Chapter 46: Spirituality FUNDA

The nurse receives a "do not resuscitate" (DNR) order for a dying client. What should the nurse do next?

Assess the client's spiritual needs

The nurse enters a client's room as the client and family are praying. Which is the most appropriate action of the nurse?

Step outside the door until the prayer is finished.

A client scheduled for outpatient surgery is requesting that the operating room be sprayed with holy water. Which is an appropriate response?

"Are you concerned how the surgery will go?"

Which question would be appropriate for the F in the FICA spiritual assessment tool?

"Do you consider yourself a spiritual person?"

A nurse is preparing to give medications to an elderly client who, due to a recent stroke, needs help putting them in her mouth. The family member appears anxious and tells the nurse not to touch the client's mouth. Which religion does the nurse assume this client practices?

Hinduism

The nurse is caring for a dying male client who practices Islam. What is the most appropriate action for the nurse after the client's death?

Ensure that a male washes the client's body.

A nursing instructor, after teaching about the importance of spirituality, identifies a need for further teaching when overhearing a student make which of the following statements?

"You can provide quality nursing care to clients even though you ignore the spiritual dimension of health."

The nurse admits a new client to the unit for elective surgery. What would be the best way for the nurse to facilitate the practice of religion for this client? Choose all that apply.

Arrange for the client's pastor to visit if desired. Attempt to meet religious dietary restrictions. Respect the need for privacy during periods of prayer.

A client self identifies as a member of the Jewish faith. When discussing diet and food preferences with the client, which assessment would be useful?

Ask the client what diet is followed at home.

The nurse is caring for a 55-year-old client admitted to the hospital for liver failure. The client states being an active member of The Church of Jesus Christ of Latter-day Saints. The client tells the nurse about strictly adhering to the religious practices that are condoned by the Church. However, the nurse overhears two health care providers discussing that the client's liver failure is likely due to chronic alcohol use. The nurse suspects that the health care providers are incorrect. Which nursing nursing action is appropriate?

Engage the client in a discussion about past and present religious practices.

A client who is admitted for a debilitating disease is talking to the nurse. The client relates that family is the only thing that matters, stating that family helps fulfill all the spiritual needs by first fulfilling the most basic of all needs. What is this basic need?

LOVE

A nursing student is studying spirituality and completing a report on The Church of Jesus Christ of Latter-day Saints. Which fact about this faith should the student include in the report?

Latter-day Saints are not allowed to use tobacco or alcohol.

Mrs. Dopson is a 75-year-old widow who lost her last offspring to cancer last month. She shares with the nurse that she fears being alone. The nurse knows that this is related to which of the following spiritual needs believed to be common to all people?

Need for love and relatedness

Mr. Baker is an 81-year-old patient who can no longer live alone safely and is being admitted to a long-term-care facility. He grew a large garden every summer and took pleasure in sharing the produce with neighbors. He now tells the nurse that he feels he is of no use to anyone. The nurse knows that this is related to which of the following spiritual needs believed to be common to all people?

Need for meaning and purpose

A nurse is caring for a client with terminal illness who believes that death and reincarnation are the ultimate gifts from a higher power. What would be most appropriate to integrate into this client's plan of care when providing spiritual support?

Provide support that builds on the client's faith.

The nurse is taking care of a client who is scheduled for a mastectomy. The client tells the nurse that the client is apprehensive about the operation and asks the nurse to read a passage from the Koran to help prepare the client for surgery. Which action by the nurse is the most appropriate?

Read the Koran passage to the client.

The nurse is caring for a client who asks that the special undergarments not be removed for an upcoming procedure. The nurse is aware that these undergarments are related to the client's religion. This religion is:

The Church of Jesus Christ of Latter-day Saints.

After being informed that his wife only has a few hours to live, the nurse hears the husband say; "If you take my wife now. I will never pray to you!" What should be the nurse's reply?

Use silence and allow the husband to express his emotions.

The client states "I have lifted my cancer to God and am accepting of God's plan for me." This is an example of an adaptive expression of spiritual needs labeled:

faith.

