Unit 4 Foundations & PrepU
What are 3 spiritual needs underlie all religious traditions and are common to all people?
Meaning and purpose Love and relatedness Forgivenes
3 factors that determine a person's response to crisis:
(1) Person's perception of the event or situation (2) Person's situational supports (external resources) (3) Coping mechanisms the person possesses (internal resources)
3 major self-evaluation feelings or affects found in people:
(1) Pride, based on a positive self-evaluation (2) Guilt, based on behaviors incongruent with ideal self (3) Shame, associated with low global self-worth
4 bases of self-esteem are:
(1) Significance, or the way people feel they are loved and approved of by the people important to them (2) Competence, or the way tasks that are considered important are performed (3) Virtue, or the attainment of moral-ethical standards (4) Power, the extent to which people influence their own and others' lives
Psychological conditions that foster healthy development of the self in children include:
- Emotional warmth and acceptance. - Effective structure and discipline. - Clearly defined standards and limits, so that children understand what goals, procedures, and conduct are approved. - Adequately defined roles for both older and younger members of the family. - Established methods of handling children that produce the desired behavior, discourage misbehavior, and deal with infractions when they occur. - Encouragement of competence and self-confidence - Helping children meet challenges. - Appropriate role models. - A stimulating and responsive environment
5 factors influencing spirituality:
1) Spirituality is experienced as a unifying force, life principle, essence of being. 2) Spirituality is expressed and experienced in and through connectedness with nature, the earth, the environment, and the cosmos. 3) People express and experience spirituality in and through connectedness with other people. 4) Spirituality shapes self-becoming and is reflected in a person's being, knowing, and doing. 5) Spirituality permeates life, providing purpose, meaning, strength, and guidance, and shaping the journey.
What are 2 things to keep in mind about a dying patient's nutritional and fluid needs?
1) The patient may not want to eat bc the GI tract shut down 2) The body experiencing third-spacing of fluid
What 2 factors can contribute to feeling shame?
1) Too many repeated episodes of Guilt 2) Inability to change our behaviors
A death that occurs within ___ hours of admission to the hospital must be reported to the coroner.
24 hours
Abnormal grief responses present beyond ___ years after a loss.
3 years
What does H in the HOPE spiritual assessment stand for?
Addresses spiritual resources, such as hope, with direct focus on religion or spirituality
What does O in the HOPE spiritual assessment stand for?
Addresses the importance of organized religion in their lives
"My parent is suffering with cancer and death will be a relief of the pain" is an example of what type of grief?
Anticipatory
What type of loss? - Experienced as a result of natural developmental processes - Ex. A first child may experience a loss of status when a sibling is born - Ex. A parent of a single child may experience a sense of loss when the child begins school
Maturational loss
Which of Engel's 6 stages of grief is described? - Dealing with loss as a common life occurrence a) Shock and disbelief b) Developing awareness c) Restitution d) Resolving the loss e) Idealization g) Outcome
g) Outcome
Which religious community prefer a nurse or doctor of the same sex? a) Adventist b) Baha'i c) Buddhism d) Christian Scientist e) Hinduism f) Jehovah's Witnesses g) Sikhism h) Islam i) Daoism j) Confucianism k) Roman Catholicism l) Judaism
g) Sikhism
What type of "self"? - Used to describe the composite of all the basic facts, qualities, traits, images, and feelings people hold about themselves - These factors strongly influence a person's ability to manage life events and ensure emotional stability - A person's self-knowledge - The basis for when starting a self-concept assessment
Global self
"It is fine if my parent dies. We have not been close for years." is an example of which stage of Kübler-Ross?
Denial
4 high-risk factors for altered self-concept related to Identity:
Developmental changes (a 12-year-old who is developing pubic hair and breasts) Trauma Gender dissonance Cultural dissonance
The hospice nurse is caring for a client who is dying. Why does the nurse provide cool foods?
Due to slowed peristalsis, clients who are dying may experience nausea and vomiting. Cool foods and fluids are preferred to prevent nausea.
Why does the nurse teach the family how to provide care to their dying loved on?
It will help them in the grieving process and decrease guilt
What type of "self"? - May develop in people who have an emotional need to respond to the needs and ambitions of significant people, such as parents, have for them
False self
T/F: Children grieve for a shorter amount of time than an adult.
False; children grieve longer than adults
T/F: An adult's sense of loss is greater than of a childs.
False; children's sense of loss is just as great as an adult
T/F: Care for dying clients should focus on pharmacologic relief of pain.
False; focus on the relief of symptoms, not limited to pain, and should use both pharmacologic and nonpharmacologic means.
