Spirituality
What does the HOPE acronym stand for?
H= sources of hope, meaning, comfort, strength, peace, love, and connection O= organized religion P= personal spirituality and practice E= effects on medical care and end-of-life issue
A nurse is caring for a client who is spiritually distressed. Which of these are factors that affect the spiritual distress of a client? Select all that apply. a.) Inability to reconcile a current life situation with spiritual beliefs b.) Separation from the religious community or supports c.) Seeking a religious leader d.) Ability to introspect
a and b Factors affecting spiritual distress include inability to reconcile a current life situation with spiritual beliefs and separation from the religious community or supports. Disconnectedness to self can be expressed through an inability to seek a religious leader or an inability to introspect.
The nurse, while assessing the spirituality of a client, recognizes that different factors can influence a person's spirituality and outlook on life. What factors determine spirituality in this client? Select all that apply. a.) Negative life experiences b.) Gender c.) Positive life experiences d.) Role in family e.) Sexual identity
a and c Both positive and negative life experiences can influence spirituality, and they in turn are influenced by the meaning a person's spiritual beliefs attribute to them. A person's gender or role in the family does not influence his or her spirituality. Sexual identify is not a factor that influences spirituality.
A nurse is conducting a spiritual assessment on a client recently admitted to the hospital unit. Which questions would be appropriate to ask the client about his religious and spiritual practices? Select all that apply. a.) "Is religion a significant part of your life?" b.) "Are there any spiritual practices that you would like to continue while hospitalized?" c.) "You would like the priest to come and visit you, right?" d.) "Does the present situation interfere with any spiritual or religious practice?"
a, b, and d A spiritual and religious assessment attempts to identify and document any practices or beliefs that are important for the client to maintain or that may alter medical or nursing treatment.
The nursing instructor is teaching a class on spiritual health and its importance in nursing care. When talking about the model using the unifying approach, which of the following does the spiritual dimension affect? Select all that apply. a.) The physiological dimension b.) The psychological dimension c.) The unifying dimension d.) The sociological dimension e.) The integrated dimension
a, b, and d In the unifying approach, the spiritual dimension grounds or affects the physiological, psychological, and sociological dimensions. There is not a unifying dimension but a unifying approach. The integrated approach is a separate model and is not a dimension.
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. a.) Meaning and purpose b.) Power c.) Formal religion d.) Love and relatedness e.) Forgiveness
a, d, and e According to Shelly and Fish (1988), there are three spiritual needs underlying all religious traditions and common to all people: need for meaning and purpose, need for love and relatedness, and need for forgiveness.
When preparing for a spiritual counselor to visit a hospitalized client, the nurse should: a.) take measures to ensure privacy during the counselor's visit. b.) ask the spiritual counselor to summarize the visit in the client's medical record. c.) ask to be present during the visit in order to explain any medical information or answer questions about the client's care. d.) ensure that the counselor is approved by the hospital administration.
a.) take measures to ensure privacy during the counselor's visit Visits between a client and a spiritual counselor require privacy. The details of the meeting are not typically documented in the client's chart, though the fact that the visit took place is often noted. The nurse may be present during the meeting, but this should take place at the client's request. Spiritual counselors do not require administrative approval; clients and their families are normally able to seek spiritual help from whomever they prefer.
A nurse is caring for a terminally ill client who believes that death and reincarnation are the ultimate gifts from God to humankind. How can the nurse provide spiritual support to this client? a.) The nurse would subtly attempt to change the client's belief. b.) The nurse would support and build on the clients' faith. c.) The nurse would provide literature to the client that offers other alternatives. d.) The nurse would request that the client refrain from talking about death.
b.) The nurse would support and build on the client's faith The nurse would support and build on the clients' faith. Nurses would not attempt to change faith that clients already possess. If faith is lost, clients will lose hope; without the will to live, many people are beyond the help of the most potent medical powers. The nurse would not attempt to change the client's belief or provide literature that says otherwise. Conversations regarding faith, however, must not pass judgment or present controversy. The need is to make clients feel accepted in their beliefs and encouraged to remain open in expressing and learning. Remediation: Add a Note
Which group of terms best defines spiritual distress? a.) Spirituality, religion b.) Alienation, despair c.) Faith, prayer d.) Forgiveness, purpose
b.) alienation, despair Terms that define spiritual distress include spiritual pain, alienation, anxiety, guilt, anger, loss, and despair. Faith, religion, purpose, forgiveness, and prayer are components of spirituality. Reference:
A hospice nurse is well aware of how difficult it is to deal with others' pain on a daily basis. This nurse should put healthy practices into place to guard against what outcome? a.) Inefficiency in the provision of care b.) Illness c.) Emotional exhaustion d.) Social withdrawal
c.) Emotional exhaustion Well before the nurse exhibits symptoms of stress or burnout, he or she should acknowledge the difficulty of coping with others' pain on a daily basis and put healthy practices in place that guard against emotional exhaustion. Emotional exhaustion is more likely to have deleterious effects than inefficiency, social withdrawal, or illness, though these may signal emotional exhaustion.
When nurses become overwhelmed in their jobs and develop symptoms of anxiety and stress, they are experiencing what condition? a.) Culture shock b.) Adaptation syndrome c.) Ineffective coping d.) Burnout
d.) Burnout The feeling of being overwhelmed in one's job and development of symptoms of anxiety and stress is referred to as burnout. Burnout can be compared with the exhaustion stage of anxiety and is characterized by a wide range of behaviors. Culture shock is a feeling of uneasiness or uncertainty in different and unfamiliar surroundings. The change that takes place as a result of the response to a stressor is adaptation. Ineffective coping means that a person does not deal effectively with stressors.
Nursing students need to learn to care for themselves in order to prepare to be professional nurses. Which activities would fail to prepare nursing students for the delivery of client care? a.) Time management, communication, and establishing a support system b.) Establishing a support system, a sense of humor, and self-awareness c.) Self-awareness, preparation for crisis, and stress management d.) A sense of humor, anticipation of loss, and developing negative body image
d.) A sense of humor, anticipation of loss, and developing negative body image Activities that would prepare nursing students for the delivery of client care include time management, communication, establishing a support system, self-awareness, stress management, a sense of humor, and preparation for crisis and loss. Negative body image of a nursing student is not desired as this can impact care to the clients.
You are caring for Carol, a hospice patient, who tells you that she is worried about how she has treated a younger sister. She asks you how to make things right. You recognize this as which of the following spiritual needs? a.) Meaning b.) Forgiveness c.) Purpose d.) Love
b.) Forgiveness According to Shelly and Fish (1988), there are three spiritual needs underlying all religious traditions and common to all people: the need for meaning and purpose, the need for love and relatedness, and the need for forgiveness.
The nurse is preparing to educate a patient about the home care of an abdominal wound. What patient behaviors does the nurse notice that demonstrate readiness to learn? (Select all that apply.) a.) The patient shows the motivation to learn. b.) The patient has accepted the therapeutic regimen. c.) The patient is unable to look at the wound. d.) The patient tells the nurse the family member will take care of it. e.) The patient requests a contact number if there are questions.
a, b, and e One of the most significant factors influencing learning is a person's learning readiness. For adults, readiness is based on culture, personal values, physical and emotional status, and past experiences in learning (Schumacher, 2011). The "teachable moment" occurs when the content and skills being taught are congruent with the task to be accomplished (Miller & Stoeckel, 2011).
Which of the following is an example of adherence to treatment? Select all that apply. a.) Maintaining a healthy diet b.) Self-monitoring for signs and symptoms of illness c.) Taking prescribed medications d.) Increasing daily activities e.) Inability to comply with follow-up appointments
a, b, c, and d Examples of behaviors facilitating health include taking prescribed medications, maintaining a healthy diet, increasing daily activities and exercise, self-monitoring for signs and symptoms of illness, practicing specific hygiene measures, seeking recommended health evaluations and screening, and performing other therapeutic and preventative measures. Inability to comply with follow-up appointments is not an example of adherence to treatment.
You are caring for Leslie Carter today. As you are giving her her morning medications, she begins a conversation about her belief in a higher power. You know that this can be interpreted as which of the following? Choose all that apply. a.) Faith b.) Spirituality c.) Religion d.) God e.) Atheism
a, b, c, and d Spirituality is anything that pertains to a person's relationship with a nonmaterial life force or higher power. An atheist is a person who denies the existence of a higher power. Faith generally refers to a confident belief in something for which there is no proof or material evidence, such as a higher power. God is defined as a higher power. Religion refers to an organized system of beliefs about a higher power.
The client is being discharged home with hospice due to a terminal disease. The nurse is arranging visitations of the spiritual leader for the next 3 months. Which of the outcomes identified supports this intervention? Select all that apply. a.) The client identifies support provided by the spiritual leader. b.) The client demonstrates spiritual practices such as praying. c.) The client expresses satisfaction with spiritual relationships. d.) The client will have strong faith of being healed. e.) The client expresses satisfaction with life.
a, b, c, and e Assessing and planning for spiritual care comprises an ongoing process. Settings that encourage this process most consistently are those in which nurses and clients can establish relationships over time and promote the relationship between the client and the spiritual program they choose. Examples of outcomes are those that support a spiritual leader, praying, and satisfaction with spiritual relationships and life. Sometimes the spiritual connection does not support a faith of being healed and this can be inconsistent with the chosen spiritual program.
