CHPN Patient & Family-Centered Care 3 — Questions and Answers
Question 1: A hospice nurse is caring for a patient whose family's cultural background discourages direct discussion of death with the patient. The nurse should:
- Insist on full disclosure to the patient regardless of cultural norms
- Explore the family's cultural beliefs and negotiate a communication approach that respects them (Correct answer)
- Avoid all discussion of prognosis with the entire family
- Document the family as non-compliant in the chart
Correct answer: Explore the family's cultural beliefs and negotiate a communication approach that respects them
Culturally competent care requires exploring and respecting cultural beliefs while ensuring the patient's own needs and preferences are not completely overridden.
Question 2: A patient requests a specific religious ritual before death. The hospice nurse's first action should be:
- Explain that hospice focuses on medical comfort, not religious rituals
- Contact the hospice chaplain and facilitate access to appropriate religious support (Correct answer)
- Ask the family to arrange this independently outside of hospice services
- Document the request and wait for the physician's approval
Correct answer: Contact the hospice chaplain and facilitate access to appropriate religious support
The hospice chaplain is the appropriate interdisciplinary team member to coordinate religious and spiritual care aligned with the patient's traditions.
Question 3: Which assessment tool is most appropriate to evaluate a hospice patient's spiritual distress?
- PHQ-9 depression scale
- FICA Spiritual History Tool (Correct answer)
- Karnofsky Performance Scale
- Pittsburgh Sleep Quality Index
Correct answer: FICA Spiritual History Tool
The FICA Spiritual History Tool assesses Faith, Importance, Community, and Address, making it appropriate for spiritual distress evaluation in hospice.
Question 4: A hospice patient from a culture where the family is expected to make all medical decisions tells the nurse privately that she does want to know her prognosis. How should the nurse proceed?
- Honor only the family's cultural role and withhold information
- Respect the patient's autonomous request and discuss the prognosis with her privately (Correct answer)
- Ask the physician to override the family's wishes formally
- Schedule a family meeting before disclosing anything to the patient
Correct answer: Respect the patient's autonomous request and discuss the prognosis with her privately
A competent patient's right to information supersedes family cultural preferences; the nurse should provide the requested information while remaining sensitive.
Question 5: When working with a family whose primary language is not English, the hospice nurse should:
- Ask a bilingual family member to interpret all clinical discussions
- Arrange for a professional medical interpreter for clinical conversations (Correct answer)
- Use simplified English and rely on gestures to communicate
- Limit communications to written materials in the family's language
Correct answer: Arrange for a professional medical interpreter for clinical conversations
Professional medical interpreters ensure accurate, unbiased communication and protect confidentiality in clinical settings.
Question 6: A family member insists that the patient must be buried in specific clothing and asks the nurse to ensure this happens. This is an example of:
- Interference with clinical care
- A cultural or religious end-of-life practice that should be documented and honored (Correct answer)
- An inappropriate request outside hospice scope
- A legal matter requiring attorney involvement
Correct answer: A cultural or religious end-of-life practice that should be documented and honored
Honoring cultural and religious end-of-life practices such as burial preparation is within the scope of patient-centered hospice care.
Question 7: The BEST description of culturally competent hospice nursing is:
- Treating all patients identically regardless of background
- Adapting care practices to align with each patient's cultural values and preferences (Correct answer)
- Prioritizing clinical protocols over cultural considerations
- Referring all cultural questions to the social worker
Correct answer: Adapting care practices to align with each patient's cultural values and preferences
Culturally competent care requires actively adapting practices, communication, and goals to align with each patient's unique cultural values.
CHPN Patient & Family-Centered Care 3
A hospice nurse is caring for a patient whose family's cultural background discourages direct discussion of death with the patient.
The nurse should: