Nokea
A hospice nurse is caring for a patient who is dying of pancreatic cancer. The patient tells the nurse, "I feel no connection to God" and "I'm worried that I've found no real meaning in life." What is the nurse's best response to this patient?
- A. Give the patient a hug and tell them that their life still has meaning.
- B. Arrange for a spiritual advisor to visit the patient.
- C. Ask if the patient would like to talk about their feelings.
- D. Call in a close friend or relative to talk to the patient.
Correct Answer: C
Rationale: When caring for a patient who is in spiritual distress, the nurse should listen to the patient first, then ask whether the patient would like to visit with a spiritual advisor. Arranging for a spiritual advisor first may not be respectful of the patient's wishes. A hug and false reassurances do not address the problem of spiritual distress. Talking to friends or relatives may be helpful, but only if the patient agrees.
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A nurse who was raised as a strict Roman Catholic but is no longer practicing stated they could not assist patients with spiritual distress because they recognize only a "field of power" in each person. The nurse says to her colleague, "My parents and I hardly talk because I've deserted my faith. Sometimes I feel really isolated from them and God-if there is a God." These statements reveal which unmet spiritual need?
- A. Meaning and purpose
- B. Forgiveness
- C. Love and relatedness
- D. Strength for everyday living
Correct Answer: C
Rationale: The data point to an unmet spiritual need to experience love and belonging, given the nurse's estrangement from their family and God after leaving the church. The other options may represent other needs this nurse has, but the nurse's statements do not support them.
A nursing student is caring for a patient admitted with chest pain related to aortic valve stenosis. The student notes the patient, who had been calm and cooperative the day before, has become contemplative and withdrawn, stating, "I've never thought much about dying, but my chances of making it through tomorrow's surgery are 50-50." How does the student best respond when the clinical professor asks the student why this behavior likely surfaced later in the patient's admission?
- A. Patients usually want to maintain privacy about their spiritual needs.
- B. People are better able to focus on spiritual needs after their spiritual advisor visits.
- C. Family members and close friends often initiate spiritual concerns.
- D. Illness increases spiritual concerns, which may initially be difficult to verbalize.
Correct Answer: D
Rationale: Illness may increase spiritual concerns, which many patients find difficult to initially express. The other options presume patients are purposefully secretive or must speak with a spiritual advisor, friends, or family to promote discussion of spiritual concerns.
A patient who stated their religion as Jewish at the intake interview was served a kosher meal ordered from a restaurant on a paper plate because the hospital had no provision for kosher food or dishes. The patient became angry and accused the nurse of insulting him, emphatically stating, "I want to eat what everyone else does-and give me decent dishes." After analyzing the data, the nurse returns to the patient and makes which of these statements?
- A. "I'm terribly sorry, I should have ordered kosher food and dishes as well."
- B. "Did someone on the staff behave condescendingly or critically?"
- C. "It seems difficult to please you today."
- D. "We did not ask about your dietary preferences; tell me what you usually eat."
Correct Answer: D
Rationale: On the basis of the patient's stated religion, the nurse assumed they would want a kosher diet. This is a form of stereotyping. When evaluating the outcome of the situation, the nurse returns to the first step of the nursing process and assesses the patient's dietary practices and preferences.
After terminating a pregnancy, a patient tells the nurse, "I shouldn't have had that abortion because I'm Catholic, but what else could I do? I'm afraid I'll never get close to my mother or back in the Church again." They then talk with their priest about this feeling of guilt. Which evaluation statement shows a solution to the problem?
- A. Patient stated, "I wish I had talked with the priest sooner. I now know God has forgiven me, and my mother is beginning to understand."
- B. Patient has slept from 10 PM to 6 AM for 3 consecutive nights without medication.
- C. Patient has developed mutually caring relationships with others.
- D. Patient has identified several spiritual beliefs that give purpose to their life.
Correct Answer: A
Rationale: The patient's statements indicate feelings of guilt, which has caused spiritual distress. Only option a clearly evaluates whether the patient's feelings of guilt have resolved after speaking to the priest.
A patient who lost their home, spouse, and children in a fire is depressed and states that they have no reason to live. The patient states, "My family was my life." The nurse documents a health problem of Spiritual Distress based on the patient's inability to find meaning and purpose in their current situation. What is the priority nursing action for this patient?
- A. Asking the patient which spiritual advisor they would like you to call
- B. Recommending that the patient engage in spiritual or religious readings
- C. Determining what has given the patient meaning and purpose in the past
- D. Reminding the patient that God is a loving and personal God
Correct Answer: C
Rationale: The nurse prioritizes determining what, in addition to their family, has given the patient's life meaning and purpose in the past. This helps the patient focus on their strengths. This assessment data can be used to further plan individualized spiritual care.