Ch. 22 - Spirituality - Sherpath, Evolve, EOC
END OF CHAPTER QUESTIONS
END OF CHAPTER QUESTIONS
Which statement made by an older adult whose husband recently died indicates the need for follow-up by the nurse? "I planted a tree at church in my husband's honor." "I have been unable to talk with my children lately." "My friends think that I need to go to a grief support group." "I believe that someday I'll meet my husband in heaven."
"I have been unable to talk with my children lately." Feelings of connectedness are important for the older adult; this statement indicates that this woman is having difficulty staying connected with her children, who are potentially an important resource for the woman. Planting a tree in her husband's honor indicates healthy coping. The need for a support group is based upon her friend's perceptions and not the widow's. Believing that she will someday join her husband in heaven signifies hope.
Which aspects would be considered positive effects of spirituality on an individual? (Select all that apply.) Behaviors Quality of life Compliance Education Lifestyle
Behaviors Quality of life Lifestyle Spirituality affects an individual's health behaviors, quality of life, and lifestyle in a positive way. Spirituality helps individuals maintain health and well-being and also cope with illness. Compliance and education are not entirely dependent on the spirituality of an individual.
The nurse comforts the parent of a 10-year-old boy diagnosed with cancer. The parent says that life would be meaningless without the child. Which trait is the parent exhibiting? Loss of belief in religion Fear of death Transcendence Spiritual distress
Spiritual distress When a person loses the ability to integrate meaning and purpose in life, he or she is said to be in spiritual distress. It causes the person to lose faith, doubt religion, and lose hope. A person who loses belief in religion finds himself or herself in conflict with self and religious belief systems. The parent does not exhibit loss of belief in religion or fear of death. Transcendence is a feeling or experience beyond normal and above the material world.
Which behavioral characteristic of a patient indicates hopelessness? Complaining about the treatment plan Demanding extra attention Seeking alternative care activities Failing to follow medical recommendations
Failing to follow medical recommendations Hopeless individuals tend to be passive and uninterested in seeking care or following through with recommendations. They feel that none of the interventions would be beneficial in treating their condition. Therefore they do not often complain or draw attention to themselves by demanding attention or seeking other care.
Which understanding would the nurse have about a patient's agnostic spiritual belief? There is not one but many gods. The existence of a God is not known. God or higher powers do not exist. God has established a covenant.
The existence of a God is not known. An agnostic believes that the nature or existence of God cannot be known. An agnostic neither believes nor claims to disbelieve in God. Individuals who practice Hinduism believe in the concept of many gods, who are different aspects of one God. An atheist does not believe that any higher power exists. Individuals who practice Judaism believe that God established a covenant with the Jews.
11. The nurse is caring for a middle-aged patient with severe heart disease who is awaiting a heart transplant. The patient must stay in the hospital until the surgery or death occurs. The patient breaks down crying saying, "I don't want this and I just want to go home." What response by the nurse is best? a. "If you go home, you know you will die." b. "What can I do to make your hospital stay better?" c. "You don't have to do this. What do you want to do?" d. "Can I call the chaplain to come talk to you?"
c. "You don't have to do this. What do you want to do?" The patient is in spiritual distress looking for meaning and purpose in the situation. The nurse is helping the patient search for meaning.
Which action would be an appropriate intervention by the nurse to help a mother bond with her dying infant? Allow the mother to hold the infant and pray. Pray for the infant as well as with the mother. Help the mother to read from a spiritual text. Arrange for the chaplain to pray with the mother.
Allow the mother to hold the infant and pray. The nurse must remove environmental barriers and allow the mother to hold the infant while praying. The nurse may pray with the mother, read passages from a spiritual book, or arrange for the chaplain to pray with the mother as a means of providing spiritual care. However, these are not nursing interventions that promote mother-infant bonding.
EVOLVE - ONLINE ONLY REVIEW QUESTIONS
EVOLVE - ONLINE ONLY REVIEW QUESTIONS
A patient is scheduled for a chemotherapy treatment and asks the nurse to pray. Which intervention would be appropriate for a nurse who is not accustomed to praying? Arrange for the chaplain to pray with the patient since the nurse is busy. Ask the family members to pray with the patient instead of the nurse. Ask if there is anything else that can be done for the patient at this time. Maintain a respectful silence and allow the patient to lead all the prayers.
Maintain a respectful silence and allow the patient to lead all the prayers. The best intervention in this situation would be to maintain respectful silence and allow the patient to lead the prayer. This provides comfort for the patient and fosters trust in the nurse. The nurse may arrange for the chaplain or family members to join in the prayer; however, the nurse's presence is required. The nurse should not evade the situation by making an excuse or asking if something else can be done.
A Catholic patient receives a meal tray on the Friday before Easter. Which food item would the nurse offer to substitute? Applesauce Cheese and crackers Spaghetti with meat sauce Tossed salad with ranch dressing
Spaghetti with meat sauce Most Catholics do not eat meat on Good Friday. Patients who practice Catholicism are able to eat applesauce, cheese, crackers, and a tossed salad with ranch dressing, provided that the salad does not contain any meat.
