Ch 36 Spirituality Health/Religion NCLEX Q's

A nurse is caring for a patient who refuses to eat until after the sun sets. Which religion does this patient most likely practice? A: Islam B: Sikhism C: Hinduism D: Catholicism

A: Islam

Which of the following nursing interventions support(s) a healing relationship with a patient? (Select all that apply): A: Praying with the patient B: Giving pain medications before a painful procedure C: Telling a patient that it is time to take a bath before family arrive to visit D: Making the patient's bed following hospital protocol E: Helping a patient see positive aspects related to a chronic illness

A: Praying with the patient E: Helping a patient see positive aspects related to a chronic illness

A nurse is caring for a patient with a seriously advanced infection who asks to have a spiritual care provider come who can offer Blessingway, a practice that attempts to remove ill health. This patient is likely a member of which religion or culture? 1. Hinduism 2. Navajo 3. Sikhism 4. Judaism

2

The nurse is assessing spiritual needs for a patient who has been newly diagnosed with a chronic illness. Which are appropriate nursing interventions for the spiritual care of this patient? Select all that apply. 1. Shared laughter 2. Shared tears 3. Listening to the patient 4. Administering medication 5. Praying with the patient 6. Ambulating the patient

1,2,3,5

The nurse is caring for a 50-year-old woman visiting the outpatient medicine clinic. The patient has had type 1 diabetes since age 13. She has numerous complications from her disease, including reduced vision, heart disease, and severe numbness and tingling of the extremities. Knowing that spirituality helps patients cope with their chronic illness, which of the following principles should the nurse apply in practice? (Select all that apply.) 1. Pay attention to the patient's spiritual identity throughout the course of her illness 2. Select interventions that you know scientifically support spiritual well-being 3. Listen to the patient's story each visit to the clinic and offer a compassionate presence 4. When the patient questions the reason for her long-time suffering, try to provide answers 5. Consult with a spiritual care advisor and have the advisor recommend useful interventions

1,3

Select the three factors that are evident when a healing relationship develops between nurse and patient. 1. The nurse being able to realistically mobilize hope for the patient 2. The patient being able to share fears of loss with significant others 3. Finding an interpretation or understanding of the patient's illness that is acceptable to the patient 4. Understanding your own beliefs about spirituality 5. Helping the patient use spiritual resources that he or she chooses

1,3,5

The nurse identifies which attributes and criteria of the concept of spirituality? Select all that apply. 1. Spirituality is universal. 2. Physical illness does not impact the spirit. 3. Spirituality manifests whether a person acts on personal beliefs or not. 4. Family and culture impact spiritual beliefs. 5. Nurses should be aware of local community-based religious organizations.

1,4,5

A nursing instructor evaluates that a nursing student understands the concept of spirituality in nursing practice when the student makes which statement? 1. A lack of spirituality theories has contributed to the omission of this aspect of care. 2. A lack of spirituality assessment can have a negative impact on patient care. 3. Spirituality assessment is not part of professional nursing care but should be included in holistic care. 4. There are currently no nursing diagnoses addressing spirituality to include in the plan of care.

2

A patient has just learned she has been diagnosed with a malignant brain tumor. She is alone; her family will not be arriving from out of town for an hour. You have cared for her for only 2 hours but have a good relationship with her. What might be the most appropriate intervention for support of her spiritual well-being at this time? 1. Make a referral to a professional spiritual care advisor 2. Sit down and talk with the patient; have her discuss her feelings and listen attentively 3. Move the patient's bible from her bedside cabinet drawer to the top of the over-bed table 4. Ask the patient if she would like to learn more about the implications of having this type of tumor

2

A 44-year-old male patient has just been told that his wife and child were killed in an auto accident while coming to visit him in the hospital. Which of the following statements are defining characteristics that support a nursing diagnosis of Spiritual Distress related to loss of family members? (Select all that apply.) 1. "I need to call my sister for support." 2. "I have nothing to live for now." 3. "Why would my God do this to me?" 4. "I need to pray for a miracle." 5. "I want to be more involved in my church."

2,3

A nurse is caring for a 78-year-old patient with chronic multiple sclerosis. The patient has severe fatigue, muscle weakness, severe muscle spasms, and difficulties with coordination and balance. Her disease will likely worsen. The nurse has gained the patient's trust and wants to assess her life satisfaction. Which of the following questions should the nurse ask? (Select all that apply.) 1. How often are you able to attend your synagogue? 2. What about your family makes you proudest? 3. What does your husband do for you at home? 4. Looking back, what is your greatest accomplishment? 5. How has your illness affected the way you live your life spiritually at home?

2,4

A nurse is preparing to teach an older adult who has chronic arthritis how to practice meditation. Which of the following strategies are appropriate? (Select all that apply.) 1. Encourage family members to participate in the exercise. 2. Have patient identify a quiet room in the home that has minimal interruptions. 3. Suggest use of a quiet fan running in the room. 4. Explain that it is best to meditate about 5 minutes 4 times a day. 5. Show the patient how to sit comfortably with the limitation of his arthritis and focus on a prayer.

2,4,5

A nurse begins a night shift, assuming care for a critically ill patient who was resuscitated earlier in the day from cardiac arrest. He survived and is physically stable, alert, oriented, and responding appropriately to the nurse's questions. Knowing that the patient experienced a period when his heart stopped beating, what would be the best approach for the nurse to use with him? 1. Have family come to visit and focus discussion about their gratitude that the patient survived 748 2. Change the subject when the patient begins talking about entering a dark tunnel when the doctors were resuscitating him 3. Sit and encourage the patient to share what he experienced during resuscitation 4. Provide the patient the opportunity to have passages from the bible read to him

3

A patient states that he does not believe in a higher power but instead believes that people bring meaning to what they do. This patient most likely is an: 1. Academic. 2. Atheist. 3. Agnostic. 4. Anarchist.

3

A patient who is recovering from a bilateral amputation of the legs below the knee shows transcendence when she states: 1. "My pain medicine helps me feel better." 2. "I know I'll get better if I just keep trying." 3. "I see God's grace and become relaxed when I watch the sun set at night." 4. "I have had a great life and a good marriage. My husband has been so helpful in my healing."