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. a.) Involvement of a sacred word or scripture b.) Ideas related to after death c.) Ethical code for right and wrong d.) Absence of a source of power or authority e.) An identity as a group
a, b, c, and e Each of the major religious groups shares several characteristics, including basis of authority or source of power; a scripture or sacred word; an ethical code that defines right and wrong; a psychology and identity, so that its adherents fit into a group, and the world is defined by the religion; aspirations or expectations; and ideas about what follows death.
The nursing instructor is teaching about spirituality and asks a nursing student about the factors that can influence a client's spirituality. Which responses by the student are accurate? Select all that apply. a.) Developmental considerations b.) Family c.) Economics d.) Ethnic background e.) Formal religion
a, b, d, and e Among the many factors that can influence a person's spirituality, the most important are developmental considerations, family, ethnic background, formal religion, and life events. Economics does not influence a client's spirituality.
A nurse working in a facility that cares for clients with Alzheimer's includes spirituality in client care. A family caregiver tells the nurse that faith has been broken and asks about help in getting through the day. What approaches can the nurse use to help the family member? Select all that apply. a.) Help the family member get relief so church services can be attended b.) Tell the family member you wish you could help but don't know how c.) Contact the family church group members for assistance d.) Give the family member some spiritual reading materials e.) Ignore the family member's concerns
a, c, and d Spiritual nurturing for the client's family caregiver(s) also is important. Recent research findings support the importance and value of caregivers' spirituality, yet this resource is often overlooked. Consider using interventions that enhance a caregiver's ability to take part in spiritual activities to satisfy his or her spiritual needs and to work with religious groups to secure helpful services. Using clergy, prayer, forgiveness, and spiritual reading materials as resources for caregivers may also be helpful.
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. a.) Clear the bedside table; cover with clean towel. b.) Complete your work so you may join them. c.) Have a chair available near the bed. d.) Clear the room of unnecessary items. e.) Keep the bed curtains open so as to allow others to join in prayer
a, c, and d When expecting a visit from a client's spiritual counselor, preparations may vary, but the following are usually recommended:• The room should be orderly and free of unnecessary equipment and items.• There should be a seat for the religious counselor at the bedside or near the client so that both can be comfortable.• The bedside table should be free of items and covered with a clean, white cover if a sacrament is to be administered.• The bed curtains should be drawn for privacy if the client can't be moved to a more private setting. The nurse should not expect or plan to join a private group such as described.
Which statements are true of factors that influence client responses and outcome achievement and of how the nurse should use them? Select all that apply. a.) The nurse should draw on positive factors to deal with other variables in the future. b.) The nurse should reinforce negative behaviors to achieve desired outcomes. c.) A client's strong motivation to learn appropriate health behaviors is an example of a positive factor. d.) A nurse uses only positive factors to manipulate client outcomes. e.) The nurse should identify which factors are helpful to attaining outcomes and manipulate them to achieve goals.
a, c, and e The nurse should reinforce positive, not negative, behaviors to achieve the outcomes for the client. The nurse can manipulate both positive and negative factors to improve client outcomes. The other choices are all true regarding positive factors.
An intensive care unit (ICU) nurse with 11 years of experience has been frequently absent or late for shifts, has been verbally abusive with coworkers she feels are unskilled at the technological tasks of the job, and cursed under her breath at a distraught family member today. The nurse manager is threatening to suspend her if it happens again. The ICU nurse may be experiencing: a.) burnout. b.) allostatic load. c.) repression. d.) sleep deprivation.
a.) burnout Burnout is the term used to describe behaviors that occur when a person is overwhelmed with the demands of a situation and is similar to the exhaustion stage of anxiety. This is commonly seen in nurses who work in high-stress environments. The individual in this scenario may have a great allostatic load and/or sleep deprivation, but there is no evidence of this in the given scenario. Repression is when a person copes by unconsciously denying the occurrence of a stressful event. Reference:
The nurse is working on an oncology unit and is visiting with colleagues about how to prevent burnout as a professional nurse. Everyone suggests things and the group comes up with a very good list of self-care behaviors and ways that will help prevent burnout. Which of the following would be good things to have on the list? Select all that apply. a.) Know that no one person can be all things to all people. b.) Have plastic surgery done to improve your appearance. c.) Keep past errors alive so you will not repeat them. d.) Live life one day at a time and do your best. e.) Emphasize your strengths and the things you do well.
a, d, and e Self-Care Behaviors: 1. Accept normal variations in physical appearance and capabilities. 2. Use problem-solving and decision-making strategies to define expectations and set goals. 3. Set priorities and accept that no one person can be all things to all people. 4. Forget past mistakes; carrying around "excess baggage" is unhealthy. 5. Emphasize strengths and abilities in self. 6. Take an active part in group activities in school, work, church, or the community. 7. Volunteer time, talents, or services. 8. Avoid excessive alcohol and drugs. 9. Live life one day at a time. 10. Get help for self-concept disturbances that interfere with healthy social and professional activities.