2. Which interventions are considered helpful to assist nurses coping with the unexpected death of a patient for whom they cared for many weeks? ( Select all that apply). a. Attending a Code Lavender with unit colleagues b. Journaling personal reflections surrounding the death of the patient c. Scheduling to work to a different shift than the one regularly worked d. Arranging a consultation with the unit manager to discuss a possible unit transfer e. Setting aside time for relaxation activities such as painting, gardening, or exercising
a. Attending a Code Lavender with unit colleagues b. Journaling personal reflections surrounding the death of the patient e. Setting aside time for relaxation activities such as painting, gardening, or exercising Attending a Code Lavender, journaling personal reflections, and setting aside time for relaxation activities are all considered helpful strategies for nurses coping with loss and stress. Scheduling to work different shifts and discussing a possible unit transfer are both forms of avoidance that may result in increased stress and delayed grieving.
8. What is the best way to provide spiritual care to a 2-year-old patient? a. Read a childhood story about good versus evil. b. Play hide and go seek and let the child find you every time. c. Let the toddler play with pretend medical supplies. d. Talk to the mother about special religious diets.
a. Read a childhood story about good versus evil. Toddlers need concrete examples of good versus evil to better understand meaning.
An emergency department nurse is caring for a patient who was severely injured in a car accident. The patient's family is in the waiting room. They are crying softly. The nurse sits down next to the family, takes the mother's hand, and says, "I can only imagine how you're feeling. What can I do to help you feel more at peace right now?" Which type of support is the nurse demonstrating? Prayer Presence Coaching Instilling hope
Presence The nurse demonstrates presence in this situation by establishing a therapeutic relationship and being with the mother during a particularly stressful time. Prayer is spoken or unspoken communication with a higher power. Coaching is not a type of spiritual support. The ability to have faith allows people to demonstrate hope (confident expectation) of a positive outcome in the face of challenging circumstances.
1. What is spirituality? a. Practicing religion b. Expressing meaningful and purpose in life c. Yoga or other meditative practices d. Spending time with family
b. Expressing meaningful and purpose in life Spirituality is the expression of meaning and purpose in life. People have different methods of expressing this ... do not assume that any one method is universally helpful.
8. The nurse is caring for a 45-year-old woman who is a breast cancer survivor. What activity associated with her cancer experience will promote this patient's spiritual well-being? a. Attending church every week b. Ensuring she follows her medication regimen c. Genetic testing on family members d. Speaking about her cancer experience to increase breast cancer awareness
d. Speaking about her cancer experience to increase breast cancer awareness Speaking about her experience helps promote meaning and purpose in life. Church attendance does not guarantee time of spiritual reflection related to her breast cancer experience. Treatment and genetic testing assist in physical treatment and risk identification but do not necessarily relate to finding meaning and purpose.
Which statement made by a patient receiving chemotherapy demonstrates an expression of hope? "I'm happy and content; I've given my best in life." "Medical science is always coming up with new discoveries." "I will attend my daughter's graduation ceremony in 6 months." "My father also had cancer but died of a heart attack instead."
"I will attend my daughter's graduation ceremony in 6 months." The patient hopes to overcome the difficulties of chemotherapy and survive cancer to be around in 6 months to attend his or her daughter's graduation ceremony. This is an expression of hope. The patient who expresses happiness and satisfaction in life may be preparing for death. Stating that medical science is always coming up with new discoveries acknowledges the possibility of a cure, but is not a confident expectation of a positive outcome. The patient compares the parent's death to the present situation and tries to rationalize by thinking that cancer may not be the cause of his or her death.
A nurse evaluates a patient for achievement of goals related to spiritual well-being and finds that the patient does not display positive outcomes. Which questions would the nurse ask to develop an appropriate continued care plan? Select all that apply. "What is the problem with you? Why aren't you coping well with the situation?" "What is holding you back, and what can I do to help restore hope?" "Why hasn't your family shown up? Are you not yet talking to them?" "Do you want me to ask your wife to talk to you? "Do you want me to put you on antidepressants?"
"What is holding you back, and what can I do to help restore hope?" "Do you want me to ask your wife to talk to you? When appropriate outcomes are not met, the nurse should ask the patient about strategies to reach positive outcomes. Asking about what is holding the patient back and if the patient wants his wife to talk to him may help the nurse determine appropriate continued care. Asking blunt questions, such as "What is the problem with you?" and "Why hasn't your family shown up?" may prompt the patient to stop talking. Opting for medication use for dealing with health-related stress is not recommended.
Which interventions would the nurse perform for a patient who is experiencing spiritual concerns? (Select all that apply.) Share personal beliefs with the patient. Actively listen when the patient speaks. Arrange for the chaplain upon admission. Allow the patient to reveal spiritual needs. Support rituals that promote spiritual growth.
Actively listen when the patient speaks. Allow the patient to reveal spiritual needs. Support rituals that promote spiritual growth. The patient seeks comfort in speaking about personal spiritual experiences or disturbances to the nurse, so the nurse must listen attentively. The nurse should ask open-ended questions about spiritual needs, so that the patient leads the conversation and reveals spiritual needs. Religious rituals provide comfort and solace to the patient. The nurse must allow the patient to perform rituals as a part of providing spiritual care. The nurse should not share personal beliefs with the patient, as they may be contradictory and conflict with the patient's own beliefs. It is not ethical for the nurse to contact the chaplain unless requested by the patient.
Which intervention would the nurse provide, in accordance with Buddhist tradition, for the family of a Buddhist patient who died? Prepare the body for cremation as soon as death occurs. Allow the family to stay with the deceased patient for 2 hours. Prepare and transfer the body to a funeral home immediately. Allow the family to participate in preparing the body for burial.