3

Evaluation of spiritual care is necessary to determine if a patient's level of spiritual health has changed following intervention. If the use of rituals was part of a nurse's care plan, which of the following questions is most appropriate to evaluate its efficacy? 1. Do you feel the need to forgive your wife over your loss? 2. What can I do to help you feel more at peace? 3. Were prayer or meditation helpful to you? 4. Should we plan on having your family try to visit you more often in the hospital?

3

You are caring for a hospitalized patient who is Muslim and has diabetes. Which of the following items do you need to remove from the meal tray when it is delivered to the patient? 1. Small container of vanilla ice cream 2. A dozen red grapes 3. Bacon and eggs 4. Garden salad with ranch dressing

3

A student nurse is developing a plan of care for a 74-year-old-female patient who has spiritual distress over losing a spouse. As the nurse develops appropriate interventions, which characteristics of older adults should be considered? (Select all that apply.) 1. Older adults do not routinely use complementary medicine to cope with illness. 2. Older adults dislike discussing the afterlife and what might have happened to people who have passed on. 3. Older adults achieve spiritual resilience through frequent expressions of gratitude. 4. Have the patient determine if her husband left a legacy behind. 5. Offer the patient her choice of rituals or participation in exercise.

3,4,5

A patient tells the nurse, "I am not a religious person. I believe things happen in life out of pure coincidence." Which evaluation of this patient's spirituality is true? 1. This patient is not a spiritual person. 2. This patient is more likely to suffer from depression. 3. This patient will experience difficulty coping with life changes. 4. This patient experiences emotion and should be asked about effects of health changes.

4

As the profession of nursing evolved to incorporate evidence-based practice, which statement is true about spirituality? 1. Evidence-based care focuses solely on the physical effects of health and illness. 2. An emphasis was placed on spirituality as nursing education moved into colleges and universities. 3. Spirituality was incorporated back into care when a concrete definition had been established. 4. Spirituality commonly encompasses a concept or belief about God and the inner person.

4

A student nurse is telling a faculty member that her patient talked about gaining spiritual comfort from being focused on her inner self, including her values and principles. The instructor explains that this is an example of: 1. Faith. 2. Community. 3. Interpersonal connection. 4. Self-transcendence.

4. Self-transcendence

A 62-year-old male patient has just been told he has a terminal illness. Which of the following statements supports a nursing diagnosis of spiritual distress related to diagnosis of terminal illness? A: "I have nothing to live for now." B: "What will happen to my wife when I die?" C: "How much longer do I have to live?" D: "I need to go to church and pray for a miracle."

A: "I have nothing to live for now."

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. This is an example of: A: Hope. B: Faith. C: Values. D: Connectedness

A: Hope.

An older adult is receiving hospice care. Which nursing intervention(s) help the patient cope with feelings related to death and dying? (Select all that apply.) A: Teaching the patient how to use guided imagery B: Encouraging the family to visit the patient frequently C: Taking the patient's vital signs every time the nurse visits D: Teaching the patient how to manage pain and take pain medications E: Helping the patient put significant photographs in a scrapbook for the family

A: Teaching the patient how to use guided imagery B: Encouraging the family to visit the patient frequently E: Helping the patient put significant photographs in a scrapbook for the family

A nurse is working in a health clinic on a Navajo reservation. He or she plans care for the patients knowing which of the following is true? A: The patients may not be on time for their appointments. B: The patients most likely do not trust the doctors and nurses. C: The patients probably are not comfortable if they have to remove their undergarments. D: Terminally ill patients probably want to receive the sacrament, the anointing of the sick.

A: The patients may not be on time for their appointments.

As the nurse cares for a patient in an outpatient clinic, the patient states that he recently lost his position as a volunteer coordinator at a local community center. He expresses that he is angry with his former boss and with God. The nurse knows that the priority at this time is to assess the patient's spirituality in relation to his: A: Vocation. B: Life satisfaction. C: Fellowship and community. D: Connectedness with his family and co-workers.

A: Vocation.

Which relationship to spirituality best describes concept of legal issues as they relate to spirituality? a. Health beliefs are often influenced by spirituality. b. Advance directive choices and choices associated with autonomy and self-determination may be influenced by spirituality. c. Culture and diversity often influence the spirituality of an individual particularly in terms of religion and morality. d. Choices associated with ethics often stem from spirituality or morality.

Advance directive choices and choices associated with autonomy and self-determination may be influenced by spirituality. Rationale Advance directive choices and choices associated with autonomy and self-determination may be influenced by spirituality is an example of the relationship of legal issues to spirituality. An example of the health, wellness, and illness concept as it relates to spirituality is that health beliefs are often influenced by spirituality. An example of culture and diversity as it relates to spirituality is that culture and diversity often influence the spirituality of an individual particularly in terms of religion and morality. An example of ethics as it relates to spirituality is that choices associated with ethics often stem from spirituality or morality.

Which of the following statements made by an older adult whose husband recently died most indicates the need for follow-up by the nurse? A: "I planted a tree at church in my husband's honor." B: "I have been unable to talk with my children lately." C: "My friends think that I need to go to a grief support group." D: "I believe that someday I'll meet my husband in heaven."

B: "I have been unable to talk with my children lately."

A patient states that he does not believe in the existence of God. This patient most likely is an: A: Academic. B: Atheist. C: Agnostic. D: Anarchist.

B: Atheist.

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? " In this example the nurse is demonstrating: A: Prayer. B: Presence. C: Coaching. D: Instilling hope.

B: Presence.

Which of the following would be the most appropriate outcome for a patient who has a nursing diagnosis of spiritual distress related to loneliness? A: Encourage the patient to meditate 2 to 3 times a week. B: The patient will set up a time to speak to a close friend in 1 week. C: Encourage the patient to phone his brother and set up a time to go out for dinner. D: The patient will experience greater connections with family members in 2 months.

B: The patient will set up a time to speak to a close friend in 1 week.

A patient expresses the desire to learn how to meditate. What does the nurse need to do first? A: Answer the patient's questions B: Help the patient get into a comfortable position C: Select a teaching environment that is free from distractions D: Encourage the patient to meditate for 10 to 20 minutes 2 times a day

C: Select a teaching environment that is free from distractions

A Catholic patient with diabetes receives the following items on his meal tray on the Friday before Easter. For which of the foods does the nurse offer to substitute? A: Apple sauce B: Cheese and crackers C: Spaghetti with meat sauce D: Tossed salad with ranch dressing

C: Spaghetti with meat sauce

Which of the following questions would best assess a patient's level of connectedness? A: What gives your life meaning? B: Which aspects of your spirituality would you like to discuss right now? C: Who do you consider to be the most important person in your life at this time? D: How do you feel about the accomplishments you've made in your life so far?

