clinician refers the client to a different dental office at the other side of the city, where the oral health professional speaks the language of the client.

ANS: B
A family member as interpreter can be unreliable due to personal and confidentiality issues. In some cases, the client or the family member in the role of interpreter can be embarrassed with the information provided. Misinterpretation of the information by family members can also occur, which can lead to incorrect diagnoses.

REF: Verbal Communication | 74