Allow the family to stay with the deceased patient for 2 hours. The nurse must allow the Buddhist family to stay with the body for 2 hours before it is transferred off the nursing unit. The Sikh community prepares the body for cremation as soon as death occurs. The nurse need not immediately prepare and transfer the body of the Buddhist patient to a funeral home. Buddhists cremate the dead; they do not bury them.
The nurse identifies a need for spiritual intervention in a patient who is atheist. Which nursing action would not be appropriate to meet the spiritual needs of this patient? Talking to the patient about enrolling in a nonreligious group meeting Asking the family about what is important in the patient's life Arranging for a clergy person to visit the patient Teaching the patient meditation and relaxation techniques
Arranging for a clergy person to visit the patient The nurse should be sensitive to a patient's personal beliefs and should not impose personal beliefs and assumptions on patients. When a nurse arranges a visit by a clergy person for an atheist patient, the nurse may offend the patient's personal beliefs and principles. This would negatively impact the therapeutic relationship and could lead to undesired outcomes. When planning interventions such as group meetings, the nurse should include the patient and should respect the patient's beliefs. The family and those closest to patients should also be included and consulted. Teaching meditation and relaxation techniques may help the patient achieve inner peace and tranquility.
The spouse of a patient who is terminally ill is in spiritual distress. Which other situations would adversely affect the spirituality of an individual? Select all that apply. Diagnosis of diabetes Major motor vehicle accident Successful surgery Birth of twins Near-death experience
Diagnosis of diabetes Major motor vehicle accident Near-death experience Spirituality is significantly influenced by chronic illness, acute illness, and near-death experiences. Diagnosis of diabetes, a chronic illness, creates stress and anxiety in a person, because that person will have to modify his or her lifestyle and diet. A person who experiences a major motor vehicle accident may be in distress and confused, possibly leading to spiritual distress. A patient who had a near-death experience feels that no one will believe his or her experiences. A successful surgery and birth of twins likely would elevate the spirituality of an individual.
Which measures would the nurse take to ensure that a Jewish patient is satisfied with the food served at the facility? Select all that apply. Do not include any pork or shellfish. Never mix meat and dairy products. Provide the patient vegetarian food. Provide food that is labeled as kosher. Refrain from cheese and eggs in the diet.
Do not include any pork or shellfish. Never mix meat and dairy products. Provide food that is labeled as kosher. Judaism prohibits adherents from consuming pork and shellfish. The nurse must ensure that observant Jewish patients do not receive any meat or dairy products in the same food tray. The nurse must also ensure that the patient receives food that is designated kosher. A patient who practices Hinduism is served vegetarian food. Jewish patients who follow a traditional diet are permitted to eat cheese and eggs.
Which questions would help the nurse assess a patient's spirituality? (Select all that apply.) Do you attend church on a regular basis? Who do you feel is the closest to you? What do you want to achieve in your life? Have you assigned a power of attorney? Do you wish to change your profession?
Do you attend church on a regular basis? Who do you feel is the closest to you? What do you want to achieve in your life? When assessing a patient's spirituality, the nurse should enquire about the patient's feelings and views on life, the level of connectedness with self and others, and the practice of religion. Asking if the patient attends church (religious practice), the one person the patient is closest to (connectedness), and the patient's aim in life (view of life) would help the nurse identify the patient's spiritual needs. Assignment of power of attorney and desire to change profession would not shed light on the patient's spirituality.
The nurse is caring for an elderly patient with Alzheimer's disease. Which signs does the nurse identify as a need for spiritual care interventions for the spouse? Select all that apply. Family pictures from the bedside table have been turned over by the spouse. The spouse requests that the nurse join in a prayer during each visit. All religious ornaments and jewelry have been removed by the spouse. The spouse contacts their faith community and has regular daily visitors. The spouse has arranged for the family's spiritual advisor to visit often.
Family pictures from the bedside table have been turned over by the spouse. All religious ornaments and jewelry have been removed by the spouse. Environmental cues such as turning over family pictures at the patient's bedside and removing religious ornaments from both the patient and the spouse would suggest that the spouse needs spiritual care. Requesting that visitors join in a prayer is normal practice for many people and does not indicate a need for spiritual care interventions. The spouse's spiritual need is already met when members of the faith community visit the patient during hospitalization. Spiritual needs are met when the family's spiritual advisor visits the patient and spouse.
A patient who is hospitalized with heart failure states that she sees her illness as an opportunity and a challenge. Despite her illness, she is still able to see that life is worth living. Which quality reflects this attitude? Hope Faith Values Connectedness
Hope Hope refers to an energizing source that is oriented to future goals and outcomes. Faith allows people to have firm beliefs despite lack of physical evidence; in this situation the patient is energized by the future and has hope that it will be positive despite her heart failure. Value is the regard that something is believed to deserve; the importance, worth, or usefulness of something. Connectedness implies that family and friends are providing the spiritual care.
A devoutly religious Christian patient suffers from an anxiety disorder. Which type of information would a nurse avoid providing to the patient pertaining to the religious aspect of connectedness? Impersonal Interpersonal Intrapersonal Transpersonal
Impersonal Religion does not promote impersonal behavior. Spirituality offers a sense of connectedness through interpersonal relationships such as the relationships with others. Spirituality also helps connect with oneself, which is called intrapersonal connection. Transpersonal connectedness refers to connection with God or a higher power.
