Deck 10: Cultural and Spiritual Care at the End of Life

Question 1

A terminally ill patient from a different culture tells the nurse that she cannot decide what to do until her brother arrives since he is the major decision maker for the family. Which of the following should the nurse do first?

A) Request that another nurse care for the patient
B) Wait until the brother arrives and, with the patient, discuss the decisions made regarding her care
C) Contact the hospital's attorney to be present when the brother arrives
D) Tell the patient that in the United States she makes the decisions, regardless of her culture of origin

Answer 1

Wait until the brother arrives and, with the patient, discuss the decisions made regarding her care

Question 2

A terminally ill patient tells the nurse that he is not ready to die because there are many people that he needs to ask for forgiveness. Which of the following can the nurse do to help this patient?

A) Suggest that the patient ask each individual mentally for forgiveness
B) Offer to work with the patient in contacting the individuals that the patient wants to talk with
C) Remind the patient that God forgives everyone
D) Tell the patient that his energy should be focused on improving his health and not dying

Answer 2

Offer to work with the patient in contacting the individuals that the patient wants to talk with

Question 3

The nurse is admitting a patient who is from her same culture. Although the nurse can communicate somewhat with the patient in her native language, she would not be able to conduct a thorough assessment without difficulty. Which of the following should the nurse do?

A) Explain that she will do the best that she can with the patient even though she does not completely understand everything the patient is saying
B) Explain that even though they are of the same culture, the nurse is going to obtain an interpreter to help with the assessment process
C) Ask the patient if her daughter can come in and interpret during the assessment process
D) Ask the patient if there is anyone else that understands the language better that can interpret during the assessment process

Answer 3

Explain that even though they are of the same culture, the nurse is going to obtain an interpreter to help with the assessment process

Question 4

A patient from another culture is being visited by a friend who is fluent in English as well as the language of cultural origin. The nurse needs to talk with the patient about starting chemotherapy and the friend volunteers to interpret. Which of the following should the nurse do?

A) Ask the friend to leave the room and explain to the patient what is going to be done without assistance from an interpreter
B) Tell the friend what the patient needs to know so that the friend can interpret
C) Explain what is going to be done so that the friend can give the patient an overview
D) Find out if the patient wants the friend to interpret and know about the patient's healthcare, and document the information in the patient's medical record

Question 5

A terminally ill patient tells the nurse that his priest is coming to anoint him with oil to aid in the healing process and requests that no one come into the room during this time. Which of the following should the nurse do?

A) Suggest that the priest come during evening hours when it is less likely he will be disturbed
B) Tell the patient that there is no way that his request can be met
C) Remind the patient that he is in the hospital and people will come and go in the room as necessary
D) Assure the patient that he and the priest will not be disturbed during the anointing process

Question 6

The nurse is answering the questions on the SPIRIT assessment before using it to assess the patient's spiritual needs. Which of the following explains why the nurse is doing this?

A) To prepare answers for questions that the patient might have difficulty with
B) To practice using the tool
C) To make sure that no questions are missed
D) To improve individual spiritual self-awareness

Question 7

The nurse is planning to conduct a spiritual assessment with a patient diagnosed with cancer. Which of the following should the nurse do first before conducting this assessment?

A) Contact a member of the clergy to be in attendance during the assessment
B) Conduct a self-assessment with the tool that will be used to assess the patient's spiritual needs
C) Provide the assessment tool to the patient to read and review before discussing the responses
D) Ask the patient if he has any spiritual needs to determine if the assessment needs to be done

Question 8

The nurse, caring for a terminally ill patient, is having difficulty with the patient's belief in God and faith for healing. Which of the following can the nurse do to support this patient's spiritual beliefs?

A) Become familiar with her own spirituality first
B) Contact a member of the clergy to talk with the patient
C) Tell the patient that faith in God is fine but that ultimately, medical care is what will heal the patient
D) Nothing, since the patient is in denial

Question 9

The nurse, preparing to administer chemotherapy to a terminally ill patient, sees that the patient is sitting quietly in the room reading the Bible. Which of the following should the nurse do at this time?

A) Ask the patient if the medication can be started while he continues to read
B) Return to administer the medication after the patient has finished reading
C) Announce that it is time for the medication and ask that the reading be done later
D) Sit down in the room and watch the patient read

Question 10

A patient from a different culture has passed away. According to tradition, the body is to be washed by members of the same sex as the patient; however, these individuals are not going to arrive at the hospital for several hours. Which of the following should the nurse do?