When conducting a spiritual assessment, the nurse must be sensitive to the client's personal beliefs. Which questions should the nurse ask? Select all that apply. a.) "Is religion or God significant to you?" b.) "Why do you still not believe in God?" c.) "Do you feel your faith is helpful to you?" d.) "Why can't you share your feelings with me? I am your nurse." e.) "Is there anyone from your church you would like to talk to?"
a,c, and e Several nurses have developed spiritual assessment tools. Stoll's (1979) Guidelines for Spiritual Assessment is an early widely recognized spiritual assessment tool. This tool is built around a definition of spirituality that encompasses religion and belief in a higher power. It identifies four areas and suggests questions for each: (a) concept of God or deity, (b) source of hope and strength, (c) religious practices and rituals, and (d) relationship between spiritual beliefs and state of health. "Is religion or God significant to you?" is a question asking about the concept of God or deity. "Do you feel your faith is helpful to you?" focuses on the relationship between spiritual beliefs and state of health. "Is there anyone from your church you would like to talk to?" asks about their source of hope and strength. Asking the client why they do not believe in God and why they will not share their belief are questions focusing on belittling and degrading the client.
The nurse has been teaching a group of colleagues about spirituality. Which statement by a colleague would indicate a need for further education? a.) "Spiritual beliefs and practices are more prevalent in the Eastern hemisphere than in the West." b.) "Spiritual beliefs and practices have the potential to give healing strength and support." c.) "A person's daily living habits can be guided by their spiritual beliefs. d.) "Spiritual beliefs can help give a person meaning in their life."
a.) "Spiritual beliefs and practices are more prevalent in the Eastern hemisphere than in the West." Spiritual beliefs and habits can give meaning to life, illness, other crises, and death; can contribute a sense of security for present and future; can guide daily living habits; can provide strength in meeting life's crises; and can give healing strength and support. Spirituality is ubiquitous and is not more prevalent in the Eastern hemisphere.
The adult child of a dying client is surprised at their parent's adamant request to meet with the hospital chaplain and has taken the nurse aside and said, "I do not think that is what my parent really wants. My parent has never been a religious person in the least." What action will the nurse take in this situation? a.) Contact the chaplain to arrange a visit with the client. b.) Perform a detailed spiritual assessment of the client. c.) Organize a meeting between the chaplain, the adult child, and the client to achieve a resolution. d.) Document the client's request and wait to see if the client reiterates the request.
a.) Contact the chaplain to arrange a visit with the client. The nurse's primary responsibility is to honor the client's request for a meeting with a spiritual advisor. Completing a spiritual assessment is not necessary at this time. Organizing a meeting between the chaplain, the adult child, and the client is not an accurate intervention at this time unless requested by the client. Documentation of the conversation with the client and calling for a spiritual advisor should be recorded in the client's health record. It is not necessary to document and wait for the client to ask again before the nurse considers the request. The client is dying and waiting for them to ask again is not warranted.
Nonadherence to therapeutic regimens is a significant problem, especially in the elderly population. Nonadherence can lead to which outcome? a.) Increased cost of treatment b.) Decreased morbidity c.) Decreased chronic illness d.) Increased compliance with medical regimen
a.) Increased cost of treatment Nonadherence to therapeutic regimens is a significant problem for elderly people, leading to increased morbidity, mortality, and cost of treatment. There is an increasing rate of nonadherence among persons with chronic illness. Elderly people may also have problems that affect adherence to therapeutic regimens, such as the side effects of medications and financial constraints. Reference:
The home health nurse is planning teaching for a client with COPD and a history of noncompliance to the medication regimen. Which factor does the nurse recognize as having the most influence on enabling complete adherence to a health regimen? a.) Motivation b.) Self-esteem c.) Cost of medication d.) Education level
a.) Motivation The most influential factor that enables complete adherence to a health regimen is client motivation. The client's self-esteem, the cost of medication, and the client's level of education may influence a client's motivation, but these are not the most influential.
A nurse has just come on duty and has received the end-of-shift report. One of the nurse's clients newly diagnosed with diabetes was admitted with diabetic ketoacidosis. Which behavior best demonstrates this client's willingness to learn? a.) The client requests a visit from the hospital's diabetic educator. b.) The client sets aside a dessert brought in by a family member. c.) The client wants a family member to meet with the dietician to discuss meals. d.) The client readily allows the nurse to measure his blood glucose level.
a.) The client requests a visit from the hospital's diabetic educator Emotional readiness also affects the motivation to learn. A person who has not accepted an existing illness or the threat of illness is not motivated to learn. The client's willingness to learn is expressed through the action of seeking information on their own accord. Seeking information shows an emotional readiness to learn. The other options do not clearly demonstrate a willingness to learn.