A young Hindu woman, who is a mother of two children, is admitted with myocardial infarction. The patient's family is very sad and refuses to leave the patient. Which nursing action would help the patient and her family cope with this difficult time? Select all that apply. Ask the family to wait in the waiting room and not visit the patient Motivate the family to perform religious rituals as needed Talk to the children and instill hope about the patient's condition Deny religious rituals in the hospital as they are not allowed Make sure a female health care provider is treating the patient
Motivate the family to perform religious rituals as needed Talk to the children and instill hope about the patient's condition Make sure a female health care provider is treating the patient The patient and the family should be allowed to perform religious rituals if safe for the patient. The nurse should try to comfort the children, who may be in shock, by instilling hope that patients like their mother can recover in a matter of time. A female Hindu patient prefers female health care providers. The family should be allowed to visit the patient. Denial of rituals may cause spiritual distress in the patient and the family.
While caring for a Muslim female patient, which religious beliefs and practices would the nurse keep in mind? Select all that apply. Privacy for prayer Health and spirituality are two different issues. Women prefer female health care providers. During the month of Ramadan, they do not eat until sundown. Medicines are not accepted because they believe that chemicals are harmful for the body.
Privacy for prayer Women prefer female health care providers. During the month of Ramadan, they do not eat until sundown. Privacy is preferred during prayer. The women of this religion prefer a female health care provider. Therefore the nurse must arrange for female health care providers so that the patient is comfortable. Ramadan is a holy month for the followers of Islam. During Ramadan, the followers of Islam do not eat and drink until sundown. So the nurse must take additional care during this month. Muslims believe that health and spirituality are connected. Buddhists believe that medicines are harmful.
When caring for a Sikh patient, which religious practices would the nurse expect to affect the care of the patient? Select all that apply. Restrictions regarding shaving Refusal of blood transfusions Need to maintain modesty Use of a turban head covering Refusal of non-vegetarian foods
Restrictions regarding shaving Need to maintain modesty Use of a turban head covering Individuals following Sikhism have restrictions for shaving that may affect their health care, especially when preparing for a surgery. The nurse may have to ensure that the patient has only same-sex caregivers to uphold the patient's preference for modesty. The use of a turban head covering may also affect the care of a patient who is confined to bed for a few days. A patient who belongs to the Jehovah's Witness group may refuse blood transfusions. A patient practicing Hinduism may refuse non-vegetarian foods.
When planning care for a sick patient, which actions would the nurse take to include spiritual care? Select all that apply. Scheduling time for religious readings Letting the patient play religious music Having family members plan a prayer session Having the patient read religious books all the time Permitting the patient to miss medication occasionally
Scheduling time for religious readings Letting the patient play religious music Having family members plan a prayer session To support spiritual activities, the nurse must allow the patient to read religious books and listen to religious music. These activities help build a healthy environment. Family members can also plan a prayer session without disturbing the patient's normal activities. Reading religious books continuously can disturb the patient's schedule of rest. Missing medication cannot be allowed even occasionally.
Which question would assess a patient's level of connectedness? What gives your life meaning? Which aspects of your spirituality would you like to discuss right now? Who do you consider to be the most important person in your life at this time? How do you feel about the accomplishments you've made in your life so far?
Who do you consider to be the most important person in your life at this time? Connectedness refers to feelings about relationships with self, others, and God; this question asks about connectedness with others. Spirituality gives life meaning. Asking the patient which aspects of spirituality to discuss is an open-ended question about spirituality. Feelings of life accomplishments involves reflection.
10. You are caring for a 28-year-old married man diagnosed with leukemia. He is hospitalized on reverse isolation. It is his anniversary and his wife is planning to visit. What would be appropriate nursing care to promote spiritual health? a. Assist him in planning a celebration of his anniversary. b. Ensure he has adequate pain medication to endure the visit. c. Maintain strict reverse isolation to prevent infection. d. Congratulate the couple on their anniversary.
a. Assist him in planning a celebration of his anniversary. Celebrating their anniversary promotes hope, love, and compassion, while fostering spiritual connections between the husband and wife.
3. The nurse has been caring for a patient who just died. The patient's daughter is crying uncontrollably, saying, "She was my best friend. I thought she would make it! I don't know what I am going to do." What is the nurse's best response? a. Express sympathy and ask if she would like to talk with a chaplain. b. Give the daughter time to cry in her mother's room alone. c. Ask the daughter if her father is still living. d. Inquire if the daughter would like to pray.
a. Express sympathy and ask if she would like to talk with a chaplain. At crisis times, spiritual advisors or chaplains are the best resource with the expertise to address family members' needs. Leaving the daughter alone or inquiring about her father would not provide the emotional support needed. The nurse should avoid making suggestions to the daughter but instead should seek to identify needs from the daughter's cues.
4. A nurse assigned to the neonatal intensive care unit (NICU) has spent most of a day working with a critically ill infant, with the mother standing by. The infant experiences a cardiac arrest and does not survive. The mother spends an hour crying and holding the baby, saying good-bye. Which spiritual care interventions are most appropriate for the nurse to implement? (Select all that apply.) a. If desired, briefly hold the baby to say good-bye after the mother leaves. b. Follow procedures to prepare the body for transport to the morgue. c. Visit the mother the next day to see how she is doing. d. Call the family spiritual adviser or the chaplain. e. Ask the mother if you could call a family member or friend to be with her.
a. If desired, briefly hold the baby to say good-bye after the mother leaves d. Call the family spiritual adviser or the chaplain. e. Ask the mother if you could call a family member or friend to be with her. It is important for nurses to take time to say "good-bye" to patients with whom they have developed a relationship. In this case, it would be appropriate for the nurse to hold the infant briefly, if desired, after the family has left before preparing the body for the morgue. With consent, the mother needs to be surrounded by appropriate persons to provide spiritual support, including a chaplain, family members, and friends. Although it is critical that the nurse follow procedures in preparing bodies for the morgue, it is not considered spiritual care. Visiting the mother after her loss could be viewed as a violation of professional boundaries, especially for a nurse who worked with the family for only a day.