T/F: It is not okay to insert a Foley catheter into a dying patient experiencing urinary incontinence.
False; it IS okay
T/F: A regular apical pulse of 90 beats/minute is an S/S of impending death.
False; the pulse may be slow and/or irregular
T/F: The actively dying client is calm and peaceful.
False; they occasionally exhibit sudden restlessness due to hunger for oxygen.
What is the goal of palliative care?
Give patients with life-threatening illnesses the best quality of life they can have by the aggressive management of symptoms
At what developmental age does a person develop a self-awareness apart from the non-self?
Infant
What type of dysfunctional grief? - A person suppresses feelings of grief - Instead manifest somatic (body) symptoms, such as abdominal pain or heart palpitations
Inhibited grief
Term - Consists of right views, aspirations, speech, conduct, mode of livelihood, effort, mindfulness, and concentration—leads to the cessation of suffering
Noble Eightfold Path
Examples of post-mortem care:
Normal anatomic position (on back, hands across their stomach) Tubes & lines removed (if no autopsy ordered) (ex. Foley catheter, IV) Soiled dressings replaced Brush their hair Close their mouth and eyes Place identification tags on both the shroud and the ankle
Term - Withdrawing medical treatment with the intention of causing the patient's death - Not doing something to preserve a patient's life
Passive euthanasia
What type of loss? - Experienced by the person but is intangible to others - Ex. Loss of youth, financial independence, or a valued environment
Perceived loss
Term - A medical order indicating a patient's wishes regarding treatments commonly used in a medical crisis - Must be completed and signed by a HCP and cannot be filled out by a patient.
Physician Order for Life-Sustaining Treatment form (POLST form)
At what developmental age does a person learn self-definition ("that's mine- not yours!")?
Preschooler
The hospice nurse is caring for a client who is dying. Why does the nurse cluster nursing activities?
Promote rest and sleep. Dying clients may exhibit sleep disturbance due to several reasons such as anxiety or environmental noise.
Which intervention will support a client who has expressed strong spiritual beliefs? a) Carefully assessing verbal and nonverbal cues of spiritual needs by the client b) Allowing the client to deal with spiritual beliefs in the client's own way c) Quickly intervening when the nurse thinks the client has a spiritual need
a) Carefully assessing verbal and nonverbal cues of spiritual needs by the client This enables the nurse to respond to the client without interjecting the nurse's feelings of spirituality
What does P in the HOPE spiritual assessment stand for?
Represents inquiry with regards to personal practices
At what developmental age does a person learn self-concept?
School aged child
The Ideal self and False self are considered as a part of what?
Self-expection
A nurse is conducting a spiritual assessment of a 73-year-old client who is being admitted to an assisted living center. Which factor(s) should the nurse prioritize? Select all that apply. a) Client's friends or support system b) Best treatment to assist client in current situation c) Available resources to assist client d) How the family feels about the situation e) Suggest ways of coping with the situation
a) Client's friends or support system b) Best treatment to assist client in current situation c) Available resources to assist client
Which position is contraindicated in post-mortem care?
Sitting position. It pulls blood
What type of loss? - Experienced as a result of an unpredictable event, including traumatic injury, disease, death, or national disaster
Situational loss
Term - The gradual withdrawal of mechanical ventilation from a patient with a terminal illness - It may be expected that a patient will not survive, death is never a certain outcome; it is not unusual for a patient to begin spontaneous respirations and live for several hours to several days
Terminal weaning
Who normally washes the body in post-mortem care?
The mortician
Who is responsible to ensure that the death certificate is signed and calls the coroner that a patient has died?
The nurse
How if self-concept formed?
These affects are learned in early childhood within relationships with significant others (those who raise us) and maintained through practice
At what developmental age does a person develop self-recognition ("No- I don't want what you want!")?
Toddler
T/F: Care for dying patients should focus on the relief of symptoms, not limited to pain, and should use both pharmacologic and nonpharmacologic means.
True
T/F: Distended abdomen is an S/S of impending death.
True
T/F: Do not reposition or unnecessarily move a dying patient.
True
T/F: Hospitals are mandated to notify transplantation programs of potential organ donors.
True
T/F: The child internalizes other persons' attitudes toward themselves and the standards of society.
True
T/F: The normal response to bereavement after 1 year include the inability to speak of the deceased without intense emotion (crying), clinical signs of depression, and feelings of meaninglessness.
True
T/F: The nurse sits on the side of the bed of a dying patient, holding the patient's hand, and crying with the patient is appropriate end-of-life care.
True
T/F: The services of a coroner may be needed in a case where the client did NOT have any recent medical consultation.