A 45-year-old client who has suffered a myocardial infarction has learned they will no longer be able to provided for their family by working in the construction industry. The client tells the nurse that they fear they will be of no use to anyone now. The nurse knows that this is related to which spiritual needs believed to be common to all people? a.) need for meaning and purpose b.) need for love and relatedness c.) need for the basic necessities of life d.) need for forgiveness
a.) need for meaning and purpose According to Shelly and Fish (1988), the three spiritual needs underlying all religious traditions and common to all people are the need for meaning and purpose, the need for love and relatedness, and the need for forgiveness. The basic necessities of life include food (including water), shelter and clothing. The client is describing the need for meaning and purpose, where their work has a goal. The need for love is to find meaning in relationships with others. Forgiveness is to reconcile differences with others.
The nurse is assessing a client's spirituality using the FICA spiritual assessment tool. What question should the nurse ask during the "C" component of this tool? a.) "Do you consider yourself a spiritual person?" b.) "Are you involved with a particular faith group?" c.) "How do spiritual concerns affect your health?" d.) "Can I discuss your concerns with your family?"
b.) "Are you involved with a particular faith group?" "Do you consider yourself a spiritual person?" "Are you involved with a particular faith group?" "How do spiritual concerns affect your health?" "Can I discuss your concerns with your family?"
A nursing instructor is discussing burnout with a group of graduating nursing students. Which statement might lead the instructor to believe that the particular student has not developed needed coping mechanisms for nursing practice? a.) "I know that I am not prepared to take on a leadership role right now since I am new and need to learn." b.) "I can handle absolutely any situation now. You teachers have trained us well." c.) "I hope I get a good preceptor. I know that will help me get used to this transition." d.) "There's so much to learn. I have to find a way to balance these new challenges with settling back into my regular life."
b.) "I can handle absolutely any situation now. You teachers have trained us well." Anxiety over the uncertainty of succeeding in a new life role is to be expected. Recognizing that this will be a stressor is an important step in positive coping and adaptation. Erroneously thinking that this will not be a challenge is a form of denial, may lead to role conflict and disillusionment, and later can become a burnout situation.
A rehabilitation nurse caring for a client who has had a stroke is approached by the client's family and asked why the client has to do so much for self-care while obviously struggling to do so. What would be the nurse's best answer? a.) "We are trying to help the client be as useful as possible." b.) "The focus on care in a rehabilitation facility is to help the client to resume as much self-care as possible." c.) "We aren't here to care for the client the way the hospital staff did; we are here to help the client get better and return home." d.) "Rehabilitation means helping clients do exactly what they did before their stroke."
b.) "The focus on care in a rehabilitation facility is to help the client to resume as much self-care as possible." In both acute care and rehabilitation facilities, the focus is on teaching the client to resume as much self-care as possible. The goal of rehabilitation is not to be "useful," nor is it to return clients to their pre-stroke level of functioning, which may be unrealistic.
A nurse is caring for a client who is upset after being told about a diagnosis of cancer. The client asks the nurse to take a minute to pray, but the nurse is not a very religious person. What is the best action for this nurse? a.) Tell the client that there are medications to be passed and maybe later. b.) Agree to pray with the client and stand in silence by the bed. c.) Inform the client that someone else of the same religion would be better to pray with the client. d.) Tell the client that praying will not help the cancer go away.
b.) Agree to pray with the client and stand in silence by the bed. Nurses can assist clients to meet spiritual needs by offering a compassionate presence. Standing quietly at the bedside while the client prays will help do this. Although nurses may differ in their beliefs about how involved they should become in meeting spiritual needs, it is impossible to nurse clients well while ignoring this dimension of health. A nurse does not have to hold the same beliefs to pray with the client. The other options are not therapeutic responses and should never be used.
Each of the major religions has several characteristics in common. What is one of those characteristics? a.) Ministers are addressed as "Reverend." b.) An ethical code defines right and wrong. c.) Communion is delivered the same way. d.) Men and women are viewed as equals.
b.) An ethical code defines right and wrong Each of the major religious groups has several characteristics in common. One of those characteristics is an ethical code that defines right and wrong. Not all religious groups have ministers and the celebration of communion. Men and women are not viewed as equals in the major religious groups.
