Cultural competence NCLEX-RN Practice Questions

Cultural competence NCLEX-RN Practice Questions help you strengthen the psychosocial integrity skills required to deliver safe, respectful, and effective care to diverse populations. In real clinical settings, nurses navigate language barriers, health beliefs, family roles, spiritual needs, and end-of-life rituals while upholding ethical and legal standards. This topic-wise set of practice questions challenges you to prioritize care, select culturally congruent interventions, and apply evidence-based communication strategies. You will encounter scenarios on interpreter use, diet and fasting, pain assessment, traditional healing, religious considerations, and health literacy. Work through each question to refine clinical judgment, reduce bias, and advocate for individualized care plans that honor client values while maintaining safety, quality, and regulatory compliance.

Q1. A client with limited English proficiency requires consent for a procedure. Which action should the nurse take first?

• Ask the client’s bilingual teen to interpret because they are readily available
• Use a qualified medical interpreter to explain the procedure and obtain consent
• Rely on translation apps to ensure accuracy and privacy
• Proceed with simplified English and obtain verbal consent

Correct Answer: Use a qualified medical interpreter to explain the procedure and obtain consent

Q2. A client states they prefer minimal eye contact and no handshakes. What is the nurse’s best initial response?

• Explain that eye contact shows respect in the hospital
• Document the preference and adjust nonverbal communication accordingly
• Request a cultural consult before changing approach
• Continue routine practice to maintain professionalism

Correct Answer: Document the preference and adjust nonverbal communication accordingly

Q3. A Muslim client hospitalized during Ramadan wishes to fast. What is the nurse’s priority action?

• Inform the client that fasting is not allowed in the hospital
• Arrange for family to bring food after sundown without further assessment
• Collaborate with the provider and dietitian to adjust medications and meals to safely accommodate fasting
• Provide only water during daylight hours

Correct Answer: Collaborate with the provider and dietitian to adjust medications and meals to safely accommodate fasting

Q4. A client requests to use a traditional healer alongside prescribed treatment. What should the nurse do?

• Advise discontinuation of all traditional practices to avoid harm
• Assess the healer’s plan and coordinate with the provider to ensure safety and compatibility
• Allow the healer without informing the care team
• Replace the prescribed treatment with the traditional approach

Correct Answer: Assess the healer’s plan and coordinate with the provider to ensure safety and compatibility

Q5. A client reports no pain but shows guarded movements and grimacing. What is the best nursing action?

• Document “no pain” and continue routine care
• Apply standard opioid dosing without further assessment
• Use a validated pain scale, explore acceptable pain goals, and reassess after intervention
• Ask family to rate the client’s pain

Correct Answer: Use a validated pain scale, explore acceptable pain goals, and reassess after intervention

Q6. After death, a family asks to perform ritual washing of the body. Which action is appropriate?

• Decline due to infection risk and proceed with standard postmortem care
• Allow the ritual within facility policy using appropriate PPE and time frames
• Permit the ritual only if the provider remains present
• Remove all religious items from the body before the family arrives

Correct Answer: Allow the ritual within facility policy using appropriate PPE and time frames

Q7. A client refuses a blood transfusion for religious reasons. What is the nurse’s best response?

• Explain refusal is unethical and obtain consent
• Respect the refusal and notify the provider to discuss clinically appropriate alternatives
• Seek a court order immediately
• Document noncompliance and discharge the client

Correct Answer: Respect the refusal and notify the provider to discuss clinically appropriate alternatives

Q8. A client misses medications due to a flexible, event-driven daily routine. Which intervention is most culturally congruent?

• Schedule all doses at fixed clock times regardless of routine
• Integrate dosing with the client’s existing activities and use reminder cues aligned with their daily patterns
• Have a family member supervise every dose
• Switch all oral meds to injections for better adherence

Correct Answer: Integrate dosing with the client’s existing activities and use reminder cues aligned with their daily patterns

Q9. A female client requests only female caregivers for intimate care due to modesty beliefs. What should the nurse do?