True
T/F: When clients who are imminently dying have pain and suffering, palliative sedation (using medication to lower client consciousness) may be utilized to limit awareness of suffering.
True
What type of dysfunctional grief? - A person may have trouble expressing feelings of loss or may deny them - Describes a state of bereavement that extends over a lengthy period
Unresolved grief
A 55-year-old client is newly diagnosed with terminal pancreatic cancer. Which nursing concern is most appropriate for the care plan? a) Death anxiety b) Unproductive coping
a) Death anxiety Death anxiety is common when the medical diagnosis is new. It is related to the inability to predict how the last stage of illness will play out
The clinical signs of impending or approaching death include:
Weakness (loss of movement, sensation, reflexes) Changes in vital signs (slow, or irregular pulse; decreased BP) Confusion (restlessness, agitation, delirium) Less socialization, more sleep Changing toilet habits (urinary or bowel incontinence or constipation) Changes in skin (cold or clammy skin; cooling, mottling, and cyanosis of the extremities and dependent area) Difficulty talking or swallowing Nausea, flatus, abdominal distention Noisy, irregular, or Cheyne-Stokes respirations
What does E in the HOPE spiritual assessment stand for?
Work with the client to discuss end-of-life issues
Which are factors that can influence a client's spirituality? Select all that apply. a) Developmental considerations b) Family c) Economics d) Ethnic background e) Formal religion
a) Developmental considerations b) Family d) Ethnic background e) Formal religion
The statement, "I am not the person I was yesterday, but I can draw on things from the past so that I can achieve in the future" is an example of: a) Self-esteem b) Self-concept c) Self-identity d) Self-evaluation
c) Self-identity The awareness that one is a distinct individual separate from others. Identity provides the person with a sense of continuity through time
A question that would be appropriate for the E in the HOPE spiritual assessment tool would be: a) "Do you have a living will?" b) "Do you want to experience a Catholic mass?" c) "Do you expect to go to heaven when you die?" d) "Do you want to end your drug addiction?"
a) "Do you have a living will?"
Which statements contribute to positive self-concept? Select all that apply. a) "I cope effectively with change and loss." b) "I set very high goals and expectations for myself." c) "I always keep in mind how I need to improve." d) "I have good relationships with others." e) "I accept and feel good about myself."
a) "I cope effectively with change and loss." d) "I have good relationships with others." e) "I accept and feel good about myself." C) Need for improvement can wear away positive self-esteem. B) Setting goals that are too high may only wear down self-concept after awhile
Which statement by the client indicates anger at dying? Select all that apply. a) "I need to take out a life insurance policy right now." b) "I just want to live long enough to see my child get married." c) "Everyone dies; death is a part of life and I have to accept it." d) "I have finalized all my financial arrangements for my family."
a) "I need to take out a life insurance policy right now." (anxiety is expressed) c) "Everyone dies; death is a part of life and I have to accept it."
A client needs a bilateral mastectomy. Having already established a strong therapeutic partnership, how can the nurse best assess the client's self-concept in light of this bodily change? a) "Now that it's scheduled, how are you feeling about the surgery that you will have?" b) "How do you think that you'll accommodate this change in your daily routines?"
a) "Now that it's scheduled, how are you feeling about the surgery that you will have?" b) Asking about the influence of the surgery on the client's lifestyle again focuses on the surgical process and the effects on the client's life.
A patient has a new diagnosis of terminal lung cancer. Which question is most important for the nurse to ask first? a) "What have you been told about your condition?" b) "Do you have any questions for your doctor?" c) "Are you experiencing any pain right now?" d) "Do you understand what an advance directive is?
a) "What have you been told about your condition?" The priority is to assess what the client has been told about the condition in order to identify whether the client's and family's knowledge will allow them to make informed decisions that will serve their best interests. Pain and advance directives are important to ask, but not the first priority at this time.
Which nursing actions are appropriate when caring for a client who participates in the Catholicism religion? a) Accommodate the practice of obligatory prayers and fasting on holy days. b) Consider the client to be open to new ideas in health care practices. c) Accept that women are not allowed to make independent decisions. d) Anticipate many dietary restrictions, conforming to individual sect doctrine. e) Accommodate certain rites to be practiced following death. f) Learn rituals marking life changes, birth, puberty, initiation rites, and death.
a) Accommodate the practice of obligatory prayers and fasting on holy days.
