Chapter 14

Your 45-year-old, mentally competent patient is having excessive blood loss from surgery. She is a Jehovah’s Witness and refuses a blood transfusion. Her blood pressure has been falling, and she has a rapid heart rate. What would an appropriate nursing intervention be? 1. Assist the RN in administering IV fluid boluses and medications to support the blood pressure. 2. Make the patient comfortable with a warm blanket because she is avoiding lifesaving measures. 3. Prepare to help the RN administer blood after the patient loses consciousness. 4. Try to convince the patient that she should have the blood transfusion.

An older Japanese adult who does not speak English is admitted to the surgical unit after major abdominal surgery, with no family member present. The nurse cannot speak the patient’s language. To assess for pain, the nurse should: 1. Look for nonverbal indicators of pain: grimacing, moaning, or restlessness. 2. Obtain the services of a translator to devise question-and-answer cards regarding pain. 3. Wait for the family to come to ask the patient about pain. 4. Use nonverbal gestures to get the patient to indicate his pain level.

. An older Mandarin-speaking woman is grimacing and refusing to eat when served hospital food. What should the nurse do to meet the patient’s nutritional needs? 1. Contact the kitchen and order a rice or noodle dish. 2. Continue serving hospital food until the patient decides to eat it. 3. Contact the primary caregiver to assess the patient’s dietary habits. 4. Use the certified health care translator to explain to the patient that the kitchen will try to accommodate her nutritional request if possible.

A patient who is Roman Catholic asks to have the priest come to hear her confession and administer communion before she goes to surgery. The priest arrives the evening before the patient is scheduled for the operating room but after normal visiting hours. The nurse should: 1. Suggest that the priest return after surgery because the patient has been medicated and is drowsy. 2. Provide privacy for the priest to hear confession and administer communion. 3. Inform the priest that the patient has not attended confession for a long time. 4. Offer to stay with the patient and the priest during the visit to assist the priest.

The nurse is caring for a newly admitted homeless male patient who states that his last meal was 12 hours ago, but insists that he must talk to the pastor before he eats. Which statement would indicate that the nurse is providing culturally congruent care? 1. “You should eat first. It’ll be easier for you to talk to the pastor once you had some food.” 2.“I’ll contact our pastoral care department to arrange the pastor visit, and the kitchen to order a meal for you. Your meal will be here for you when you are ready to eat.” 3. “I’ll contact the pastor and ask him to come in as soon as possible. Would you like me to ask him to bring some food with him?” 4. “The pastor doesn’t mind if you eat before you see him. You should have some food. It will make you feel better.”