C: Who do you consider to be the most important person in your life at this time?

A nurse is using the B-E-L-I-E-F tool to complete a spiritual assessment on a 12-year-old male who has recently been diagnosed with acute lymphocytic leukemia. Which of the following questions would the nurse use to assess the child's involvement in the spiritual community? A: Which church do you attend? B: Which sports do you like to play? C: Are there any foods you cannot eat? D: In which church activities do you participate?

D: In which church activities do you participate?

A nurse is formulating diagnoses for patients in a hospice program who are experiencing spiritual distress. In which diagnoses is spiritual distress the etiology of another problem? Select all that apply. a. Ineffective Individual Coping related to loss of religion as a major support in life b. Powerlessness related to feeling unprepared for death and the afterlife experience c. Self-Esteem Disturbance related to failure to reconcile illness with spiritual beliefs d. Risk for Impaired Religiosity related to inability to attend church as usual e. Spiritual Distress related to fear of dying alone f. Impaired Religiosity related to inability to exercise reliance on spiritual beliefs

a, b, c. Spiritual distress may affect other areas of human functioning. In the first three nursing diagnoses, spiritual distress is the etiology of another problem. In the last three diagnoses, spiritual distress is the problem.

A nurse is an active member of an evangelical church. The nurse prays with some clients. Which statements by the nurse would indicate appropriate​ considerations? ​(Select all that​ apply.) a. "I pray only with clients whose minds can still make choices." b. "Praying together is the best therapeutic relationship." c. "I tell clients who don​'t join me that they​'re on my prayer list." d. "I ask clients about wanting to pray together." e. "Before ​praying, I confirm that it​'s a convenient time for clients."

a. "I pray only with clients whose minds can still make choices." d. "I ask clients about wanting to pray together." e. "Before ​praying, I confirm that it​'s a convenient time for clients." Rationale It is appropriate for the nurse to ask about clients​'​ desires, to select only those who can make​ decisions, and to select those for whom it is a convenient time. Being too enthusiastic about the effects of prayer or trying to include those who are opting out is not appropriate.

A nursing student has attended nutritional in-service regarding dietary practices of a variety of religions. Which statement made by the nursing student would indicate the need for further teaching? a. "Muslims eat all forms of meat." b. "Mormons typically avoid coffee and tea." c. "Most Hindus are vegetarian and do not eat beef." d. "If a Jewish client practices a Kosher diet, it is inappropriate to mix dairy and meat."

a. "Muslims eat all forms of meat." Rationale Muslims do not eat pork; therefore the statement made by the student nurse indicating that Muslims eat all forms of meat would indicate the need for further teaching. Most Hindus are vegetarian and do not eat beef. Mormons typically avoid alcohol, coffee, and tea. On a Kosher diet, it is inappropriate to mix dairy and meat.

Which exemplar is consistent with the moral principle of nonmaleficence? a. A client has an adverse reaction to an antibiotic administered by the nurse b. A client's physical health improves with the recommended exercise regimen c. The nurse ensures administering pain medication to a client within 10 minutes d. The nurse ensures client assessment findings are documented accurately

a. A client has an adverse reaction to an antibiotic administered by the nurse Rationale Nonmaleficence is the duty to "do no harm." A client may be at risk of harm as a known consequence of a nursing intervention that is intended to be helpful, such as an adverse reaction to a medication. Option 2 is an example of beneficence, when nursing actions benefit clients. Option 3 is an example of fidelity, when the nurse is faithful to agreements and promises. Option 4 is an example of responsibility, when the nurse recognizes the standards to which he or she will be held.

After having an abortion, a patient tells the visiting nurse, "I shouldn't have had that abortion because I'm Catholic, but what else could I do? I'm afraid I'll never get close to my mother or back in the Church again." She then talks with her priest about this feeling of guilt. Which evaluation statement shows a solution to the problem? a. Patient states, "I wish I had talked with the priest sooner. I now know God has forgiven me, and even my mother understands." b. Patient has slept from 10 PM to 6 AM for three consecutive nights without medication. c. Patient has developed mutually caring relationships with two women and one man. d. Patient has identified several spiritual beliefs that give purpose to her life.

a. Because this patient's nursing diagnosis is Spiritual Distress: Guilt, an evaluative statement that demonstrates diminished guilt is necessary. Only answer a directly deals with guilt.

According to Roach, which are included in the six C's of caring in nursing? (Select all that apply.) a. Competence b. Commitment c. Comportment d. Compassion e. Courtesy

a. Competence b. Commitment c. Comportment d. Compassion Rationale Courtesy is not listed by Roach as one of the six C's of caring. The six C's are; compassion, competence, confidence, conscience, commitment, and comportment.

Two nurses are discussing the ways in which spiritual practices affect individuals. "I can​'t believe how many different ways they affect ​people," one concludes. The other nurse agrees. Which individual habits and events could be connected to spiritual​ practices? ​(Select all that​ apply.) a. Dress b. Medications c. Birth and death d. Healing e. Diet and nutrition

a. Dress b. Medications c. Birth and death d. Healing e. Diet and nutrition Rationale All of the above answers are correct. Diet and​ nutrition, medications,​ healing, dress, and birth and death all could be connected with spiritual practices.

The nurse is creating a brochure about effective​ self-care for nurses. Which statements should the nurse include in the​ brochure? ​ (Select all that​ apply.) a. Effective​ self-care promotes enhanced critical thinking ability. b. ​Self-care activities include getting adequate rest. c. Prayer and meditation are examples of​ self-care activities. d. Effective​ self-care builds​ self-esteem. e. Effective​ self-care promotes depersonalization of clients.

a. Effective​ self-care promotes enhanced critical thinking ability. b. ​Self-care activities include getting adequate rest. c. Prayer and meditation are examples of​ self-care activities. d. Effective​ self-care builds​ self-esteem. Rationale Effective​ self-care leads to more than just physiologic health and physical fitness. Along with enhancing the individual​'s sense of​ well-being, effective​ self-care also builds​ self-esteem, which in turn promotes effective use of problem solving and critical thinking skills. Effective​ self-care reduces the risk for​ burnout, the manifestations of which include depersonalization of clients. General examples of​ self-care activities are eating a balanced​ diet, exercising on a regular​ basis, getting adequate rest and​ sleep, and engaging in recreational activities.