Which religious community does not take narcotics or stimulants? a) Adventist b) Baha'i c) Buddhism d) Christian Scientist e) Hinduism f) Jehovah's Witnesses g) Sikhism h) Islam i) Daoism j) Confucianism k) Roman Catholicism l) Judaism
a) Adventist
Which religious groups would the nurse anticipate to regard Saturday as the Sabbath? (Select all that apply.) a) Adventist b) Baha'i c) Buddhism d) Christian Scientist e) Hinduism f) Jehovah's Witnesses g) Sikhism h) Islam i) Daoism j) Confucianism k) Roman Catholicism l) Judaism
a) Adventist l) Judaism
What type of death? - Clinician provides the client with the means to cause their own death - A lethal combination of drugs is made available to the client wishing to die a) Assisted suicide b) Passive euthanasia c) Active euthanasia
a) Assisted suicide
A 16-year-old client has suffered a traumatic leg amputation. The client comments, "I hate the way I look now with my leg gone." Which action will the nurse take to support the client? a) Discuss the benefit of talking with others who have lost a limb. b) Demonstrate fashions that conceal the loss of the leg.
a) Discuss the benefit of talking with others who have lost a limb. Demonstrating fashions to conceal the leg can be beneficial in the long run but cannot take the place of confronting one's feelings
The hospice nurse is caring for a client who is dying. Which intervention(s) should be included in the plan of care? Select all that apply. a) Gently massage the arms and legs. b) Obtain the blood pressure frequently. c) Offer normal amounts of food and fluids. d) Routinely administer pain medications.
a) Gently massage the arms and legs. d) Routinely administer pain medications. B) Unnecessary and disrupts rest C) Small food portions of favorite foods are recommended to prevent suppression of appetite or nausea
In relation to self-evaluation, which is based on behaviors incongruent with ideal self? a) Guilt b) Shame
a) Guilt
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) Negative life experiences c) Positive life experiences 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.
Which is true of organ donation? a) Nursing focus should be directed at client and family care at the time of life-sustaining therapy withdrawal b) Nursing focus should be directed at organ donation once it is decided to withdraw life support
a) Nursing focus should be directed at client and family care at the time of life-sustaining therapy withdrawal
Which of Engel's 6 stages of grief is described? - Characterized by denying the loss or accepting it and becoming emotionally flat a) Shock and disbelief b) Developing awareness c) Restitution d) Resolving the loss e) Idealization g) Outcome
a) Shock and disbelief
Which aspect of spiritual assessment is described? - Inability to accept death of son A 46-year-old woman, agnostic, only son died 6 months ago (lung cancer) "I've often wondered throughout my life if there is a God—thought maybe if I had tried harder I'd have recognized him. Now, I don't care if God exists or not because if he allows this I don't want to know him." "My son was my whole life; there's nothing left for me to live for." Lost 10 lb in 6 months since son died; leaves home only when necessary to purchase food, go to bank, and engage in other routine activities. a) Spiritual Pain b) Spiritual Alienation c) Spiritual Anxiety d) Spiritual Guilt e) Spiritual Anger f) Spiritual Loss g) Spiritual Despair
a) Spiritual Pain
A patient is being discharged home on hospice due to a terminal disease. The nurse is arranging visitations of the spiritual leader for the next 3 months. Which 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) 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. e) The client expresses satisfaction with life.
Which question assesses a client's self-esteem during a focused self-concept assessment? Select all that apply. a) Who would you like to be? b) What are your personal strengths? c) Do you like who you are? d) What would you change about yourself if you could?
a) Who would you like to be? c) Do you like who you are? d) What would you change about yourself if you could?
Which statement by the client indicates acceptance of dying? a) "I need to take out a life insurance policy right now." b) "I just want to live long enough to see my child get married." c) "Everyone dies; death is a part of life and I have to accept it." d) "I have finalized all my financial arrangements for my family."
d) "I have finalized all my financial arrangements for my family."
A client diagnosed with acute kidney injury has been informed about the need to start dialysis. Which assessment information supports the client is struggling with a change in life role? a) Client exhibits signs of posttraumatic stress disorder b) Client's worry about the inability to continue work
b) Client's worry about the inability to continue work Life roles, such as one's occupation or profession, can constitute a major portion of a person's identity. The ability to successfully execute societal roles, as well as one's own expectations regarding role-specific behaviors (or role performance), is easily compromised by illness or injury. The inability to work temporarily is an example of this.
Which religious community declines most medical procedures other than orthopedic services? a) Adventist b) Baha'i c) Buddhism d) Christian Scientist e) Hinduism f) Jehovah's Witnesses g) Sikhism h) Islam i) Daoism j) Confucianism k) Roman Catholicism l) Judaism
d) Christian Scientist
A question that would be appropriate for the O in the HOPE spiritual assessment tool would be: a) "Do you have a living will?" b) "Do you want to experience a Catholic mass?" c) "Do you expect to go to heaven when you die?" d) "Do you want to end your drug addiction?"
b) "Do you want to experience a Catholic mass?"
