Nursing 101

Which core issue of spirituality includes a patient's basic human need for achievement? 1) Hope 2) Faith 3) Love 4) Forgiveness

1) Hope Rationale: Hope includes the basic human needs to achieve, create, and make something of one's life. Faith addresses our ongoing effort to make sense of our life and our purpose for being. With the aspect of love, we extend our love to others with hope of receiving love. Forgiveness is not a core issue of spirituality.

An agnostic nurse is caring for a devoutly religious patient. The client says, "I am so frightened. Please say a prayer with me." The patient begins praying aloud. What should the nurse do? 1) Remain quietly beside the bed until the client finishes the prayer. 2) Walk quietly from the room while the client is praying. 3) Stop the client and say, "I am not comfortable with prayer. I will get someone to join you." 4) Stay during the prayer and say "Amen" at pauses and when the prayer is finished.

1) Remain quietly beside the bed until the client finishes the prayer. Rationale: The nurse might choose to pray or not to; but the nurse must respect the client's dignity and provide spiritual support. Remaining at the bedside during prayer provides support for the client without compromising the nurse's beliefs. The nurse does not need to pray but merely should remain quiet and respectful while the client prays. Only if the client asks should the nurse say she is uncomfortable praying. Secretly exiting the room while the patient is praying is neither respectful nor honest. Participating in the prayer by interjecting and closing with "Amen" is also dishonest because the agnostic nurse does not believe in prayer.

During the admission assessment, a patient tells the nurse that he does not believe there is a God. The nurse should document his religious affiliation as: 1) Agnostic 2) Atheist 3) Sikhism 4) Rastafarianism

2) Atheist Rationale: Those who actively deny the existence of God are known as atheists. Agnostics believe it is not possible to know whether or not God actually exists. Sikhism combines the teachings of Hinduism and Islamic Sufism (a mystical branch of Islam); they believe in the presence of one God, not multiple gods. Rastafarians follow the Old and New Testaments of the Bible and emphasize a deep love of God.

A patient of Mormon faith is admitted to the hospital with new onset diabetes mellitus. Based on his religious affiliation, which item(s) should the nurse be sure is replaced on the patient's dinner tray? Select all that apply. 1) Pork 2) Tea 3) Meat 4) Coffee

2) Tea 4) Coffee Rationale: Mormons follow a strict health code, known as the Word of Wisdom, which prohibits the consumption of tea, coffee, and alcohol. Conservative Jews avoid pork products. Most Hindus are lacto-vegetarians, which means they consume milk but not eggs. Buddhists, Hindus, some Rastafarians, and some Christians (on Fridays during Lent) do not consume meat.

Which of the following questions would provide information about "O" in a HOPE assessment and "S" in a SPIRIT assessment? 1) Do you have any dietary restrictions or needs on religious holidays? 2) What is your religion or what church do you go to? 3) How comfortable are you with discussing spirituality? 4) Do you have an advance directive?

2) What is your religion or what church do you go to? Rationale: In the HOPE assessment "O" represents "organized religion." In the SPIRIT tool, "S" represents "spiritual/religious belief system." Dietary needs provide information about ritualized practices and restrictions ("R" in the SPIRIT tool; "E" in the HOPE approach). Asking about the patient's comfort with discussing spirituality addresses personal spirituality ("P" in the SPIRIT tool; "P" in the HOPE approach). Advance directives address terminal events planning ("T" in the SPIRIT tool; "E" in the HOPE approach).

A patient remarks to the nurse, "What's the point of going through all these medical treatments. They make me feel so bad, and I will never be well anyway." What is the most helpful action for the nurse to take? 1) Explore with the patient what has triggered his emotions. 2) Treat the patient with dignity and respect. 3) Pray with the patient in a private setting. 4) Assist the patient to identify areas of hope in life.

4) Assist the patient to identify areas of hope in life. Rationale: The patient is demonstrating Hopelessness. All of the responses would be appropriate under certain circumstances, but helping the patient identify areas of hope in life most directly addresses Hopelessness. The nurse does not need to explore the trigger for the patient's emotions—he has said that it is the treatments and the lack of hope for returning to wellness. All patients should be treated with dignity and respect; however, this alone would not address Hopelessness. The nurse should pray with the patient only after first learning whether this would be helpful to the patient; in this scenario, that information is not available.

Match the following descriptions with the correct religion. Descriptions A. Teaches reliance on God for healing rather than medicine or surgery B. Will not allow whole blood transfusions but can chose regarding albumin or clotting factor C. Follows strict health code; avoids alcohol, tea, coffee, and smoking D. All harmony and disease is based in spirituality E. Uses five pillars of faith; forbidden to eat pork F. Observes strict dietary laws, wears skull cap (yarmulke or kippah), and follows written law (Torah) Religions 1. Buddhism 2. Islam 3. Christian Scientist 4. Catholicism 5. Judaism 6. Jehovah's Witness 7. Rastafarianism 8. Mormonism 9. American Indian

A, 3 B, 6 C, 8 D, 9 E, 2 F, 5

Mary, a young adult female, has experienced a miscarriage after 10 weeks of pregnancy. She is crying and states that this probably happened because her husband does not believe in God. Your best response to Mary is which of the following? A. "God doesn't punish people for their beliefs." B. "Do you want to talk about your anger at your husband's lack of faith?" C. "You sound very upset. Would you like to talk about these feelings?" D. "You sound really upset. Would you like to see the hospital chaplain?"

C. "You sound very upset. Would you like to talk about these feelings?" Rationale: This response acknowledges her distress and doubts and offers her an opportunity to verbalize her conflicts. Response A does not validate her feelings. Response B does not keep the focus on her and her own spiritual needs. Response D can be helpful, but you have missed an opportunity to allow her to explore her feelings related to the miscarriage.

A person who spends a great deal of time reviewing his belief system and comparing and contrasting it to alternatives is experiencing which of the following? A. Spiritual growth B. Religiosity C. Religious struggle D. Spiritual distress

C. Religious struggle Rationale: Religious struggle is conflict that arises within the self, with others, and with God that can lead to spiritual growth, crisis, or despair. Growth is learning and becoming more versed in one's faith and belief system. Religiosity is a preoccupation with religion or religious themes. Spiritual distress is intense conflict between one's faith beliefs and a situation that is counter to or challenges these beliefs.

Mr. Jones, a former patient who survived a serious illness, comes to your patient care unit Saturday afternoon. He has packets of literature about his religion; its philosophy, values, meeting places; and some prayers. He asks if he can place the information in the family waiting area. Your best response is to do which of the following? A. Tell him that it would be helpful for many of the families. B. Tell him no; hospital policy doesn't allow for it. C. Tell him that you would be happy to do it for him; take the literature and place it in the staff lounge. D. Tell him you're unsure of the hospital's policy and will need to discuss it with your manager.

D. Tell him you're unsure of the hospital's policy and will need to discuss it with your manager. Rationale: The best response is to find out if the hospital has a policy on literature and solicitation before you either encourage or discourage the patient's action. Response A does not represent respecting those patients or families who may be uncomfortable with this literature. Response B can be correct but does not demonstrate respect or appreciation of the patient's spirituality. Response C avoids the problem and does not address the spiritual issues.

List four different types of prayers.

Prayer may be of the following types: ● Adoration ● Praise ● Thanksgiving ● Penitence ● Offering ● Intercession ● Petition

What three key dimensions are assessed with the JAREL spiritual well-being scale?

The following key dimensions are assessed with the JAREL scale: ● Faith/belief ● Life/self-responsibility ● Life satisfaction/self-actualization

List three core issues of spirituality.

● Faith ● Hope ● Love