6. A female nurse is caring for a male patient who is a follower of Islam. How would this affect the nurse's care? a. Integrate prayer times around care. b. Have the wife present during bathing. c. Provide for a kosher diet. d. Maintain the headdress covering.
a. Integrate prayer times around care. Muslims pray five times a day facing Mecca with cleansing preparation (providing a washcloth is appropriate). Modesty is important, which implies that it is best to have a male assistant complete the bath. Muslims do not follow kosher diets or use a headdress.
5. A nurse is caring for an American Indian who lives on a reservation. What spiritual practices would the nurse incorporate in care for this patient? a. Storytelling b. Native American foods c. Organic-based medications d. Native American dance and music
a. Storytelling Storytelling is central to American Indian beliefs.
9. The nurse is caring for an 8 year old who is receiving an intramuscular injection. The patient says, "You hurt me all the time. What did I do wrong?" What is the nurse's best response? a. "You didn't do anything wrong." b. "Why do you think you did anything wrong?" c. "Who told you that you did something wrong?" d. "It will only be a little bee-sting."
b. "Why do you think you did anything wrong?" This question encourages the child to think about case and effect. Spiritual care differs according to the patient's developmental age. For the school-age child, spiritual growth happens as a result of finding meaning in social relationships and applying principles of ethical and moral reasoning.
3. A nurse is caring for a Hindu patient. What religious practice might affect nursing care? a. Patient will refuse pain medication because pain is due to bad karma. b. Family may bring in hot or cold food and drink from home to help remove toxins. c. Patient may have special head coverings that cannot be removed. d. Religious leaders are usually involved in health care decision making.
b. Family may bring in hot or cold food and drink from home to help remove toxins. Hindus integrate both Western and Eastern medicine. They believe that disease is caused by toxins in the body and medicine or hot/cold food helps remove toxins. Headdress and gurus are associated with Sikhism.
7. How do you best provide spiritual care to an infant? a. Meet basic feeding needs. b. Hold and rock the infant. c. Play with the infant using brightly colored soft objects. d. Set regular sleeping schedules.
b. Hold and rock the infant. Spiritual care for an infant is to promote love and compassion. Building trust and loving relationships is fundamental to development of their primal faith.
9. The nurse is caring for a religious patient who is going to surgery the next day. The patient states that she is afraid and asks the nurse to pray with her, although the nurse is not religious. What is the most appropriate response by the nurse? a. "I am not confident praying, but I will think about you tomorrow." b. "I need to take care of other patients right now, but I will be back." c. "I am uncomfortable praying. May I call the chaplain for you?" d. "I don't do that. Nurses are not allowed to do that at our hospital."
c. "I am uncomfortable praying. May I call the chaplain for you?" Offering to call the chaplain because the nurse is uncomfortable praying is the best option. Avoiding the subject or focusing on the nurse's feelings or needs is not appropriate and will not provide for the patient's stated spiritual need.
5. Which statement by a patient best illustrates reflection on a spiritual need? a. "My husband told me what to do about this situation, and I'm sure he's right." b. "There is little I can do now to change my circumstances. I just need to adapt." c. "I need to think a little more about how I feel about undergoing this treatment." d. "Whatever the physician wants to do is fine. I don't have much of an option."
c. "I need to think a little more about how I feel about undergoing this treatment." Reflection requires intentional thought about a situation to determine how it affects or is affected by the person's beliefs and values. Simply having someone tell the person what to do is not reflection. Adopting a fatalistic attitude or accepting the decision of a physician without inquiry are not reflection either.
7. When caring for patients who are Jewish, how best can the nurse address their religious needs? a. Order a kosher diet. b. Allow time for prayer before each meal. c. Ask about religious holidays, particularly religious practices around the Sabbath. d. Ask about religious practices affecting care.
d. Ask about religious practices affecting care. There are a variety of levels of observance within the Jewish community. It is best to ask patients about what practices will affect their care. Do not assume that all persons of faith are equally observant of religious traditions.
Which statement from a patient with terminal cancer supports a nursing diagnosis of hopelessness (ICNP)? "I have nothing to live for now." "What will happen to my spouse when I die?" "How much longer do I have to live?" "I need to go to church and pray for a miracle."
"I have nothing to live for now." Patients with hopelessness (ICNP) verbalize lack of hope and meaning. The statement "I have nothing to live for now" indicates that the patient feels no meaning or hope for their life. Worrying about what will happen to family members, how much longer the patient has to live, and verbalizing the need to go to church to pray are not actions a person with hopelessness would typically perform.
The nurse is caring for a patient with acute renal failure who is also recovering from the recent loss of a young child. Which statements made by the patient indicate spiritual distress? (Select all that apply.) "I always thank God for my faith community, who stood by me." "I need to talk to the chaplain and seek help in this situation." "Why is God punishing me; how can I handle this illness alone?" "I don't trust anybody now; I didn't expect this to happen to me." "I've always been very religious; why would my God do this to me?"