While interviewing a client, a nurse is told that the client practices Catholicism. This client is identifying:

his faith.

Which set of terms best reflects nursing's view of clients as holistic beings?

mind, body, spirit

A new client is on the hospital unit. He was recently diagnosed with metastatic pancreatic cancer and was told that any treatment would be palliative. He tells a nurse that there is no God that he knows of who would subject someone to this. The client's statement is most reflective of:

spiritual crisis.

An appropriate goal for the client with a nursing diagnosis of Spiritual Distress related to intense pain and suffering as verbalized by the client would be that the client will:

participate in supportive spiritual practices

A nurse is conducting online research for information related to spiritual needs and religious traditions. The nurse demonstrates understanding of the information by identifying which need as common to all? Select all that apply.

Love Meaning Forgiveness

According to Shelly and Fish (1988), which of the following are spiritual needs underlying all religious traditions that are common to all people? Select all that apply.

Meaning and purpose Love and relatedness Forgiveness

Mr. Field is a 45-year-old man who has suffered a myocardial infarction. Mr. Field provided for his family by working in the construction industry, which he will no longer be able to do. He tells his nurse that he fears he will be of no use to anyone now. The nurse knows that this is related to which of the following spiritual needs believed to be common to all people?

Need for meaning and purpose

The nurse is assessing a client for spirituality using the HOPE acronym. Which statement describes an element of this tool?

O = organized religion

A client who is on hospice care and has no immediate family has been given less than 1 week to live. The nurse caring for the client recognizes that providing presence is most important, especially when a client is dying. What would be the best way for this nurse to provide presence to this client?

Hold the client's hand and sit by the bedside as often as possible.

The nursing diagnosis Spiritual Distress related to crisis of illness as evidenced by loss of meaning in life and overuse of pain medication is created for a client who attempted to take his life. Which intervention is appropriate for these problems?

Plan and coordinate a multidisciplinary team conference including the chaplain.

The family members of a dying client have asked for the hospital chaplain's help in having a member of the clergy come to the client's bedside to perform the anointing of the sick. The nurse who is providing care for the client should recognize that the family is likely which religion?

Roman Catholic

The nurse is assisting a client with his meal selection for the next day. The client states, "I can't have meat tomorrow, it's a Holy Day." The nurse recognizes that the client is a member of which religious organization?

Roman Catholic

A nurse is preparing a presentation for a group of staff nurses about spirituality and the importance of meeting clients' spiritual needs. As part the presentation, the nurse plans to address the major religious groups. Which characteristic would the nurse identify as being common to the major religions? Select all that apply.

Involvement of a sacred word or scripture Ideas related to after death Ethical code for right and wrong An identity as a group

Which client statement most clearly suggests the potential of a nursing diagnosis of Spiritual Anxiety?

"Now that I'm nearing the end, I'm worried that God won't think I lived a good enough life."

The nursing instructor has been discussing spirituality with a group of nursing students. Which statement by a student would indicate a need for further education?

"Spiritual beliefs and practices do not give strength when a person is in crisis."

Upon assessment, the client reports not belonging to an organized religion. Which assessment question would the nurse ask to assess the client's spirituality?

"Tell me about spiritual or religious beliefs that are important to you."

The nurse is caring for a critically ill client who informs the nurse that there is a conflict between the client's spiritual beliefs and a proposed health option. Which question does the nurse ask to begin a conversation about the conflict that the client is experiencing?

"Would you like to talk to someone to help you make an informed decision?"

The nurse is caring for a client that practices Islam in the hospital. When dietary brings the client a food tray for supper, which food on the tray should the nurse remove that is against the dietary laws for a practicing Muslim?

A pork chop

A client who is admitted to the ER with severe right-sided abdominal pain is diagnosed with appendicitis. The surgeon is called and proceeds to explain the procedure to the client and asks her to sign the consent. The client refuses and informs the doctor that her husband needs to be called to do this. Which of the following religions does this client likely practice?