An elderly female patient has come to the clinic for a scheduled follow-up appointment. The nurse learns from the patient's daughter that the patient is not following the instructions she received upon discharge from the hospital last month. What is the most likely factor causing the patient not to adhere to her therapeutic regimen? a.) Ethnic background of health care provider b.) Costs of the prescribed regimen c.) Presence of a learning disability d.) Personality of the physician
b.) Costs of the prescribed regimen Variables that appear to influence the degree of adherence to a prescribed therapeutic regimen include gender, race, education, illness, complexity of the regimen, and the cost of treatments. The ethnic background of the health care provider and the personality of the physician are not considered variables that appear to influence the degree of adherence to a prescribed therapeutic regimen. A learning disability could greatly affect adherence, but cost is a more likely barrier.
The nurse working on a hospice unit is giving an in-service on the importance of faith and religion in client care. What does the nurse tell the group is a benefit of religious fellowship? a.) It distracts the client. b.) It offers support for the client. c.) It puts a good label on the client. d.) It allows for further isolation.
b.) It offers support for the client Regular religious fellowship benefits health by offering support that buffers the effects of stress and isolation. Fellowships provide a way for the client to be involved in another activity related to their spirituality rather than a distraction. It does not put a label on a person that allows others to discriminate.
The nurse is assessing a client for spirituality using the HOPE acronym. Which statement describes an element of this tool? a.) H = sources of help b.) O = organized religion c.) P = persons important in the person's life d.) E = external stressors affecting spirituality
b.) O = organized religion The HOPE assessment tool asses the client's spirituality. The acronym stands for: H—Sources of hope, meaning, comfort, strength, peace, love, and connection O—Organized religion P—Personal spirituality and practice E—Effects on medical care and end-of-life issue
Which would be most important for the nurse to do in order to maximize client adherence with the discharge plan? a.) Telling the client to adhere to the plan b.) Partnering with the client from the beginning c.) Encouraging the client to ask for help d.) Monitoring the client continuously
b.) Partnering with the client from the beginning The nurse can optimize discharge plan compliance by partnering with the client from the first encounter. Because clients with mental illnesses may have limited cognitive abilities and residual motivational and anxiety problems, the nurse should explain in detail all after-care plans and instructions to the client.
A nurse caring for a client asks about any food preferences when discussing diet. This is important for which reason? a.) Religious practices and beliefs make caring for clients interesting. b.) Religious practices and beliefs can directly influence a client's self-care practices. c.) Religious practices and beliefs are not that important in relation to the client's illness. d.) Religious practices and beliefs are difficult to understand.
b.) Religious practices and beliefs can directly influence a client's self-care practices Nurses are better able to meet clients' spiritual needs when they understand the clients' religious beliefs. These beliefs can directly influence clients' responses to illness and suffering, self-care practices such as diet and hygiene, spiritual practices, and moral codes. Religious practices and beliefs can be easy to understand and if asking a client about them, a nurse is exemplifying care and compassion in the client and their beliefs.
A nurse manager is auditing the nursing unit's adherence to infection control practices. Which observation causes the nurse manager to be most concerned that the clients on the unit are at risk for infection? a.) A nurse does not wear a mask when entering the room of a client on contact precautions. b.) Several nurses fail to perform hand hygiene between clients. c.) A nurse does not use sterile scissors to cut the tape for a wound dressing. d.) A client receives a prophylactic antibiotic 20 minutes late.
b.) Several nurses fail to perform hand hygiene between clients Hand hygiene is the single most important infection prevention and control practice. A mask is not necessary for clients on contact precautions, and tape does not have to be cut with sterile scissors. Although administering the antibiotic late is cause for concern, it does not present as big a risk as failure to perform hand hygiene.
An older adult client has been admitted to the unit for bleeding due to diverticulitis. The client tells the nurse that they are concerned because the next day is Ash Wednesday and if they are in the hospital, they will not be able to receive ashes as is custom on this holy day. What action should the nurse take? a.) Tell the client that it will be OK to miss receiving ashes because they are in the hospital. b.) Tell the client staff will contact their priest to see if they can perform the ritual in the hospital room. c.) Tell the client that it is OK and they can receive ashes next year. d.) Express understanding of how the client must feel but there is nothing nursing staff can do about the situation.
b.) Tell the client staff will contact their priest to see if they can perform the ritual in the hospital room. When a client expresses a spiritual or religious concern, the nurse should help make the appropriate referral or offer to contact the client's spiritual adviser. Other options are to contact the health care facility's pastoral ministry department or use a referral list of clergy in the local community. If no representative of the client's religion can visit in the hospital at a particular time, suggest a visit from a member of the clergy from another faith. The client, depending on the situation and the immediacy of the need, may welcome such a suggestion. Telling the client that it is OK to miss receiving ashes this year or that the nurse can do nothing about the situation are statements that are nontherapeutic.