"Why is God punishing me; how can I handle this illness alone?" "I don't trust anybody now; I didn't expect this to happen to me." "I've always been very religious; why would my God do this to me?" Spiritual distress happens when the person's belief system is challenged during health crises or life-changing events. When the patient asks why God would do this, the patient expresses doubt in the utility of devotion to God. The patient expresses distrust and questions the need to have faith in God. The individual may also be depressed and express feelings of loneliness and that the illness is a punishment. The patient who seeks comfort in a faith community or a chaplain is coping well and will more than likely overcome spiritual distress.
A Muslim patient is scheduled for transplant surgery. The patient asks the nurse to postpone the operation for an hour so that the evening prayers can be completed before the operation. How would the nurse respond to such a request? Ask the patient to finish his prayers early. Offer to pray on his behalf so the operation is on time. Ask the family to persuade the patient to be on time for surgery. Agree to the patient's request and postpone surgery.
Agree to the patient's request and postpone surgery. The nurse should allow time for the patient's religious rituals, prayers, spiritual visitations, and attendance in religious services. These are integral parts of the patient's spiritual well-being. Followers of Islam have specific timing for prayers and should not be asked to pray early. The nurse may offer to pray with the patient but not on his behalf, as the nurse may not know the prayer ceremonies the patient prefers. The nurse should not ask the family to persuade the patient to be on time for the operation if that means he misses his prayer time.
A patient states that he does not believe in the existence of God. Which term describes this patient? Academic Atheist Agnostic Anarchist
Atheist Atheists do not believe in the existence of God. An academic is a learned person who is either involved heavily in school or is an educator by profession. An agnostic believes that the nature or existence of God is unknowable. An anarchist is a person who rebels against any authority, established order, or ruling power.
10. How do people who participate in organized religion differ from nonreligious people? a. Religious people are healthier than spiritual people. b. Religious people are more spiritual than nonreligious people. c. Religious people express their spirituality through faith traditions. d. Religious people have spiritual practices, whereas nonreligious people do not have spiritual practices.
c. Religious people express their spirituality through faith traditions. Religious people express their beliefs through faith traditions. Research has not indicated that religious people are healthier or more spiritual than those who do not participate in organized religion. Nonreligious people may practice various spiritual disciplines.
1. The nurse is caring for a 16-year-old boy receiving chemotherapy for testicular cancer. He says that his parents are religious and left a cross next to his bed for "good luck." What is the most appropriate response by the nurse? a. "Would you like to talk with a chaplain?" b. "Sounds like you are not very religious." c. "How well do you get along with your parents?" d. "What helps you get through tough times?"
d. "What helps you get through tough times?" Asking an open-ended question is the best response that the nurse can make to this patient's comment. It will encourage the patient to share what he thinks would be most supportive at this time. Asking the patient if he would like to talk with a chaplain is incongruent with his comment about having a cross for good luck. Sharing that he does not sound religious is judgmental, and asking about his relationship with his parents is changing the subject.
2. What is transcendence? a. Out of body experience b. A meditative state c. A higher power d. Spiritual growth over time
d. Spiritual growth over time Transcendence is moving beyond who you are toward who you will become. By definition, it is spiritual growth over space and time or moving beyond one's current self.
A nurse is caring for a patient who refuses to eat until after sunset. Which religion does this patient most likely practice? Islam Sikhism Hinduism Catholicism
Islam Patients who practice Islam do not eat until after the sun goes down during the month of Ramadan. Sikhism, Hinduism, and Catholicism do not have restrictions on eating in relationship to sunrise and sunset.
Which statement made by an elderly patient whose spouse died a week ago indicates spiritual distress? "All my prayers and good deeds were in vain." "I will have to move to an assisted-living facility." "Can you arrange a meeting with the chaplain?" "I wish we could have spent more time together."
"All my prayers and good deeds were in vain." The patient is going through a phase of disturbed faith and lacks confidence in his or her prayers and good deeds. This indicates that the patient is experiencing spiritual distress. When the patient is thinking about moving to an assisted-living facility, the patient is trying to find practical solutions to meet health care needs. If the patient seeks a meeting with the chaplain, the patient is trying to reconcile with self and overcome grief. The patient expresses sadness, not spiritual distress, at being unable to spend more time with the spouse.
Which phrase describes spirituality? The practice of rites and rituals A system of beliefs and customs An organized expression of faith A focus on the meaning of existence
A focus on the meaning of existence Spirituality focuses on the meaning of life, death, and existence. It is an expression of one's innermost self. Religion is an organized structure that helps understand spirituality. It involves the practice of rites, rituals, belief, customs, and faith.
The nurse is caring for a patient with end-stage liver cirrhosis who declared himself an atheist at the time of admission. The patient now asks to see the chaplain. Which action by the nurse would be appropriate? Inform the patient's family about the request. Allow the patient time to reconsider the request. Inquire about the reason for the sudden change. Arrange for the chaplain to meet with the patient.
Arrange for the chaplain to meet with the patient. The nurse must be compassionate and nonjudgmental and arrange for the chaplain to meet the patient. The nurse need not inform the family. This would be a violation of confidentiality. Spiritual assessments are subjective and may change according to circumstances. The nurse need not give the patient time to think about the request. The nurse must be understanding and not question the patient's change in beliefs.