A nurse working in the memory care unit listens as the newly admitted client talks about his work as a pilot as if he had just left the airport. The nurse knows he has been retired for decades. What does the nurse recognize as the benefits of hearing his work life​ story? ​(Select all that apply.) a. Helping the client maintain a sense of identity b. Focusing on the positive aspects of a past work life c. Keeping his verbal abilities exercised d. Entertaining the other clients and families e. Giving the nurse insight into the client​'s behavior

a. Helping the client maintain a sense of identity e. Giving the nurse insight into the client​'s behavior Rationale Hearing details of the client​'s past work life helps the client maintain a sense of​ identity, and gives the nurse insight into the client​'s behavior. It is not a matter of focusing on the positive​ aspects, exercising verbal​ ability, or providing entertainment.

A nurse is observing a newly admitted client for details to add to the spiritual assessment. Which clinical observations would be useful​ additions? ​(Select all that​ apply.) a. Interactions with others b. Behavior c. Mood d. Speech e. Mealtime choices

a. Interactions with others b. Behavior c. Mood d. Speech Rationale Clinical observations of​ behavior, speech,​ mood, and interactions with others would be useful. Observing mealtime choices is not an example of a clinical observation the nurse would make. This item would be asked during the initial admission assessment of the client.

A nurse who is a certified diabetes specialist is aware of the negative effects of fasting on glucose control. The nurse knows that clients with diabetes and clients with other conditions are often exempt from fasting requirements. Which people have conditions that often exempt them from religious​ fasting? ​(Select all that​ apply.) a. Menstruating women b. Growing teenagers c. Nursing mothers d. People over 65 e. Marathon runners

a. Menstruating women c. Nursing mothers Rationale People who are often exempted from​ fasting, besides​ diabetics, are nursing mothers and menstruating women. The same exemption is not extended to growing​ teenagers, marathon​ runners, or people over 65.

A nursing instructor teaching a course on religion includes which as core aspects of spirituality? (Select all that apply.) a. Religion b. Forgiveness c. Hope d. Faith e. Health

a. Religion b. Forgiveness c. Hope d. Faith Rationale Because spirituality is a reflection of an inner experience that is expressed individually, it includes as many representations as there are human beings. Core aspects of spirituality include religion, faith, hope, transcendence, and forgiveness. Health beliefs are often influenced by spirituality but is not a core concept of spirituality.

A client admitted for major cardiac surgery states a religious preference. Then the client lists all the church​'s rules that the client disagrees with. What does the admitting nurse understand about the client​'s religious​ status? a. The client is a dissenting member of that group. b. The client is a former member of that group. c. The client is an outsider trying to be part of that group. d. The client has been excommunicated from that group.

a. The client is a dissenting member of that group. Rationale The client is a dissenting member of that group. It is not a matter of past​ membership, of being​ rejected, or of being an outsider.

The nursing instructor asks the class to describe empirical knowing. Which student responses are most​ accurate? ​(Select all that​ apply.) a. ​"It includes observations related to​ nursing." b. ​"It's subjective in​ nature." c. ​"It incorporates​ nursing-related facts." d. ​"It can be developed through ongoing academic​ education." e. ​"It's also called the science of​ nursing."

a. ​"It includes observations related to​ nursing." c. ​"It incorporates​ nursing-related facts." d. ​"It can be developed through ongoing academic​ education." e. ​"It's also called the science of​ nursing." Rationale Empirical​ knowing, also referred to as "the science of ​nursing," is based in​ nursing-related facts and​ observations, and in nursing theories and analyses that seek to explain these facts and observations. Methods of developing empirical knowing include ongoing academic nursing education. Empirical knowing is objective in nature.

The nurse educator is instructing a group of students about ways of knowing. Which statement by the student best reflects ethical​ knowing? a. "Ethical knowing relates to the nurse​'s specific personal style during care delivery." b. "Ethical knowing applies to every intentional nursing action that may be subject to being judged right or wrong." c. "Ethical knowing refers to the nurse​'s ongoing​ self-exploration and journey toward ​self-actualization." d. "Ethical knowing is rooted in​ nursing-related facts and observations."

b. "Ethical knowing applies to every intentional nursing action that may be subject to being judged right or wrong." Rationale Ethical knowing incorporates every intentional action and behavior by the nurse that may be subject to being judged right or wrong. Personal knowing refers to the nurse​'s ongoing​ self-exploration and journey toward​ self-actualization. Empirical knowing is based in​ nursing-related facts and​ observations, and nursing theories and analyses that seek to explain these facts and observations.Aesthetic knowing relates to the nurse​'s specific personal style during care delivery.

During a classroom discussion about Maslow​'s hierarchy of​ needs, a nursing student​ asks, open double quote"What is the most basic level of ​need?close double quote" What is the best response by the nursing​ instructor? a. "Love and belonging needs are the most​ basic; these include relationships and affection." b. "Physiologic needs are the most​ basic; these include shelter and water." c. "Safety needs are the most​ basic; these include physical and psychological safety." d. "Esteem needs are the most​ basic; these include respect and competence."

b. "Physiologic needs are the most​ basic; these include shelter and water." Rationale In Maslow​'s hierarchy of​ needs, physiologic needs are at the most basic​ level; these needs include​ air, food,​ water, and shelter. The second level is safety​ needs, which comprise physical​ safety, financial​ stability, harmonious family​ relationships, and freedom from psychological threats. The third level of need encompasses love and belonging and includes relationships and affection. The fourth​ level, self-actualization, is reflective of the individual​'s need to reach his highest level of function and​ fulfillment, both personally and professionally. The fifth and highest level is esteem​ needs, which include​ confidence, independence,​ competence, respect, and achievement.