A client with end-stage COPD has reached the end of the 6-month period for hospice services and the family caregiver states, "I don't know what we will do if they cut off our hospice services." What is the best response by the hospice nurse? a) "We can discontinue the service for a period of time and then when your family member gets worse, readmit them." b) "I will contact the health care provider to extend services since your family member meets the criteria."
b) "I will contact the health care provider to extend services since your family member meets the criteria." Hospice care is generally provided to clients that have 6 months or less to live, although they are not automatically discharged when they reach 6 months after having been admitted to hospice care. The client may still receive care as long as the HCP certifies that the client continues to meet the criteria for hospice services
A client is terminally ill with cancer. The client states to the nurse, "Am I going to die?" What is the most therapeutic response by the nurse? a) "You will go when it is your time." b) "What have you been told?"
b) "What have you been told?" When a client asks a question that is surprising or unexpected, it is best to find out what the client has been told about the situation or how they feel about it. A) Making a cliché statement such as "you will go when it is your time" does not meet the client's need for an answer or for expressing their feelings
A client with terminal illness is refusing food and fluids. The family is concerned and suggests that a feeding tube be used. Which is the best response by the nurse? a) "Do you feel that if you force your loved one to eat, he will get better?" b) "When clients are in this stage, food and fluid are unnecessary."
b) "When clients are in this stage, food and fluid are unnecessary." The most therapeutic response the nurse can give to the family is honesty in the dying process
Faith is best defined as: a) An organized belief system about a higher power. b) A belief in something for which there is no proof or material evidence.
b) A belief in something for which there is no proof or material evidence.
A client states, "My children still need me. Why did I get cancer? I am only 30." This client is exhibiting which stage, according to Kübler-Ross? a) Denial b) Anger
b) Anger The Anger phase says "Why me?"
Which religious community is permanent sterilization prohibited and abortion discouraged? a) Adventist b) Baha'i c) Buddhism d) Christian Scientist e) Hinduism f) Jehovah's Witnesses g) Sikhism h) Islam i) Daoism j) Confucianism k) Roman Catholicism l) Judaism
b) Baha'i
A desire to fulfill wishes, make a will, visit relatives, and put affairs in order are signs of which stage of death and dying, according to Kübler-Ross? a) Acceptance b) Bargaining
b) Bargaining Acceptance - the client feels tranquil and is prepared to die with all arrangements in order
Which of Engel's 6 stages of grief is described? - Involves the rituals surrounding loss; with death - Includes religious, cultural, or social expressions of mourning, such as funeral services a) Shock and disbelief b) Developing awareness c) Restitution d) Resolving the loss e) Idealization g) Outcome
c) Restitution
Which nursing actions are appropriate when caring for a client who participates in the Hindu religion? Select all that apply. a) Accommodate the practice of obligatory prayers and fasting on holy days. b) Consider the client to be open to new ideas in health care practices. c) Accept that women are not allowed to make independent decisions. d) Anticipate many dietary restrictions, conforming to individual sect doctrine. e) Accommodate certain rites to be practiced following death. f) Learn rituals marking life changes, birth, puberty, initiation rites, and death.
b) Consider the client to be open to new ideas in health care practices. d) Anticipate many dietary restrictions, conforming to individual sect doctrine. e) Accommodate certain rites to be practiced following death.
The client's advance directives state they do not wish to have prolonged life measures, and that only the heart, kidneys, and liver should be donated. The client's spouse wants to also donate the client's corneas. What is the appropriate nursing action? a) Prepare for harvesting of the client's heart, kidneys, liver, and corneas. b) Contact the organ procurement team to discuss organ donation with the spouse c) Discontinue life support in keeping with the client's wishes d) Explain that organ harvesting requires that the client donate all organs or none.
b) Contact the organ procurement team to discuss organ donation with the spouse
Which of Engel's 6 stages of grief is described? - Characterized by physical and emotional responses such as anger, feeling empty, and crying: "Why me?" a) Shock and disbelief b) Developing awareness c) Restitution d) Resolving the loss e) Idealization g) Outcome
b) Developing awareness
Which is true of organ donation? a) Non-heart-beating cadavers are not potential organ donors. b) Non-heart-beating cadavers are potential organ donors.
b) Non-heart-beating cadavers are potential organ donors.