In a case where a patient suffers from spiritual distress, which patient feelings should the nurse be aware of? Select all that apply. Doubt Being cheated Loneliness Loss of faith Desire to kill others
Doubt Loneliness Loss of faith One of the common symptoms observed in a patient experiencing spiritual distress is to doubt self and others. The patient also feels lonely or abandoned and suffers from a loss of faith. The feeling of being cheated and the desire to kill others are not found commonly. So, when caring for such a patient, a nurse needs to be cautious. Spiritual distress also occurs when there is conflict between a person's beliefs and the treatment prescribed for health. Some treatment regimens may not be acceptable to patients from a specific culture or religion.
Which spiritual care would the nurse provide for a Catholic patient who is terminal? Provide an adjacent room in which the family may pray for the patient. Arrange for a religious person to read the Sunnah for the patient. Arrange for the patient and family to participate in the bris ritual. Ensure that the patient receives the sacrament of anointing of the sick.
Ensure that the patient receives the sacrament of anointing of the sick. The sacrament of anointing of the sick is specifically related to the Catholic religion and is performed for a dying patient. The nurse may allow the family to pray at the patient's bedside, rather than praying in another room. The Sunnah includes the teachings of the Prophet Muhammad's life and may be used in the spiritual care of an individual practicing Islam. The newborn son of a Jewish family is circumcised on the eighth day during the bris ritual, which is not performed in a health care facility.
An atheist believes which concept? A supernatural power governs the universe. God is the ultimate being in the universe. God does not exist. Sins from the past have to be faced in the current life.
God does not exist. Atheists do not believe in God. They often seek meaning in life through whatever they do and how they treat others. Many people believe in God as the Supreme Being controlling the universe or a supernatural power that governs the universe. People following Hinduism believe that sins from the past have to be dealt with in the present or future life.
Which nursing actions suggest trust-building and a caring presence for an injured patient in the emergency room? (Select all that apply.) Holding the patient's hand while talking to provide emotional support Informing the patient that the injuries can be treated but will take time Remaining calm and calling for the appropriate health care team to treat the patient Focusing on the patient's treatment and not wasting time talking to his family Calling the family to be with the patient and leaving the patient with them
Holding the patient's hand while talking to provide emotional support Informing the patient that the injuries can be treated but will take time Remaining calm and calling for the appropriate health care team to treat the patient In an acute care setting, the nurse should establish presence and build trust with the patient by using supporting touch and words of hope and encouragement. The patient is often confused and overwhelmed with the sudden and unexpected change in his physical and spiritual well-being, so the nurse should be calm and confident and have a decisive approach. While focusing on the treatment, the nurse should also be there for the patient and family. Talking to the patient and family is never a waste of time. Although a patient's family may be present, the nurse should not leave the patient's side.
A patient is diagnosed with end-stage renal disease. The patient tells the nurse, "I know I am going to be all right, and I will be healthy again. I believe in God, and He will make things right. My spouse and I are yet to tour the world." Which kind of spiritual belief does this patient exhibit? Hope Self-transcendence Transcendence Agnosticism
Hope Hope is a belief that something positive is going to happen. It exists where faith and spirituality are present. Hope is comforting and energizing to people facing extreme emotional and physical distress, hardships, and personal challenges. It is a valuable resource motivating a person to achieve. Self-transcendence is a feeling and a sense of connecting to one's inner self. Transcendence is a feeling or experience beyond normal and above the material world. Agnosticism is a belief that there is no known ultimate reality.
The spouse of a patient who suffered a stroke tells the nurse that the patient's faith will help in a speedy recovery. Which aspect would the nurse understand about faith? It is a connection with a God or a higher power. It is a connection with oneself through reflection. It is the process of moving beyond the moment toward the future. It is a belief based on trust and life experiences rather than science.
It is a belief based on trust and life experiences rather than science. Faith is a belief beyond oneself that values trust and life experiences more than scientific evidence. Prayer is a spiritual practice that is a form of communication with God or a higher power. A spiritual individual may connect with him- or herself through reflection or searching for the meaning of certain events in life. Transcendence is the process of moving beyond the present condition to what one will become in the future.
Which health practices would the nurse expect to find among Chinese patients? Select all that apply. Practice of Gua-sha therapy Sweat lodge ceremonies Use of the mugwort herb Fasting to remove toxins External suction therapy
Practice of Gua-sha therapy Use of the mugwort herb External suction therapy The Chinese practice Gua-sha therapy, which involves rubbing the oiled skin to reduce fever and pain. They use mugwort herb to promote blood circulation through warmth. This procedure is known as moxibustion. The Chinese use cupping, or external suction therapy, to improve blood circulation during pain or for respiratory and digestive problems. Native Americans perform the sweat lodge ceremony, which is a healing ritual. This ceremony incorporates prayers and sauna conditions in sweat lodge structures. According to Hinduism, illness is a buildup of toxins; Hindus therefore fast to remove excess toxins from their bodies.
Which measures should the nurse take to ensure that a Muslim pregnant patient is comfortable during the birth and subsequent stay at the health care facility? (Select all that apply.) Arrange for only Muslim caregivers. Do not mix meat and dairy products. Provide the patient privacy for prayer. Refrain from including pork in the diet. Arrange for care by female caregivers.
Provide the patient privacy for prayer. Refrain from including pork in the diet. Arrange for care by female caregivers. The nurse must ensure that the Muslim patient is allowed to pray in privacy according to Islamic tradition. The patient must not be served pork because the consumption of pork is strictly prohibited in Islam. Muslims have a high preference for modesty and would prefer to have same-sex caregivers. It is not necessary that the caregivers must also be Muslims. An observant Jewish patient would be offended if meat and dairy products were served together.