The nurse caring for a client and observes which client behavior as an indicator of spiritual health? a. A client who insists on wearing pajama bottoms b. A client who listens to meditative music each morning before breakfast c. A client who ambulates in the hallway d. A client discussing his hobbies

b. A client who listens to meditative music each morning before breakfast Rationale Indicators of spiritual health include, but are not limited to, faith and hope; meaning and purpose in life; ability to love, forgive, pray, and worship; participation in spiritual rites; expression. A client who listens to meditative music each morning before breakfast demonstrates spiritual health. All behaviors are appropriate client behaviors.

A dialysis nurse does not agree with a client​'s decision to stop treatment. "I promised my spouse I would try it for a​ while, but it​'s too ​much," the client reveals. In supporting the client​'s ​decision, which principle of morality is the nurse​ honoring? a. Veracity b. Autonomy c. Fidelity d. Justice

b. Autonomy Rationale In supporting the client​'s ​decision, the nurse is honoring the principle of autonomy​ (the client​'s right to make​ decisions). It is not a matter of fidelity​ (keeping a​ promise), veracity​ (telling the​ truth), or justice​ (fairness).

The staff nurse is writing a journal article that explores the principle of caring as it applies to nursing. Which statements should she include in the​ article? ​(Select all that​ apply.) a. Client care is synonymous with caring in nursing. b. Caring in nursing extends beyond feelings of interest or concern. c. Nursing interventions can be implemented in the absence of genuine caring. d. In​ nursing, demonstration of caring includes the​ safe, proficient implementation of nursing interventions. e. In​ nursing, concern for the client​'s ​well-being will produce​ safe, effective care.

b. Caring in nursing extends beyond feelings of interest or concern. c. Nursing interventions can be implemented in the absence of genuine caring. d. In​ nursing, demonstration of caring includes the​ safe, proficient implementation of nursing interventions. Rationale Client care comprises the implementation of collaborative and independent nursing interventions that are intended to restore​ health, prevent illness or​ injury, or promote wellness. Yet nursing interventions can be implemented even in the absence of genuine interest or concern for the ​client's ​well-being. Likewise, genuine interest or concern for the client​'s ​well-being does not necessarily equate to​ safe, proficient implementation of nursing interventions. In​ nursing, the meaning of caring extends well beyond simply implementing interventions or feeling interest or concern.

A nurse is working in a busy intensive care unit. A client is admitted with extensive medical problems and requires a ventilator. Because the nurse has already been assigned to care for two other clients, the nurse requests that the nurse manager change assignments so that appropriate attention can be given to this new admission. Which one of Roach's six C's of caring is the nurse emulating? a. Commitment b. Conscience c. Confidence d. Compassion

b. Conscience Rationale Conscience deals with morals, ethics, and an informed sense of right and wrong as well as an awareness of personal responsibility. This nurse understands the situation of taking on a critically ill client while already caring for two previously assigned clients and makes an appropriate request for a change in assignment. Compassion is about being aware of one's relationship to others, sharing joys, sorrows, pain, and accomplishments, and participating in the experience of another. Confidence is the quality that fosters trust. It means the nurse has comfort with himself, his clients, and his family. Commitment is a convergence between one's desires and obligations and the deliberate choice to act in accordance with them.

The client tells her​ nurse, open double quote"You helped me learn how to recognize my own health needs without telling me how I should think.close double quote" Which nursing caring behavior or process is the client best​ describing? a. Presencing b. Empowerment c. Compassion d. Competence

b. Empowerment Rationale Empowerment assists the client to autonomously identify her own health needs in lieu of being instructed how to do so. Competence is the nurse​'s ability to effectively demonstrate a set of​ attributes, such as a professional attitude and​ knowledge, skills, and​ values, and to fulfill her professional responsibility through nursing practice. Compassion develops as a result of being directly involved with the client​'s experience. Presencing involves the nurse​'s immersion in a nurse-client interaction that helps the client define her health choices while understanding the client​'s authority to make her own decisions.

A nurse who is comfortable with one's own spirituality is caring for patients who need spiritual counseling. Which nursing action would be most appropriate for these patients? a. Calling the patient's own spiritual adviser first b. Asking whether the patient has a spiritual adviser the patient wishes to consult c. Attempting to counsel the patient and, if unsuccessful, making a referral to a spiritual adviser d. Advising the patient and spiritual adviser concerning health options and the best choices for the patient

b. Even when a nurse feels comfortable discussing spiritual concerns, the nurse should always check first with patients to determine whether they have a spiritual adviser to consult. Calling the patient's own spiritual adviser (answer a) may be premature if it is a matter the nurse can handle. Answers c and d deny patients the right to speak privately with their spiritual adviser from the outset, if this is what they prefer.

The student nurse is following a preceptor on the assigned clinical shift. Which behavior of the nurse would the student interpret as caring? a. Making sure that all medications and treatments are done on time b. Explaining an invasive procedure to the client, then asking if it is all right to begin the procedure c. Advising the physician that the client wants to speak to him or her prior to a procedure d. Using aseptic technique when performing a dressing change

b. Explaining an invasive procedure to the client, then asking if it is all right to begin the procedure Rationale Caring practice involves connection, mutual recognition, and involvement. It is more than just performing skills adequately or even efficiently. It's a sense that the nurse has made a difference to someone else. Caring means that people, relationships, and things matter. Explaining a procedure, then seeking permission to begin lets the client know that the nurse respects the client as an individual. All the other options are examples of appropriate and professional nursing care but do not address a caring aspect.

As a client comes into the admitting​ area, a nurse notices a jeweled cross on the client​'s necklace. The nurse​ comments, "Great ​look; I can see your religious beliefs are important to ​you," and starts with the spiritual assessment of the client. How would this approach be​ evaluated? a. Complimenting the client​'s appearance is helpful b. No time was taken to establish rapport with the client c. A focus on jewelry might appear materialistic d. It is efficient and effective to dive right into the interview

b. No time was taken to establish rapport with the client Rationale Starting with the spiritual assessment of the client leaves no time to establish rapport with the client. It is not about​ jewelry, compliments, or starting quickly.

A young client has just learned of a diagnosis of stage 4 lung cancer. The client was about to graduate from school and get married. "I can​'t believe in God ​anymore" the client tells the oncology nurse. "He should be ​all-loving." Which situation would the nurse identify the client as​ expressing? a. A justice complaint b. Spiritual distress c. Fear of unemployment d. Premarital anxiety

b. Spiritual distress Rationale The client is expressing spiritual distress about the loss of hope in his belief system. It is not a complaint about​ justice, anxiety about a planned​ marriage, or fear of the job market.