Which nursing action helps to maintain a sense of self for clients? Select all that apply. a) Maintaining the privacy of the client's room number b) Offering a simple explanation before initiating any procedure c) Address the client by name d) Speak to the client respectfully
b) Offering a simple explanation before initiating any procedure c) Address the client by name d) Speak to the client respectfully
What type of death? - Withdrawal of medical treatment with the intention of causing the client's death - Ex. Stop dialysis a) Assisted suicide b) Passive euthanasia c) Active euthanasia
b) Passive euthanasia
Because of religious beliefs, a client's view on health care does not involve blood transfusions. How can the nurse best handle this client situation? a) Explain to the client that there are times when a blood transfusion may be necessary. b) Record this information in the client's chart.
b) Record this information in the client's chart. A) Explaining to the client that there may be times when a blood transfusion is necessary to save the client's life will not change the belief and will cause a loss of trust with the nurse.
The statement, "I know who I am and I know my strengths and weaknesses" is an example of: a) Self-esteem b) Self-concept c) Self-identity d) Self-evaluation
b) Self-concept Self-evaluation is the conscious assessment of the self, leading to self-respect or self-worth. "Have I met my expectations? Do I like who I see in the mirror? Do I like how I behave?"
In relation to self-evaluation, which is associated with low global self-worth? a) Guilt b) Shame
b) Shame
Which aspect of spiritual assessment is described? - Separated from "faith community" A 72-year-old Orthodox Jewish man, recently admitted to Protestant long-term care facility following 3-week hospitalization for stroke "I guess Yahweh has written me off; first the stroke that killed half my body and then I'm abandoned here where I can't even observe the Sabbath." "I want to go home." a) Spiritual Pain b) Spiritual Alienation c) Spiritual Anxiety d) Spiritual Guilt e) Spiritual Anger f) Spiritual Loss g) Spiritual Despair
b) Spiritual Alienation
A client is coping ineffectively with a recent a mastectomy. The client refuses to participate in the care of the surgical site. What goal is appropriate for the client's care plan? a) The client will assist with the dressing change. b) The client will look at the surgical site in a mirror within 2 days.
b) The client will look at the surgical site in a mirror within 2 days. Goals are client-focused and must have a time frame
Which question assesses a client's self-identity during a focused self-concept assessment? a) Who would you like to be? b) What are your personal strengths? c) Do you like who you are? d) What would you change about yourself if you could?
b) What are your personal strengths?
A question that would be appropriate for the H in the HOPE spiritual assessment tool would be: a) "Do you have a living will?" b) "Do you want to experience a Catholic mass?" c) "Do you expect to go to heaven when you die?" d) "Do you want to end your drug addiction?"
c) "Do you expect to go to heaven when you die?"
Which illustrates interrole conflict? a) A doctor is asked to decide whether an ex-alcoholic client is a liver transplant candidate. b) A nurse is asked to provide birth control education even though she does not believe in using birth control. c) A father is expected to play the role of father, wage earner, and cook for the family and is unsure of how to fulfill all of them d) A husband decides he wants to quit his job in order to try something new and his wife values financial security.
c) A father is expected to play the role of father, wage earner, and cook for the family and is unsure of how to fulfill all of them Interrole conflict exists when a person is expected to fulfill 2 or more roles simultaneously
What type of death? - Clinician directly causes the death of the client (administers a lethal dose of medication) a) Assisted suicide b) Passive euthanasia c) Active euthanasia
c) Active euthanasia
Which action will the nurse perform for a patient who has just died? a) Place the client in a semi-Fowler's position b) Provide a complete bath. c) Allow the client's family to see the client's body before it is discharged. d) Have the nurse technician place identification tags on the outside of the shroud.
c) Allow the client's family to see the client's body before it is discharged. A) The body is placed in normal anatomic position (flat/supine) to avoid pooling of blood B) In most cases it is unnecessary to wash the body, and some religions strictly forbid it D) The nurse is legally responsible for placing identification tags
Which religious community is associated with the Noble Eightfold Path? a) Adventist b) Baha'i c) Buddhism d) Christian Scientist e) Hinduism f) Jehovah's Witnesses g) Sikhism h) Islam i) Daoism j) Confucianism k) Roman Catholicism l) Judaism
c) Buddhism
Which religious community is there dietary restrictions on some holy days? a) Adventist b) Baha'i c) Buddhism d) Christian Scientist e) Hinduism f) Jehovah's Witnesses g) Sikhism h) Islam i) Daoism j) Confucianism k) Roman Catholicism l) Judaism
c) Buddhism
Which aspect of spiritual assessment is described? - Challenged belief and value system - Ex. A 37-year-old previously healthy executive recovering from massive MI. "My parents were strict Methodists, but when I left home for college I stopped going to church ... never gave it much thought ... there was always something else to do. I started going again but it never meant much." - Ex. "Now that I am nearing the end of life, I am worried that a higher power will not think I lived a good enough life" - Often observed lying quietly in bed awake; asked to see minister. a) Spiritual Pain b) Spiritual Alienation c) Spiritual Anxiety d) Spiritual Guilt e) Spiritual Anger f) Spiritual Loss g) Spiritual Despair
c) Spiritual Anxiety
A new nurse observes a priest visiting the clients every Saturday afternoon and praying with them. This activity supports which of the nursing outcomes? a) The client expresses hope and sense of meaning. b) The client expresses satisfaction with life. c) The client uses a type of spiritual experience that provides comfort. d) The client will experience alternate venues of spiritual expression.
