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WorksheetsCulturally Congruent Care Scenarios
Total questions: 10
Worksheet time: 5mins
Interpreter dynamics: At triage, a patient speaks Cebuano; her nephew offers to translate. The case involves intimate partner violence. What’s the best next step?
Request a trained interpreter and speak directly to the patient, not the nephew.
Proceed with the nephew to save time; clarify later.
Ask the nephew to summarize only the “non-sensitive” parts.
Use Google Translate on your phone.
Fasting & diabetes: A 67-year-old with diabetes wants to fast for a nine-day novena. What action most reflects culturally congruent care?
Forbid fasting and document refusal.
Allow fasting with no changes to insulin; respect autonomy.
Align goals, adjust insulin timing/dose, set glucose thresholds that break the fast, and schedule monitoring.
Transfer to another provider due to conflict of values.
Family decision-making: A patient’s adult son consistently answers for her, and she nods along. What should you do first?
Speak only with the son to avoid disrespect.
Exclude the son to protect autonomy.
Ask the son to sign consent on her behalf.
Clarify who the decision-makers are while ensuring the patient’s voice is heard directly.
Nonverbal cues: During assessment, a patient avoids eye contact and responds briefly. Which response reduces cultural misinterpretation?
Document “non-cooperative; likely hiding information.”
Consider cultural norms around eye contact and continue with open-ended, respectful prompts.
Escalate to security.
Increase personal space by moving farther away and ending the interview.
Barriers in documentation: A patient follows a halal diet and prefers female examiners. Which documentation is most useful for continuity of care?
Place a sticky note on the bedside table.
Tell the oncoming nurse verbally.
Enter a structured note: dietary rule, modesty need, agreed adaptations, and any safety limits, dated and sourced.
Rely on the family to inform the next shift.
Time pressure: The ED is crowded; you have two minutes. What’s the highest-yield cultural screen?
Ask 2–3 essential questions (beliefs/practices, decision-makers, language) and plan teach-back.
Skip culture to prioritize vitals.
Hand a 3-page cultural survey.
Defer all questions to discharge.
Bias check: A migrant worker requests stronger pain meds after minor surgery. A colleague mutters, “drug-seeking.” What should you do?
Decline opioids based on the colleague’s concern.
Increase dose without assessment to avoid bias.
Ask the family to validate the pain level.
Use a standardized pain scale, reassess, and discuss options in a brief team huddle.
Working without an interpreter: No interpreter is available; the patient’s adult daughter offers to help. Which is the safest interim approach?
Decline help and proceed in English.
Brief the daughter to interpret verbatim, avoid side conversations, use short sentences, and confirm with teach-back—then arrange a trained interpreter ASAP.
Ask the daughter to “summarize” only.
Postpone all care until tomorrow.
Essentialism risk: A staff nurse assumes a new Filipino patient “will prefer family to decide everything.” What’s the best corrective action?
Provide a lecture on stereotypes during handover.
Ignore; the assumption is usually true.
Model person-centered assessment: ask the patient about decision-making preferences and document the response.
Ask the barangay captain to clarify.
Institutional constraints: ICU policy limits visiting to 1 hour/day; the family requests longer presence for prayer and caregiving. What’s the best response?
Deny the request—policy is policy.
Explore safe flexibility: schedule prayer blocks, designate caregivers, set infection-control boundaries, and document the negotiated plan.
Let everyone in if they wear masks.
Tell them to pray outside to avoid delays.