Islam

A client who is admitted with severe back pain rates it a 10 on a scale of 1 to 10. After assessing the client for pain, the nurse tells the client that the physician had ordered pain medication and its effect should be felt 10 to 15 minutes after its administration. However, the client refuses the pain medication and informs the nurse that opioids are contrary to his religion. Which religion does this client practice?

Adventist

The nurse's client states that his pastor is coming in a few hours to pray with him and offer sacrament. The nurse plans to do the following things in preparation for this. Select all that apply.

Clear the bedside table; cover with clean towel. Have a chair available near the bed. Clear the room of unnecessary items.

The school nurse is concerned about the week-long absence of Jerry, a third grader. The nurse visits the home and learns that Jerry has been diagnosed with appendicitis by a local clinic doctor. The parents, who are Christian Science church members, have had several church groups in to pray over Jerry. He is not improving and is getting worse. The nurse should do which of the following?

Contact Child Protection Services

The son of a dying female client is surprised at his mother's adamant request to meet with the hospital chaplain and has taken the nurse aside and said, "I don't think that's what she really wants. She's never been a religious person in the least." What is the nurse's best action in this situation?

Contact the chaplain to arrange a visit with the client.

While interviewing a hospitalized client, he states, "The holy days of Ramadan are coming soon. I am not to have any food or drink from sunrise to sunset during this time." Further assessment reveals that the client's request is associated with which religion?

Islam

A nurse is paying particular attention to the spiritual needs of a client today. The nurse identifies that spiritual beliefs can have a positive effect on general health of a client in which ways? Select all that apply.

Diet Support system Endurance of extreme stress Positive emotions

A client in a long-term care facility has recently begun to refuse to cooperate with the staff, is having difficulty agreeing with the treatment goals suggested by the nurse, and is showing more stress when the family goes home. What is the best response from the nurse?

Question the client concerning spiritual concerns

An older adult client is spiritual and has a deep faith. The client asks the nurse to say a prayer for the client. The nurse, who is not very comfortable praying out loud, wants to honor the client's request. What would be the best action by the nurse?

Read a printed interfaith prayer to the client.

A nurse interviews a client and finds that, because of religious beliefs, the client's view on health care does not involve blood transfusions. How can the nurse best handle this client situation?

Record this information in the client's chart.

While studying religion and spirituality, the nursing student exhibits an understanding of the concepts when making which of the following statements?

Religion is a collection of spiritual beliefs and practices.

The home care nurse visits a client with asthma and observes several lighted candles by the client's bedside. Which action should the nurse take?

Replace the lighted candles with battery operated candles.

The nurse caring for a bedridden hospitalized client who states that this will be the first time that he has missed a Methodist church service in 50 years plans care based on which of the following NANDA-I diagnoses?

Spiritual Distress related to inability to attend church services evidenced by verbal states of guilt

A client informs the nurse about being unsure of some of the health practices as a newly practicing Jehovah's Witness. What information can the nurse share with the client regarding cultural beliefs about blood products?

Spiritual care consultants can provide support to the client.

A nurse is developing a plan of care to meet a client's spiritual needs. When identifying appropriate interventions, which concept would the nurse need to integrate as the foundation for all the interventions?

Supportive presence

A nurse is educating staff members about the importance of meeting the spiritual needs of clients on the unit. What spiritual needs should be met in the delivery of care? Select all that apply.

need for meaning and purpose need for love and relatedness need for forgiveness

The nurse is caring for a 6-year-old child who was in a motor vehicle accident and has lost a lot of blood through an open leg wound. The parents inform the nurse that the child cannot have blood transfusions due to their religious beliefs. What decision does the nurse determine that the court will support regarding the child's blood transfusion?

not support the parents' right to refuse treatment for the child

A terminally ill client tells the nurse that he does not belong to an organized religion. It is safe for the nurse to assume:

the client may still be deeply spiritual.

When the client tells the nurse that she believes God's reality is personal, and that God is the creator of all beings, the nurse determines the client is expressing:

theism.