c) The client uses a type of spiritual experience that provides comfort. Most older adults enjoy participating in conventional religious practices such as worship and prayer either alone or in groups to facilitate effective relationships and coping
The nurse should give priority to addressing which need of a client who is displaying symptoms of dysfunctional grief? a) Pain management b) Spiritual distress c) Self-care activities d) Coping strategies
d) Coping strategies Coping strategies are necessary in the grieving process and for resolution of grief B) Spiritual needs of the client are important as well and should be considered after coping strategies have been addressed
A question that would be appropriate for the P in the HOPE spiritual assessment tool would be: a) "Do you have a living will?" b) "Do you want to experience a Catholic mass?" c) "Do you expect to go to heaven when you die?" d) "Do you want to end your drug addiction?"
d) "Do you want to end your drug addiction?"
Which of Engel's 6 stages of grief is described? - Involves dealing with the void left by the loss a) Shock and disbelief b) Developing awareness c) Restitution d) Resolving the loss e) Idealization g) Outcome
d) Resolving the loss
Which aspect of spiritual assessment is described? - Failure to live according to religious rules - Ex. A 23-year-old, single, Baptist woman. "I was raised in a strict Baptist home but had to leave ... I needed more room to be me. I like life here at the university but there's a restlessness in me I can't describe. I've dated several men... It would kill my mother if she knew I lived with Gary for 3 months." "What it really comes down to is my own sense of betraying myself, my family, and my religion. Who am I anyway?" a) Spiritual Pain b) Spiritual Alienation c) Spiritual Anxiety d) Spiritual Guilt e) Spiritual Anger f) Spiritual Loss g) Spiritual Despair
d) Spiritual Guilt
When preparing the care plan for a dying client, which goal is NOT appropriate? a) Expression of feelings b) Management of pain c) Use of coping strategies d) Urinary elimination
d) Urinary elimination Urinary elimination are not specific to the dying client
Which religion has a death ritual of placing the body on the floor to facilitate the soul's journey? a) Adventist b) Baha'i c) Buddhism d) Christian Scientist e) Hinduism f) Jehovah's Witnesses g) Sikhism h) Islam i) Daoism j) Confucianism k) Roman Catholicism l) Judaism
e) Hinduism
Which religious community believes the soul has no beginning or end? a) Adventist b) Baha'i c) Buddhism d) Christian Scientist e) Hinduism f) Jehovah's Witnesses g) Sikhism h) Islam i) Daoism j) Confucianism k) Roman Catholicism l) Judaism
e) Hinduism
Which religious community disposes of the body via cremation? a) Adventist b) Baha'i c) Buddhism d) Christian Scientist e) Hinduism f) Jehovah's Witnesses g) Sikhism h) Islam i) Daoism j) Confucianism k) Roman Catholicism l) Judaism
e) Hinduism
Which religious community does the nurse administering medications avoid touching the patient's lips? a) Adventist b) Baha'i c) Buddhism d) Christian Scientist e) Hinduism f) Jehovah's Witnesses g) Sikhism h) Islam i) Daoism j) Confucianism k) Roman Catholicism l) Judaism
e) Hinduism
Which of Engel's 6 stages of grief is described? - The exaggeration of the good qualities of the person or object, followed by acceptance of the loss and a lessened need to focus on it a) Shock and disbelief b) Developing awareness c) Restitution d) Resolving the loss e) Idealization g) Outcome
e) Idealization
A client is newly diagnosed terminal cancer and is concerned about how his wife is coping with the diagnosis. Which is NOT a factor to assess that may affect the family member's grief? a) Financial concerns b) Cultural practices c) Religious beliefs d) Social support e) Previous relationships
e) Previous relationships
Which aspect of spiritual assessment is described? - Inability to accept illness - A 38-year-old homosexual man recently diagnosed with AIDS "My parents are fundamentalists...all I ever heard at home was how much Jesus loves me ... all the while my mom was beating the daylights out of me.... Does He love me? Does He love me so much that He had my parents throw me out when I finally told them I was gay? Does He love me so much that I got AIDS and now no one comes near me?" a) Spiritual Pain b) Spiritual Alienation c) Spiritual Anxiety d) Spiritual Guilt e) Spiritual Anger f) Spiritual Loss g) Spiritual Despair