• Explain assignments are random and cannot be changed
• Try to accommodate the request within staffing and client safety needs
• Ask the client to bring a family member for care
• Assign male caregivers but provide extra privacy screens

Correct Answer: Try to accommodate the request within staffing and client safety needs

Q10. The nurse uses the LEARN model for cultural communication. Which sequence is correct?

• Listen, Evaluate, Act, Respond, Normalize
• Learn, Explain, Affirm, Reassure, Negotiate
• Listen, Explain, Acknowledge, Recommend, Negotiate
• Link, Explore, Ask, Refer, Navigate

Correct Answer: Listen, Explain, Acknowledge, Recommend, Negotiate

Q11. A client with limited health literacy and limited English proficiency needs discharge teaching. Which approach is best?

• Provide a lengthy written handout in English
• Use a trained interpreter, plain language, pictograms, and teach-back
• Teach the family only, not the client
• Speak slowly and louder until understood

Correct Answer: Use a trained interpreter, plain language, pictograms, and teach-back

Q12. During assessment, the client responds with silence. What is the nurse’s most therapeutic action?

• Fill the silence with more questions to avoid discomfort
• Allow the silence, observe nonverbal cues, and gently explore its meaning
• Document the client as uncooperative
• End the interview and return later without explanation

Correct Answer: Allow the silence, observe nonverbal cues, and gently explore its meaning

Q13. The nurse notices circular skin marks; the client reports recent cupping. What should the nurse do first?

• Report suspected abuse to social services immediately
• Document findings and inquire nonjudgmentally about traditional practices and symptom relief
• Apply topical steroids to the marks
• Instruct the client to stop all traditional therapies

Correct Answer: Document findings and inquire nonjudgmentally about traditional practices and symptom relief

Q14. A client follows a hot–cold balance theory of illness and wants “hot” foods for a “cold” condition. Best nursing response?

• Explain this belief is incorrect and must be avoided
• Integrate safe dietary preferences with the treatment plan and timing of medications
• Discontinue medications in favor of diet changes
• Allow any foods regardless of restrictions

Correct Answer: Integrate safe dietary preferences with the treatment plan and timing of medications

Q15. A client uses herbal teas with prescribed anticoagulants. What is the priority action?

• Encourage herbal use for faster recovery
• Assess the specific herbs and consult the provider/pharmacist for interactions
• Tell the client to stop all herbs immediately without discussion
• Ignore unless side effects occur

Correct Answer: Assess the specific herbs and consult the provider/pharmacist for interactions

Q16. A client wears a religious amulet preoperatively and requests it stay on. What should the nurse do?

• Remove the amulet and discard it for sterility
• Secure the amulet per policy (e.g., pinned outside the gown or placed in a labeled bag) and ensure it is returned post-op
• Allow metal items in the surgical field without precautions
• Ask the family to take it home to avoid liability, without documenting

Correct Answer: Secure the amulet per policy (e.g., pinned outside the gown or placed in a labeled bag) and ensure it is returned post-op

Q17. A parent declines vaccination due to cultural beliefs. The nurse’s best first step is to:

• Report the family to child protective services
• Explore the parent’s concerns, provide evidence-based information, and use motivational interviewing
• Administer the vaccine without consent
• Discharge the family from the practice

Correct Answer: Explore the parent’s concerns, provide evidence-based information, and use motivational interviewing

Q18. A client who keeps kosher receives a tray with pork and dairy together. What should the nurse do first?

• Ask the client to eat only the dairy items
• Verify the diet order and request a corrected kosher tray immediately
• Remove the pork item and leave the rest
• Document the client’s refusal as noncompliance

Correct Answer: Verify the diet order and request a corrected kosher tray immediately

Q19. Which statement reflects culturally sensitive communication?

• “In our hospital, eye contact is required from all clients.”
• “Please share how you prefer to be addressed and your comfort with touch and eye contact.”
• “Everyone here communicates the same way.”
• “I will explain first; questions can come later.”

Correct Answer: “Please share how you prefer to be addressed and your comfort with touch and eye contact.”

Q20. Best practice when working with an interpreter includes:

• Speaking to the interpreter and asking them to summarize
• Speaking in long paragraphs to reduce interruptions
• Addressing the client directly, using first-person statements, and pausing frequently
• Asking the interpreter to add cultural advice during interpretation

Correct Answer: Addressing the client directly, using first-person statements, and pausing frequently

Q21. The team plans discharge teaching but the only available interpreter is the client’s 12-year-old child. What should the nurse do?

• Proceed with the child to avoid delays
• Reschedule until a qualified medical interpreter is available
• Teach only the client using pictures
• Ask another client to interpret

Correct Answer: Reschedule until a qualified medical interpreter is available

Q22. Which action best exemplifies cultural humility?

• Completing a one-time cultural course and considering it sufficient
• Engaging in ongoing self-reflection to recognize and mitigate personal biases
• Relying on cultural checklists for all clients
• Assuming similar beliefs among members of the same group

Correct Answer: Engaging in ongoing self-reflection to recognize and mitigate personal biases

Q23. A recent refugee avoids eye contact and startles easily. What is the nurse’s priority?

• Obtain a detailed trauma history immediately
• Provide trauma-informed care focusing on safety, choice, and empowerment
• Encourage exposure therapy during admission
• Assign the client to a busy room to desensitize

Correct Answer: Provide trauma-informed care focusing on safety, choice, and empowerment

Q24. A client has difficulty distinguishing medication names due to language barriers. What strategy is most effective?

• Rely on color of pills only
• Use bilingual labels, pictograms, synchronized pill organizers, and teach-back with an interpreter
• Ask the client to memorize generic names
• Switch all medications to liquids

Correct Answer: Use bilingual labels, pictograms, synchronized pill organizers, and teach-back with an interpreter

Q25. The nurse suspects spiritual distress in a hospitalized client. Which collaborative action is best?

• Advise the client to focus on medical care only
• Request a chaplain/spiritual care consult with client consent
• Provide religious materials without asking
• Delay support until discharge

Correct Answer: Request a chaplain/spiritual care consult with client consent

Q26. A client indicates that health decisions are made by the eldest family member. What should the nurse do?

• Insist on speaking only to the client for all decisions
• With the client’s permission, include the identified family decision-maker in discussions
• Ask the family to wait outside during all care
• Obtain consent from any available family member

Correct Answer: With the client’s permission, include the identified family decision-maker in discussions

Q27. A client with diabetes plans to fast for a religious holiday. The safest nursing plan includes:

• Instructing the client to continue all medications unchanged
• Coordinating insulin/timing adjustments, glucose monitoring, and hypoglycemia education with the provider
• Encouraging only water intake all day
• Delaying all care until fasting ends

Correct Answer: Coordinating insulin/timing adjustments, glucose monitoring, and hypoglycemia education with the provider

Q28. A family requests extra time for prayers before a procedure, causing scheduling pressure. What is the best response?

• Deny the request due to schedule
• Negotiate a brief, defined period for prayer while coordinating with the surgical team
• Ask the family to pray silently during transport
• Proceed immediately and allow prayer in recovery

Correct Answer: Negotiate a brief, defined period for prayer while coordinating with the surgical team

Q29. Which statement reflects an individualized, culturally competent assessment?

• “All people from your background have similar pain tolerance.”
• “Tell me about your health beliefs and practices that are important to your care.”
• “We follow hospital routines; personal beliefs are secondary.”
• “I will apply the standard cultural profile for your group.”

Correct Answer: “Tell me about your health beliefs and practices that are important to your care.”

Q30. The nurse prepares comprehensive discharge education for a client with limited English proficiency. Which plan is most appropriate?

• Schedule a qualified interpreter, provide translated materials at appropriate literacy level, and confirm understanding with teach-back
• Give English-only handouts and ask the family to translate later
• Use medical jargon with detailed explanations
• Shorten teaching to avoid fatigue and skip verification

Correct Answer: Schedule a qualified interpreter, provide translated materials at appropriate literacy level, and confirm understanding with teach-back

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