A nurse has transferred from a clinic setting to an inpatient unit. The nurse notices several questions about spiritual beliefs on the admission form that the nurse had never asked new clinic clients. What is the most likely reason for asking these​ questions? a. Finding a better match for a semiprivate room b. The Joint Commission​'s accreditation requirements c. Invitation to attend the hospital​'s worship services d. Identify which members of the clergy to call for spiritual emergencies

b. The Joint Commission​'s accreditation requirements Rationale The most likely reason to ask questions about spiritual beliefs is The Joint Commission​'s requirements for clients admitted to an institution. The requirements are not mandated for clinic clients. It is not about attending worship​ services, matching​ roommates, or calling the right clergyperson.

A client in the emergency department has a severe injury, and treatment requires red blood cells. The client is a Jehovah's Witness who believes it would be medical rape for the nurse to give the transfusion. Which statement by the nurse would most likely lead to resolution of this conflict? a. "You must accept the transfusion; if you don't, you will need to leave." b. "Don't worry, you can ask for pardon after the transfusion." c. "May I call a representative of your religion so I can understand your position?" d. "I understand your position and I'll be with you as you die."

c. "May I call a representative of your religion so I can understand your position?" Rationale Jehovah's Witnesses have a well-developed network of representatives who can be called to help explore medical options with their fellow believers and the medical staff. The nurse is respecting the client's beliefs by offering to call a representative. Forcing the client to have the transfusion is unethical. Telling the client to ask for pardon later is minimizing the client's faith. Telling the client the nurse will remain until client dies without exploring alternative treatments is not appropriate care.

A client asks the nurse to pray for the client. What would be the best initial response by the nurse who believes in prayer? a. "May I call the chaplain to come pray with you?" b. "I know your faith is important to you. It is to me too." c. "What should I pray for?" d. "Isn't it wonderful that we have God to share our concerns with."

c. "What should I pray for?" Rationale The best response is to first assess. By asking the client what to pray for, the nurse is making an assessment. Offering to call the chaplain may be seen as distancing by the client. Assuming that nurse understands the client's experience is patronizing, and introducing the importance of one's own faith at this point is not appropriate. Telling the client that it is wonderful that we have a God with whom we share concerns does not address the need of a client who is distressed and wants to pray.

The nurse is preparing to lead a group discussion on spiritual distress. The nurse is aware that which are treatment related factors that can contribute to spiritual distress? (Select all that apply.) a. Death of a significant other b. Experiencing pain c. Abortion d. Blood transfusions e. Surgery

c. Abortion d. Blood transfusions e. Surgery Rationale Treatment-related factors include a recommendation for blood transfusions, abortion, surgery, dietary restrictions, amputation of a body part, or isolation. Experiencing pain is a physiological factor that can cause spiritual distress and death of a significant other is a situational factor.

When the assisted living nurse asks the new client about her religious​ beliefs, the client​ answers, "I am not convinced that a Higher Power exists. But I am still open to thinking about it." Which category of religious beliefs does the client identify​ with? a. Nontheistic b. Monotheistic c. Agnostic d. Atheistic

c. Agnostic Rationale The client identifies with​ agnostics, who believe that the existence of a Higher Power has not been proved. The client is not an​ atheist, who does not believe in any god. The client is not a​ monotheist, who believes in one god. There is no category called nontheistic.

The nurse delivers the evening meal tray to a Jewish client who states that the tray is unacceptable because there is meat and a carton of milk on the tray. Which is the appropriate intervention by the nurse? a. Remove the milk from the tray. b. Remove the meat from the tray. c. Call the dietary staff for a new appropriate tray. d. Tell the client to only eat the meat or drink the milk.

c. Call the dietary staff for a new appropriate tray. Rationale The tray is removed and a new tray is requested. The Orthodox Jewish religion prohibits the serving of dairy and meat products together, or the serving of meat and dairy using the same utensils and plates. The tray would be considered contaminated since both products were on the tray, so removing or eating one of the products will not resolve the issue for the client.

A nurse who is caring for patients on a pediatric ward is assessing the children for their spiritual needs. Which is the most important source of learning for a child's own spirituality? a. The child's church or religious organization b. What parents say about God and religion c. How parents behave in relationship to one another and their children, to others, and to God d. The spiritual adviser for the family

c. Children learn most about their own spirituality from how their parents behave in relationship to one another, their children, others, and God/higher being. The remaining three options are less important sources of learning.

The nurse caring for a Jewish client at the time of death is aware that which is considered to be a Jewish tradition with regards to death? a. Assist in making arrangements to have the body cremated within 24 hours. b. Turn the head or body toward Mecca. c. Drape the mirrors in black. d. A ritual bath must be given by a family member.

c. Drape the mirrors in black. Rationale Jews have a tradition of burial within 24 hours following death, except on the Sabbath, and they sit Shiva (gather to pay respects), draping any mirrors in black to ensure that guests are focused on memory of the deceased rather than on themselves. In Muslim and Jewish religions, believers may require that a ritual bath must be given by a family member but this is not always the case. Hindus cremate the body within 24 hours to release the soul from any earthly attachment. Muslims who are dying want their body or head turned toward Mecca.

The nursing instructor is teaching a class about the relationship between the concept of​ self-care and the concept of professional behaviors. Which statement should he include in the​ teaching? a. Focusing on​ self-care diminishes the nurse​'s professionalism toward clients. b. Prioritizing​ self-care weakens the nurse​'s professional affiliation with nursing. c. Inadequate​ self-care can impair professional work performance by leading to decreased physical wellness. d. Psychosocial wellness does not influence professional behaviors.

c. Inadequate​ self-care can impair professional work performance by leading to decreased physical wellness. Rationale Inadequate​ self-care can lead to decreased physical and psychosocial wellness. In​ turn, decreased wellness may contribute to impaired work performance as well as a weakened affiliation with the profession of nursing. As a​ result, the nurse​'s demonstrated professionalism toward​ clients, peers, and other members of the healthcare team may suffer.