A client scheduled for complex heart surgery has been reading their religious text for hours each day, cries often, and is not sleeping well. What might these observations cue the nurse about the client? a.) These behaviors are expected before major surgery. b.) These behaviors are signs of spiritual distress. c.) Family members live far away and the client is lonely. d.) The client is naturally emotional and reactive.
b.) These behaviors are signs of spiritual distress Many clients find it difficult to talk about their spiritual beliefs and problems but may have behavioral indicators of spiritual distress. Significant behavioral observations include sudden changes in spiritual practices, mood changes, sudden interest in spiritual matters, and disturbed sleep. The client may or may not have family available or be emotionally reactive.
Which set of terms best reflects nursing's view of clients as holistic beings? a.) physical, psychosocial, religious b.) mind, body, spirit c.) id, ego, superego d.) spiritual, egocentric, naive
b.) mind, body, spirit Nursing has a long history of incorporating spirituality into client care. References to spirituality underlie a primary idea in nursing, that clients are viewed as holistic beings in body, mind, and spirit. Id, ego, and superego are concepts associated with psychoanalytic theory. A holistic view is more than physical, psychosocial, religious, egocentric, and naïve.
The client is a 75-year-old widow who lost their last child to cancer last month. The client shares with the nurse that they fear being alone. To which spiritual needs does the nurse attribute this fear? a.) need for meaning and purpose b.) need for love and relatedness c.) need for the basic necessities of life d.) need for forgiveness
b.) need for love and relatedness The three spiritual needs underlying all religious traditions and common to all people are the need for meaning and purpose, the need for love and relatedness, and the need for forgiveness. The client is experiencing a loss of love and relatedness. A need for meaning and purpose can be related to loss of a job or function. Need for forgiveness is reconciling differences with other persons. Basic necessities are something necessary or indispensable such as food, water, and shelter.
A nurse is assisting a client with bathing. The client tells the nurse that she has great respect and faith in a particular spiritual leader. The nurse interprets this information as fulfilling which need for the client? a.) financial strength and support b.) sense of security for present and future c.) power to perform miracles d.) living a longer life
b.) sense of security for present and future Whatever the spiritual or religious beliefs the person holds and practices, these beliefs contribute to a sense of security for the present and future; give meaning to life, illness, other crises, and death; guide daily living habits; drive acceptance or rejection of other people; furnish psychosocial support within a group of like-minded people; provide strength in meeting life's crises; and give healing strength and support. However, spiritual beliefs do not guarantee a person gains financial power and strength, the power to perform miracles, or the ability to live longer.
Which religious groups would the nurse anticipate to regard Saturday as the Sabbath? (Select all that apply.) a.) Roman Catholicism b.) Buddhism c.) Adventist d.) Judaism e.) Islam f.) Hinduism
c and d Saturday and Sunday are considered the Sabbath in the religions of the Adventist and Judaism. Reference:
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. a.) Offer to pray with the client whenever she likes. b.) Discuss similarities and differences between the nurse's religion and the client's religion. c.) Arrange for the client's pastor to visit if desired. d.) Attempt to meet religious dietary restrictions. d.) Respect the need for privacy during periods of prayer.
c, d, and e The following are means the nurse can use to help the client continue normal spiritual practices in the unfamiliar environment of the hospital or care center:• Familiarize the client with the religious services and materials available within the institution.• Respect the client's need for privacy or quiet during periods of prayer.• Assist the client to obtain devotional objects and protect them from loss or damage.• Arrange for the client wishing to receive the sacraments to do so.• Attempt to meet the client's religious dietary restrictions.• Arrange for the client's minister, priest, or rabbi to visit if the client so wishes.Proselytizing is never acceptable in professional settings. Addressing spiritual issues should not be coercive. Praying with clients should not be initiated by the nurse unless there is no pastoral care available and the client requests it. Comparing and contrasting religious beliefs is not likely to benefit the client.
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 will be important. What action will the nurse take to provide presence to this client? a.) Check on this client every hour. b.) Sit in the chair on the other side of the room for 10 minutes each hour. c.) Hold the client's hand and sit by the bedside as often as possible. d.) Tell the client that the nurse is there when needed and to just ring the call bell.
c.) Hold the client's hand and sit by the bedside as often as possible The nurse can offer supportive presence by holding the client's hand to show that they are sincerely concerned, or simply by being present to communicate value and respect. The other options do not show that the nurse truly cares. Checking on the client every hour demonstrates the nurse wanting to take care of physical needs rather than spiritual needs. Sitting in the chair on the other side of the room is not a caring behavior. Telling a client who is close to death to use the call bell demonstrates a nurse's inability to give caring behaviors.
