In caring for the patient’s spiritual needs, the nurse asks 20 questions to assess the patient’s relationship with God and a sense of life purpose and satisfaction. Which method is the nurse using?

Choice A reason: Low blood pressure is not typically associated with prolonged stress. Chronic stress elevates cortisol, which can increase blood pressure via sympathetic activation. Hypotension may occur in acute stress response (e.g., shock), but prolonged stress more commonly causes hypertension, making this an incorrect condition to monitor.

Choice B reason: Prolonged stress suppresses immune function by elevating cortisol, reducing lymphocyte activity and increasing infection risk. Conditions like respiratory or urinary tract infections become more likely. Monitoring for infections is essential, as stress weakens the body’s ability to fight pathogens, making this a correct condition to assess.

Choice C reason: Alopecia, or hair loss, can result from prolonged stress due to elevated cortisol disrupting hair follicle cycles, leading to telogen effluvium. Stress-induced autoimmune conditions like alopecia areata may also occur. Monitoring for hair loss is appropriate, as it reflects stress’s physiological impact, making this a correct choice.

Choice D reason: Prolonged stress increases diabetes risk by raising cortisol and catecholamines, which elevate blood glucose and impair insulin sensitivity. This can exacerbate or precipitate type 2 diabetes. Monitoring glucose levels is critical, as stress contributes to metabolic dysregulation, making this a correct condition to assess.

Choice E reason: Chronic stress is linked to cancer through immune suppression and inflammation, which may promote tumor growth. Elevated cortisol and stress hormones can impair DNA repair mechanisms. Monitoring for cancer risk, especially in high-stress patients, is warranted, as stress is a known risk factor, making this a correct choice.

Choice A reason: Scolding the surgeon is unprofessional and escalates the situation unnecessarily. It fails to respect the colleague’s role while disregarding therapeutic communication. A firm, respectful explanation upholds the patient’s wishes without confrontation, making this an inappropriate response that could harm professional relationships.

Choice B reason: Firmly explaining that the patient does not wish to have visitors respects the patient’s autonomy and the agreed-upon “Do not disturb” sign. This response is professional, assertive, and protects the patient’s need for rest, reducing agitation while maintaining collegiality, making it the most appropriate action.

Choice C reason: Allowing the surgeon to enter disregards the patient’s expressed need for privacy and the “Do not disturb” sign. This undermines trust and exacerbates the patient’s agitation, contradicting the nurse’s role as an advocate. This action fails to prioritize the patient’s well-being, making it incorrect.

Choice D reason: Calling security is an extreme measure, inappropriate for a non-threatening situation. It escalates a manageable interaction and risks damaging professional relationships. A firm explanation is sufficient to enforce the patient’s wishes, making this an overreactive and unnecessary response to the situation.