CSG Cultural Considerations in Gerontological Practice 2 — Questions and Answers
Question 1: An 82-year-old Muslim resident with type 2 diabetes wishes to fast during Ramadan. What is the RDN's most appropriate first step?
- Assess his risk with the medical team and discuss safe fasting options, including religious exemptions (Correct answer)
- Refer him to the chaplain and take no further nutrition action
- Tell him fasting is prohibited because of his diabetes
- Allow fasting with no changes to his medications
Correct answer: Assess his risk with the medical team and discuss safe fasting options, including religious exemptions
Fasting safety is assessed individually with the medical team, and Islam exempts people who are ill or frail, which can be discussed respectfully.
Question 2: Which approach best shows cultural humility when assessing an older adult's diet?
- Relying only on what family members report
- Asking open-ended questions about the foods, meals, and traditions the client values (Correct answer)
- Assuming food habits from the client's ethnic background
- Using one standard food list for every client
Correct answer: Asking open-ended questions about the foods, meals, and traditions the client values
Cultural humility means lifelong self-reflection and learning from each person instead of assuming you already know their culture.
Question 3: An older Orthodox Jewish client in a hospital needs a therapeutic diet. Which accommodation is most appropriate?
- Serving vegetarian meals prepared in the regular kitchen
- Asking the family to bring in every meal
- Providing certified kosher meals, such as sealed double-wrapped trays, that meet the diet order (Correct answer)
- Removing pork but serving meat and dairy together
Correct answer: Providing certified kosher meals, such as sealed double-wrapped trays, that meet the diet order
Strict kosher observance requires certified preparation and keeping meat and dairy separate, which sealed certified meals provide.
Question 4: Which traditional Hispanic food pattern is most important to address for an older adult with hypertension?
- Herbal teas such as manzanilla
- Frequent use of beans and corn tortillas
- Fresh tropical fruit at meals
- High-sodium seasonings, cured meats, and canned ingredients (Correct answer)
Correct answer: High-sodium seasonings, cured meats, and canned ingredients
Sodium from seasoning packets, bouillon, and processed meats is the main modifiable factor for blood pressure in this pattern.
Question 5: An older Vietnamese client says she uses fish sauce daily. Which recommendation is most culturally appropriate for her heart failure?
- Measure and reduce the amount, try lower-sodium versions, and add flavor with herbs, lime, and garlic (Correct answer)
- Replace it with soy sauce
- Ban fish sauce completely
- Ignore it because condiments add little sodium
Correct answer: Measure and reduce the amount, try lower-sodium versions, and add flavor with herbs, lime, and garlic
Keeping a valued food while cutting the amount improves adherence and still lowers sodium.
Question 6: When an older client has limited English proficiency, what is the best practice for a nutrition consultation?
- Speak slowly and louder in English
- Use a qualified medical interpreter (Correct answer)
- Give only written English handouts
- Use the client's adult child as interpreter
Correct answer: Use a qualified medical interpreter
Federal standards (Title VI and the CLAS standards) call for qualified interpreters because family interpreters can cause errors and privacy problems.
Question 7: Which statement about lactose intolerance in older adults is most accurate?
- It is rare in people of African, Asian, and Native American descent
- Lactose intolerance always means calcium needs cannot be met
- Lactase persistence is most common among people of Northern European descent (Correct answer)
- All older adults must avoid dairy
Correct answer: Lactase persistence is most common among people of Northern European descent
Lactase nonpersistence is the global norm and is highly common among African, Asian, Hispanic, and Native American groups.