A nurse cares for a client who was just given the diagnosis of pancreatic cancer. The client asks the nurse to help them understand why their god gave them "this death sentence; I have lived a good life all along." The nurse is not comfortable acting as a spiritual counselor. What action should the nurse take? a.) Tell the client the nurse does not want to talk about this because the nurse is not comfortable doing so. b.) Change the subject to avoid focusing on the diagnosis. c.) Suggest to the client that they can call their spiritual advisor to help give counsel. d.) Tell the client that the nurse will talk about this later.
c.) Suggest to the client that they can call their spiritual advisor to help give counsel. Not every nurse feels comfortable in the role of spiritual counselor. Those who do not can suggest that the client talk to a pastoral caregiver or spiritual counselor. When a client expresses a desire to speak to a spiritual counselor, the nurse should help make the appropriate referral or offer to contact the client's own spiritual adviser. Other options are to contact the health care facility's pastoral ministry department or use a referral list of clergy in the local community. Changing the subject or telling the client you do not want to talk about this is not therapeutic.
Research findings have demonstrated that the group of clients who have indicated a greater need for spirituality include those diagnosed with a.) Nonmalignant tumors b.) Congenital defects c.) Terminal illness d.) Hypertension
c.) Terminal illness One study by Sherman in 1996 has shown that terminally ill clients or those who have a life-threatening medical diagnosis demonstrate that spirituality is potentially a very significant variable. When these clients confronted their own mortality, reliance on spiritual assets such as faith and prayer increased when compared with non-terminally ill, hospitalized clients or healthy, non-hospitalized people.
When asked about their religious preference, the client becomes very upset with the nurse. Which response is appropriate for this situation? a.) "There is nothing to be upset about. This is part of my assessment." b.) "I can see that this upsets you. Let me come back later when you are feeling better." c.) "You need to understand that I am just doing my job here." d.) "I can see that this question upsets you. Do you have any questions about this?"
d.) "I can see why this questions upsets you. Do you have any questions about this?" The nurse should assist the client in understanding that the nursing history is a review of the whole human being and that questions will be wide ranging, including spiritual health, physical health, and emotional health. A client who appears angry, anxious, depressed, or defensive when asked spiritual questions may need to hear something like, "I can see that this question upsets you. Do you have any questions about this?" Telling the client that the nurse is just completing their job or telling the client that it is part of the assessment is not appropriate or therapeutic.
A nurse is caring for a hospitalized child who is 9 years old. What information does the nurse consider when planning the child's spiritual assessment? a.) The child is unlikely to have any concept of spirituality. b.) Data should be exclusively obtained from the parents. c.) In most cases, only terminally ill children believe in a higher power. d.) Children have definite perceptions of a higher power.
d.) Children have definite perceptions of a higher power Heller studied spirituality in children. In that study of 40 children between the ages of 4 and 12 years, Heller found that the children had definite perceptions of a higher power.
The nurse is caring for a client who is preparing to undergo a left mastectomy. As the nurse performs the physical assessment, the client informs the nurse that she is unable to accept blood products as treatment due to her religion. The nurse interprets this as a belief of which religion? a.) Buddhism b.) Baha'i International Community c.) Latter Day Saints d.) Jehovah's Witnesses
d.) Jehovah's Witnesses Jehovah's Witnesses oppose the "false teachings" of other sects; opposition often extends to modern science, including medicine. Buddhists believe in the Four Noble Truths and the Noble Eightfold Path. Latter Day Saints believe in divine healing through the "laying on of hands." The Baha'i International Community believes in a basic harmony between religion and science.
The nurse is teaching the client with hypertension about maintaining an exercise program. Which teaching strategy will be most helpful? a.) Give the client a written exercise program to follow. b.) Explain the exercise program to the client's spouse. c.) Offer reassurance that that the client can follow the exercise program. d.) Tailor a program to the meet client's needs and abilities.
d.) Tailor a program to the meet client's needs and abilities Tailoring or individualizing a program to the client's lifestyle has been shown to be an effective strategy for changing health behaviors. Providing a written program, explaining the program to the client's spouse, and reassuring the client that he or she can do the program may be helpful but are not as likely to promote adherence as individualizing the program.
A 55-year-old client with end-stage kidney injury has asked to be taken off dialysis. The client now shares with the nurse that they have mistreated their only child in the past and would like to reconcile this before dying. The nurse knows that this is related to which spiritual need believed to be common to all people? a.) need for meaning and purpose b.) feed for love and relatedness c.) need for the basic necessities of life d.) need for forgiveness
d.) need for forgiveness According to Shelly and Fish (1988), the three spiritual needs underlying all religious traditions and common to all people are the need for meaning and purpose, the need for love and relatedness, and the need for forgiveness. The client is pursuing reconciliation, which is in the need for forgiveness category. The need for basic necessities is related to Maslow's hierarchy of need and include food (including water), shelter and clothing. The need for love and relatedness corresponds to having meaningful relationships. The need for meaning and purpose is for one to feel that the work they perform or the duties they complete are meaningful and respected.
