Nokea
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 The student notes the patient, who had been calm and cooperative the day before, has become contemplative and withdrawn, stating, "I've never thought much about dying, but my chances of making it through tomorrow's surgery are 50-50."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.
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A parish nurse is speaking to a congregant whose adolescent child was arrested for shoplifting. The congregant is very angry, stating they cannot face the child, let alone discuss the situation: "I just will not tolerate a thief." What nursing action will best assist the congregant at this time?
- A. Assuring the congregant that many parents feel the same way
- B. Reassuring the congregant that many teenagers act rebelliously and that it will pass
- C. Assisting the congregant to identify how withholding forgiveness hurts them
- D. Asking the congregant if they have spent sufficient time with their child
Correct Answer: C
Rationale: Helping the congregant identify how their unforgiving feelings may be harmful to themselves is the only intervention that directly addresses forgiveness, a universal spiritual need.
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.
A nurse is caring for patients in a long-term care facility. Which nursing actions are appropriate based on the religious beliefs of these patients? Select all that apply.
- A. Asking a Buddhist if they have any diet restrictions related to the observance of holy days
- B. Asking a Christian Scientist who is in traction if they would like to try nonpharmacologic pain measures
- C. Administering medications to a Muslim patient and avoiding touching the patient's lips
- D. Asking a Roman Catholic patient if they would like to attend Mass in the common room on Sunday
- E. Avoiding scheduling treatment and procedures on Saturday for a Hindu patient
- F. Consulting with the medicine man of a Native American patient and incorporating their suggestions into the care plan
Correct Answer: A,B,D,F
Rationale: The nurse should ask a Buddhist if they have any diet restrictions related to the observance of holy days. Since Christian Scientists avoid the use of pain medications, the nurse should offer nonpharmacologic pain relief measures. A nurse should ask a Roman Catholic if they would like to attend Mass on Sunday. The nurse would appropriately consult with the medicine man of a Native American patient and incorporate their suggestions into the care plan.
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.
A surgeon tells a patient who is a Jehovah's Witness that they need emergency surgery to repair an aortic aneurysm, which will require blood transfusions. The patient states, "If I receive blood, I will not go to paradise. It is against my religion." What nursing response to the patient is appropriate?
- A. "I understand you will not receive blood products, even if it means you will die."
- B. "Please listen to the surgeon; I've seen many aneurysms successfully repaired"
- C. "Have you discussed your decision to refuse surgery with your family?"
- D. "What can I say to help you through this difficult decision?"
Correct Answer: A
Rationale: Patients who practice the Jehovah's Witness faith believe blood transfusions violate God's laws and do not allow them. The nurse supports the patient's beliefs. It is disrespectful of the nurse to attempt to coerce a decision or impose their beliefs on the patient.