Nokea
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.
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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 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 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 patient states they feel very isolated from their family and church, and even from God, "in this huge medical center so far from home." When preparing expected outcomes for this patient, which most appropriately measures relief of the patient's spiritual distress?
- A. The patient will express satisfaction with the compatibility of their spiritual beliefs and everyday living.
- B. The patient will identify spiritual beliefs that meet their need for meaning and purpose.
- C. The patient will express peaceful acceptance of limitations and failings.
- D. The patient will identify spiritual supports available to them in this medical center.
Correct Answer: D
Rationale: Each of the four options represents appropriate spiritual goals, but identifying spiritual supports available to this patient in this medical center at this point in time, is the most appropriate and realistic.
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.