A patient states, "My religion does not permit me to bathe today." Which nursing action would be appropriate? Tell the patient that the health care provider has prescribed a bath today. Insist that a bath be taken because it is the patient's scheduled bath day. Call an appropriate clergyperson and ask whether the patient is telling the truth. Request a clarification of the patient's beliefs and adapt a plan for bathing accordingly.
Request a clarification of the patient's beliefs and adapt a plan for bathing accordingly. A patient's religious and cultural preferences should be considered when providing hygiene. Facility schedules should not take priority over the patient's religious beliefs, nor should the health care provider's instructions. Verifying the patient's beliefs with clergy is inappropriate. Telling the patient the provider has ordered the bath and insisting that the patient take a bath is not providing spiritually competent care. The nurse should not call a clergyperson to learn if the patient is telling the truth.
Which observations by the nurse indicate positive outcomes in a patient with a nursing diagnosis of spiritual distress? Select all that apply. The patient expresses increased hope of becoming healthy. The patient's relationship with his partner is satisfactory. The patient is compliant with his medication regimen. The patient is not talking to his family and friends. The patient remains at home and watches TV all day.
The patient expresses increased hope of becoming healthy. The patient's relationship with his partner is satisfactory. The patient is compliant with his medication regimen. When evaluating for goal-directed outcomes, the nurse should check for an increase in hope; purpose of life; increased connectedness with self, others, and God or another supreme being; and an increase in overall health. Goals set during the planning phase should be the benchmark for assessing the extent of positive outcomes of care. Patients who are hopeful for good health and who have an increased level of connectedness to their partners exhibit positive outcomes. The patient with positive outcomes tends to become compliant with the prescribed medication regimen. Patients who avoid family and friends and remain confined to home and a single activity exhibit further need for spiritual intervention.
Which signs or behaviors of spiritual distress would the nurse identify in the patient with breast cancer? Select all that apply. The patient is angry and expresses a lack of faith in God. The patient is disturbed and expresses an inability to pray. The patient does not wish to speak to friends and family. The patient desires to meet with a spiritual adviser. The patient seeks reconciliation with family members.
The patient is angry and expresses a lack of faith in God. The patient is disturbed and expresses an inability to pray. The patient does not wish to speak to friends and family. Patients often experience spiritual distress when confronted with life-threatening diagnoses. A patient with spiritual distress may be angry and express a lack of faith in a higher authority or God. The patient may be disturbed and express an inability to pray or communicate with God. The patient may be depressed and may not want to talk to his or her friends and family. A patient who has accepted the diagnosis may also desire to meet a spiritual advisor. A patient who seeks reconciliation with family members has likely accepted the situation.
6. What is the most important aspect of providing spiritual care in nursing practice? a. Call a chaplain. b. Complete the FICA spiritual assessment and refer as needed. c. Recognize situations and patient behaviors indicating a spiritual need. d. Spend some time in self-reflection.
c. Recognize situations and patient behaviors indicating a spiritual need. Changes in spiritual needs happen in the moment, and it is critical for nurses to recognize when a spiritual need arises. The FICA tool is not sensitive to daily changes in spiritual need. Calling a chaplain may be an appropriate intervention when the need arises. Nurses should integrate self-reflection in their own spiritual practices to find meaning in their life experiences, but that is not the most important aspect of providing spiritual care.
Karma is defined by which phrase? The result of past behaviors The cycle of birth and rebirth The individual's moral conduct The path of liberation to harmony
The result of past behaviors According to Hinduism, karma is a consequence of past behaviors. Samara is reincarnation, or the cycle of birth and rebirth. Dharma is the moral conduct of an individual. Moksha is the path of liberation toward harmony, which occurs through reincarnation.
A patient just gave birth and says, "It's like a miracle. I don't have words to explain this feeling. My baby is perfect, like something out of this world. Thank you, God." Which feeling is the patient experiencing? Self-transcendence Transcendence Connectedness Hope
Transcendence Transcendence is a feeling or experience beyond normal and above the material world. It induces positive feelings by allowing people to have new experiences and new perspectives that are beyond the ordinary. Self-transcendence is a feeling and a sense of connecting to one's inner self. Through connectedness, a person feels connected to himself or herself, to others, and to a Supreme Being or God. Hope is a feeling of expectation or desires for positive things to happen.
A patient who is highly spiritual and prays often has just been diagnosed with cancer. Which levels would the nurse expect to increase in this patient during the course of the treatment? Select all that apply. Well-being Suicidal ideation Social functioning Symptom distress Treatment compliance
Well-being Social functioning Treatment compliance It has been observed that patients who are highly spiritual are better able to cope in difficult situations. The nurse would expect this patient to develop increased levels of well-being. This patient will also demonstrate a high level of social functioning, as the patient will likely be more capable of interacting with society normally despite having health problems. The patient will likely observe and follow all the treatment regimens as prescribed. Patients who are less spiritual tend to be more prone to depression and may have suicidal ideation. A patient who is less spiritual may experience increased levels of distress from symptoms as a result of decreased coping abilities.
4. A nursing is caring for a Chinese patient. What question is best to determine religious practices? a. Are there any religious practices I need to know about to help care for you? b. What is your religion? c. Would you like to talk to a chaplain? d. Tell me about your family.
a. Are there any religious practices I need to know about to help care for you? Chinese people have diverse religious practices. It is best to inquire what practices affect care. Do not assume a specific religion.