A) Complete after-death care and when the members arrive, permit them to conduct the ritualistic washing
B) Complete after-death care and prepare to have the body sent to the morgue
C) Ensure that the deceased patient is not disturbed until the members arrive to conduct the ritualistic washing
D) Have the deceased patient sent to the morgue and when the members arrive, permit the ritualistic washing to occur there

Question 11

The nurse desires to learn more about a particular culture since more patients from that culture are being admitted to the hospital where she works. Which of the following can the nurse do to increase her knowledge?

A) Plan an extended vacation to the country of the culture's origin
B) Attend informational programs and talk with friends from the same culture to learn more about it
C) Nothing can be done since it is difficult to truly learn everything there is to know about another culture
D) Decide that regardless of the culture of origin, the nurse has the responsibility to provide competent care and will do so without any extra effort

Question 12

The family of a terminally ill patient tells the nurse that members of the patient's church are coming to the hospital to lay hands on him and invites the nurse to participate. The nurse does not believe in this intervention and does not want to participate. Which of the following should the nurse do?

A) Tell the family members that the intervention is inappropriate and cannot be done
B) Respectfully decline and offer to find another healthcare professional that is more comfortable participating
C) Tell the patient that this type of intervention provides false hope and strengthens denial of the inevitable
D) Contact a member of the clergy to be in attendance to make sure that nothing unusual occurs

Question 13

A terminally ill patient tells the nurse that he is thankful for having a personal relationship with God and Jesus Christ since he realizes that death is a natural part of living and he is looking forward to meeting his maker. Which of the following does this information provide to the nurse?

A) The patient thinks there is a heaven when there really is not
B) Belief in God helps the patient deny that he is going to die
C) The patient will miss going to church
D) The patient's spirituality is a great source of strength to the patient at this time

Question 14

Which of the following can the nurse do to support a terminally ill patient's spiritual needs?

A) Assess the patient's spirituality before planning interventions
B) Assess the patient's religion and contact appropriate clergy to visit with the patient
C) Ask the patient which religious rituals he would like to follow while in the hospital
D) Ask the patient if he believes in God and what the nurse can do to support his beliefs

Question 15

The newborn baby of a Roman Catholic patient has died. The mother is concerned that since the baby died before being baptized, he is doomed to live in purgatory. Which of the following can the nurse do to support this patient?

A) Find a priest and keep the baby in the morgue until he arrives and can conduct a formal baptism of the child
B) Counsel the mother about purgatory being a myth
C) Explain that all newborns that die go directly to heaven
D) Find a healthcare provider who is of the Roman Catholic faith and prepare for the child to be baptized

Question 16

The nurse is assigned to care for a patient from a culture with which she has limited experience. Which of the following should be done to ensure that this patient receives culturally competent care?

A) Reassign the patient to a nurse with more experience working with patients from the culture
B) Remind the nurse that "a patient is a patient" regardless of his culture of origin
C) Give the nurse a pamphlet describing the differences in the patient's culture
D) Assign an interpreter to be with the nurse when providing care to the patient

Question 17

A terminally ill patient tells the nurse that he hates being in the hospital because he is separated from the things that provides him with strength and support during this difficult time. Which of the following can the nurse do to support this patient?

A) Offer to pray with the patient
B) Tell the patient that he will be going home in a few days and that he will need to wait
C) Find out what would help provide him with the same strength and support he has at home and offer to supply these items
D) Call a clergy member to come and visit with the patient

Question 18

A nurse with experience caring for patients from a particular culture is admitting a patient from that culture. Which of the following should the nurse do to ensure the patient receives culturally sensitive care? 1) Question the patient regarding variations in rituals to find out why he does not follow the usual cultural beliefs and patterns

A) Plan care based upon the needs of previous patients needs from that culture
B) Assume that the patient's desires care be accommodated according to those of the majority of patients from the culture
C) Assess the patient's cultural needs

Question 19

Because of religious beliefs, a terminally ill patient is not accepting medication that could prolong and improve his quality of life. This decision is in violation of the nurse's beliefs. Which of the following should be done?

A) Give the nurse a verbal warning of insubordinate behavior
B) Remind the nurse that every patient has the right to make their own decisions regarding healthcare
C) Facilitate another nurse who is more accepting of the patient's beliefs to provide care to the patient
D) Suspend the nurse from work for 3 days

Question 20

A terminally ill patient tells the nurse that he misses attending mass at his church. Which of the following can the nurse do to help this patient?

A) Remind the patient that he is too weak to attend mass
B) Ask the patient what he misses most about going to church
C) Offer to phone members of the congregation to come and visit him in the hospital
D) Offer to find a religious service on the in-room television for the patient to watch and participate in