A nurse working in an emergency department assesses how patients' religious beliefs affect their treatment plan. With which patient would the nurse be most likely to encounter resistance to emergency lifesaving surgery? a. A patient of the Adventist faith b. A patient who practices Buddhism c. A patient who is a Jehovah's Witness d. A patient who is an Orthodox Jew

c. Patients who practice the Jehovah's Witness faith believe blood transfusions violate God's laws and do not allow them. The other religious groups do not restrict modern lifesaving treatment for their members.

A nurse is performing spirituality assessments of patients living in a long-term care facility. What is the best question to assess for spiritual needs? a. Can you describe your usual spiritual practices and how you maintain them daily? b. Are your spiritual beliefs causing you any concern? c. How can I and the other nurses help you maintain your spiritual practices? d. How do your religious beliefs help you to feel at peace?

c. Questioning how the staff can meet patients' spiritual practices assesses spiritual needs. Asking the patient to describe spiritual practices assesses spiritual practices. Asking about concerns assesses spiritual distress, and asking about feeling at peace assesses the need for forgiveness.

A nurse who was raised as a strict Roman Catholic stated she couldn't assist patients with their spiritual distress because she recognizes only a "field power" in each person. She said, "My parents and I hardly talk because I've deserted my faith. Sometimes I feel real isolated from them and also God—if there is a God." Analysis of these data reveals which unmet spiritual need? a. Need for meaning and purpose b. Need for forgiveness c. Need for love and relatedness d.Need for strength for everyday living

c. The data point to an unmet spiritual need to experience love and belonging given her estrangement from her family and God after leaving the church. The other options may represent other needs this nurse has, but the data provided do not support them.

A nurse educator teaches students about caring nursing practice. Which situation demonstrates that the nurse is able to implement the whole idea of caring? a. The nurse makes lists every morning, so the day stays organized and planned. b. The nurse is a volunteer at church and school events. c. The nurse is able to carve out time for a favorite hobby at least once a week. d. The nurse takes care of aging parents in addition to providing care to immediate family.

c. The nurse is able to carve out time for a favorite hobby at least once a week. Rationale It is imperative that nurses attend to their own needs because caring for self is central to caring for others. As nurses take on multiple commitments to family, work, school, and community they risk exhaustion, burnout, and stress. None of the other options depicts the nurse caring for self, but rather caring for other people or trying to stay on top of the many tasks involved in a daily routine.

A man who is a declared agnostic is extremely depressed after losing his home, his wife, and his children in a fire. His nursing diagnosis is Spiritual Distress: Spiritual Pain related to inability to find meaning and purpose in his current condition. What is the most important nursing intervention to plan? a. Ask the patient which spiritual adviser he would like you to call. b. Recommend that the patient read spiritual biographies or religious books. c. Explore with the patient what, in addition to his family, has given his life meaning and purpose in the past. d. Introduce the belief that God is a loving and personal God.

c. The nursing intervention of exploring with the patient what, in addition to his family, has given his life meaning and purpose in the past is more likely to correct the etiology of his problem, Spiritual Pain, than any of the other nursing interventions listed.

A nurse performing a spiritual assessment collects assessment data from a patient who is homebound and unable to participate in religious activities. Which NANDA-I-approved diagnostic label would the nurse use when assessment data point to a spiritual problem that can be treated by independent nursing intervention? a. Spiritual Alienation b. Spiritual Despair c. Spiritual Distress d. Spiritual Pain

c. The only NANDA-I-approved nursing diagnosis among the options is Spiritual Distress. The other options may be further specifications of the broader diagnosis Spiritual Distress.

Mr. Brown's teenage daughter had been involved in shoplifting. He expresses much anger toward her and states he can not face her, let alone discuss this with her: "I just will not tolerate a thief." Which nursing intervention would the nurse take to assist Mr. Brown with his deficit in forgiveness? a. Assure him that many parents feel the same way. b. Reassure him that many teenagers go through this kind of rebellion and that it will pass. c. Assist the patient to identify how unforgiving feelings toward others hurt the one who cannot forgive. d. Ask him if he is sure he has spent sufficient time with his daughter.

c. This is the only nursing intervention that directly addresses the patient's unmet spiritual need concerning forgiveness. Answers a and b may make him feel better initially, but neither addresses his need to forgive. Answer d is likely to make him feel guilty.

A hospice nurse is caring for a patient who is dying of pancreatic cancer. The patient tells the nurse "I feel no connection to God" and "I'm worried that I find no real meaning in life." What would be the nurse's best response to this patient? a. Give the patient a hug and tell him that his life still has meaning. b. Arrange for a spiritual adviser to visit the patient. c. Ask if the patient would like to talk about his feelings. d. Call in a close friend or relative to talk to the patient.a

c. When caring for a patient who is in spiritual distress, the nurse should listen to the patient first and then ask whether the patient would like to visit with a spiritual adviser. To arrange for a spiritual adviser first may not respect the wishes of the patient. A hug and false reassurances do not address the diagnosis of spiritual distress. Talking to friends or relatives may be helpful, but only if the patient desires their visits.

The nurse caring for a client in an acute care setting recognizes which observation as an environmental cue to spiritual preferences? a. A client saying prayer before breakfast b. A client expressing fear of death c. A minister at the bedside d. A rosary sitting on the bedside table

d. A rosary sitting on the bedside table Rationale Items in the client's room, such as, a bible, Torah, Koran, religious medal indicate an environmental cue of religious or spiritual preference. Therefore, a rosary sitting on the bedside table is an environmental cue. A client saying prayer before breakfast is a behavioral cue. A client expressing fear of death is a verbalization cue and a minister at the bedside is an interpersonal relationship cue of religious or spiritual preference.

A nurse is admitting a client to the hospital and is aware that which is the best time for the nurse to conduct the initial spiritual assessment? a. At the beginning of the assessment process prior to taking the vital signs b. After introduction and prior to beginning the assessment c. At the beginning of the assessment process immediately after taking the vital signs d. At the end of the admission process

d. At the end of the admission process Rationale Although the nurse will continually be assessing, the initial spiritual assessment is best taken at the end of the assessment process or following the psychosocial assessment, after the nurse has developed a relationship with the client and/or the client's support person. A nurse who has demonstrated sensitivity and personal warmth, earning some rapport, will be more successful during a spiritual assessment.