e) Spiritual Anger
Which religious community believes in the concept of "false teachings"? a) Adventist b) Baha'i c) Buddhism d) Christian Scientist e) Hinduism f) Jehovah's Witnesses g) Sikhism h) Islam i) Daoism j) Confucianism k) Roman Catholicism l) Judaism
f) Jehovah's Witnesses
Which religious community does not accept blood transfusions? a) Adventist b) Baha'i c) Buddhism d) Christian Scientist e) Hinduism f) Jehovah's Witnesses g) Sikhism h) Islam i) Daoism j) Confucianism k) Roman Catholicism l) Judaism
f) Jehovah's Witnesses
Which nursing actions are appropriate when caring for a client who participates in the Judaism religion? a) Accommodate the practice of obligatory prayers and fasting on holy days. b) Consider the client to be open to new ideas in health care practices. c) Accept that women are not allowed to make independent decisions. d) Anticipate many dietary restrictions, conforming to individual sect doctrine. e) Accommodate certain rites to be practiced following death. f) Learn rituals marking life changes, birth, puberty, initiation rites, and death.
f) Learn rituals marking life changes, birth, puberty, initiation rites, and death
Which aspect of spiritual assessment is described? - Terminal illness; anticipatory grieving; inability to find comfort in religion - A 40-year-old mother of 3 sons currently in advanced stage of ovarian cancer. "I've tried hard to do it all right ... I read my Bible, prayed every day, went to church each Sunday, loved my husband and kids ... why is this all happening to me? Why must I lose it all? Where is God now that I need him? Some mornings I wish I could shoot myself and end it all—instead another day drags on. Who can help me?" - Cries frequently, no longer interested in everyday activities of family, no interest in praying, told family not to have pastor call anymore. "No one can help now." a) Spiritual Pain b) Spiritual Alienation c) Spiritual Anxiety d) Spiritual Guilt e) Spiritual Anger f) Spiritual Loss g) Spiritual Despair
f) Spiritual Loss
Which aspect of spiritual assessment is described? - Feeling that no one (not even God) cares - A 92-year-old frail widow who lives alone; crippled with arthritis; has 2 married sons she has not seen for years. Says to community nurse who visits every week, "No one should have to live like this. If it weren't for the neighbor who comes on Saturday with a few groceries and you, I'd be dead. I guess that would be for the best. It's been a long time since I felt like my living or dying would matter to anyone. Because I'm 92 now, I guess even God doesn't want me. Couldn't you do something to put me out of my misery?" a) Spiritual Pain b) Spiritual Alienation c) Spiritual Anxiety d) Spiritual Guilt e) Spiritual Anger f) Spiritual Loss g) Spiritual Despair
g) Spiritual Despair
Which religion believes all outcomes are seen as being predetermined? a) Adventist b) Baha'i c) Buddhism d) Christian Scientist e) Hinduism f) Jehovah's Witnesses g) Sikhism h) Islam i) Daoism j) Confucianism k) Roman Catholicism l) Judaism
h) Islam
Which religion has a death ritual of the body being washed by the same gender? a) Adventist b) Baha'i c) Buddhism d) Christian Scientist e) Hinduism f) Jehovah's Witnesses g) Sikhism h) Islam i) Daoism j) Confucianism k) Roman Catholicism l) Judaism
h) Islam
Which religious community believes in a "medicinal" concern for maintaining and prolonging human health and life (sheng)? a) Adventist b) Baha'i c) Buddhism d) Christian Scientist e) Hinduism f) Jehovah's Witnesses g) Sikhism h) Islam i) Daoism j) Confucianism k) Roman Catholicism l) Judaism
i) Daoism
Which religious community is associated with the harmony of the universe? a) Adventist b) Baha'i c) Buddhism d) Christian Scientist e) Hinduism f) Jehovah's Witnesses g) Sikhism h) Islam i) Daoism j) Confucianism k) Roman Catholicism l) Judaism
i) Daoism
Which religious community is associated with the appreciation of life? a) Adventist b) Baha'i c) Buddhism d) Christian Scientist e) Hinduism f) Jehovah's Witnesses g) Sikhism h) Islam i) Daoism j) Confucianism k) Roman Catholicism l) Judaism
j) Confucianism