As the nurse is discharging a​ client, the client​ states, open double quote"You​'ve been a great nurse. You​'re knowledgeable and​ skilled, and you have a great attitude. You​'re a real professional.close double quote" Which nursing caring behavior or process is the client best​ describing? a. Presencing b. Empowerment c. Compassion d. Competence

d. Competence Rationale Competence is the nurse​'s ability to effectively demonstrate a set of​ attributes, such as professional attitude and​ knowledge, skills, and​ values, and to fulfill her professional responsibility through nursing practice. Empowerment assists the client to autonomously identify her own health needs in lieu of being instructed how to do so. Compassion develops as a result of being directly involved with the client​'s experience. Presencing involves the nurse​'s immersion in a nursedash-client interaction that helps the client define her health choices while understanding the client​'s authority to make her own decisions.

A patient states she feels so isolated from her family and church, and even God "in this huge medical center so far from home." A nurse is preparing nursing goals for this patient. Which is the best goal for the patient to relieve her spiritual distress? a. The patient will express satisfaction with the compatibility of her spiritual beliefs and everyday living. b. The patient will identify spiritual beliefs that meet her need for meaning and purpose. c. The patient will express peaceful acceptance of limitations and failings. d. The patient will identify spiritual supports available to her in this medical center.

d. Each of the four options represents appropriate spiritual goals, but identifying spiritual supports available to her in the medical center demonstrates a goal to decrease her sense of isolation.

The Roman Catholic family of a baby who was born with hydroencephalitis requests a baptism for their infant. Why is it imperative that the nurse provide for baptism to be performed? a. Baptism frequently postpones or prevents death or suffering. b. It is legally required that nurses provide for this care when the family makes this request. c. It is a nursing function to assure the salvation of the baby. d. Lack of baptism when desired may increase the family's sorrow and suffering.

d. Failure to ensure that an infant baptism is performed when parents desire it may greatly increase the family's sorrow and suffering, which is an appropriate nursing concern. Whether baptism postpones or prevents death and suffering is a religious belief that is insufficient to bind all nurses. There is no legal requirement regarding baptism, and although some nurses may believe part of their role is to ensure the salvation of the baby, this function would understandably be rejected by many.

A dying client states, "Part of what makes dying hard is that I don't know for sure where I am going. What do you believe happens in the hereafter?" Which ethical guideline should guide the response by the nurse? a. Share one's personal beliefs. b. Share all spiritual beliefs, favoring none. c. Never share personal spiritual beliefs. d. First assess the client's beliefs.

d. First assess the client's beliefs. Rationale Assessment is always the first step of the nursing process and it is applicable with spiritual care as well. While an assessment may lead the nurse to share personal beliefs, these are never urged on the client. Never sharing beliefs, sharing all beliefs, or sharing only the nurse's personal beliefs may not respect the beliefs of the client or the nurse.

Even though the nurse performs a detailed nursing history in which spirituality is assessed on admission, problems with spiritual distress may not surface until days after admission. What is the probable explanation? a. Patients usually want to conceal information about their spiritual needs. b. Patients are not concerned about spiritual needs until after their spiritual adviser visits. c. Family members and close friends often initiate spiritual concerns. d. Illness increases spiritual concerns, which may be difficult for patients to express in words.

d. Illness may increase spiritual concerns, which many patients find difficult to express. The other options do not correspond to actual experience.

The nurse is working on the obstetrical unit. Which action taken by the nurse would be inappropriate when caring for a client and their newborn infant? a. Assisting in the baptism of a seriously ill infant if a chaplain is not available b. Allowing a parent of the Muslim religion to shave a tuft of the infant's hair c. Discharging an infant Jewish girl prior to her being named d. Insisting a Jewish couple name their child prior to the circumcision

d. Insisting a Jewish couple name their child prior to the circumcision Rationale It is inappropriate for the nurse to insist a child be named prior to a procedure. In the Jewish religion it is recognized that following the ritual circumcision by the trained person, called a mohel, the child is named. It is also acceptable for the girl to be named in the Synagogue on the first Sabbath after birth. It is appropriate for the nurse to assist in performing baptism on an infant when the clergy or chaplain is unavailable. It is a religious practice of Muslims to name the child and shave a tuft of hair from their head on the seventh day after birth.

The family of a client who died of heart failure is making arrangements for a ritual bath to be given by a ritual burial society. Nurses are making arrangements for access and privacy. Which religions have this​ tradition? ​(Select all that apply.) a. Buddhism b. Lutheran Christianity c. Baptist Christianity d. Judaism e. Islam

d. Judaism e. Islam Rationale Both the Muslim and Jewish religions have a tradition of a ritual bath after death. That is not true of the Buddhist religion or the Baptist or Lutheran traditions within Christianity.

Which situation would the nurse anticipate for a client with a spiritual need related to others? a. Need to transcend life challenges b. Need to prepare for and accept death c. Need to know when to give and take d. Need to cope with loss of a loved one

d. Need to cope with loss of a loved one Rationale Examples of spiritual needs related to others include need to cope with loss of loved ones and need to forgive others. The need to transcend life challenges and need to prepare for and accept death are examples of spiritual needs related to self. The need to know what and when to give and take is an example of spiritual needs among and within groups.

A patient whose last name is Goldstein was served a kosher meal ordered from a restaurant on a paper plate because the hospital made no provision for kosher food or dishes. Mr. Goldstein became angry and accused the nurse of insulting him: "I want to eat what everyone else does—and give me decent dishes." Analysis of these data reveals what finding? a. The nurse should have ordered kosher dishes also. b. The staff must have behaved condescendingly or critically. c. Mr. Goldstein is a problem patient and difficult to satisfy. d. Mr. Goldstein was stereotyped and not consulted about his dietary preferences.

d. On the basis of his name alone, the nurse jumped to the premature and false conclusion that this patient would want a kosher diet.

During a midterm evaluation, the nurse educator tells the students they need to work on improving their aesthetic knowledge. Which is a good way for the students to accomplish this? a. Study harder. b. Take better notes. c. Read about the same topic from a variety of sources. d. Spend time in the clinical area with seasoned nurses.

d. Spend time in the clinical area with seasoned nurses. Rationale Aesthetic knowing is the art of nursing and is expressed by the individual nurse through his or her creativity and style in meeting the needs of clients. Understanding how other nurses meet the needs of their clients, and seeing a variety of methods to provide the same care, will help improve this type of knowledge for the students. The other options are ways to improve empirical knowing.