Chapter 36 Spiritual Health
A nurse is providing spiritual care to a group of patients. Match the group to their belief. a. Nature controls life and health. b. Organ transplantation or donation is not considered. c. Observance of the Sabbath is important. d. Past sins cause illness. e. Nonhuman spirits invading the body cause illness. 1. Hinduism 2. Buddhism 3. Islam 4. Judaism 5. Appalachians
1.ANS:D 2.ANS:E 3.ANS:B 4.ANS:C 5.ANS:A 1. ANS:DDIF:Understand (comprehension)REF:739 OBJ:Discuss the influence of spirituality on patients' health practices. TOP:CaringMSC:Management of Care 2.ANS:EDIF:Understand (comprehension)REF:739 OBJ:Discuss the influence of spirituality on patients' health practices. TOP:CaringMSC:Management of Care 3.ANS:BDIF:Understand (comprehension)REF:739 OBJ:Discuss the influence of spirituality on patients' health practices. TOP:CaringMSC:Management of Care 4.ANS:CDIF:Understand (comprehension)REF:739 OBJ:Discuss the influence of spirituality on patients' health practices. TOP:CaringMSC:Management of Care 5.ANS:ADIF:Understand (comprehension)REF:739 OBJ:Discuss the influence of spirituality on patients' health practices. TOP:CaringMSC:Management of Care
The nurse is caring for a group of patients. Which patient will the nurse see first? a. A patient saying that God has left and there is no reason for living. b. A patient refusing treatment on the Sabbath. c. A patient having a folk healer in the room. d. A patient praying to Allah.
ANS: A A patient saying that God has left and there is no reason for living must be seen first for safety reasons. It must be determined by the nurse if the patient is planning suicide or is just angry and frustrated. A patient refusing treatment on the Sabbath is within that patient's right and doesn't need to be seen first. A patient with a folk healer is within the patient's right and does not need to be seen first. A patient praying to Allah is within the patient's right and does not need to be seen first. DIF:Analyze (analysis)REF:739 | 743 OBJ: Assess a patient's spirituality. TOP: Assessment MSC: Management of Care
The nurse is caring for a patient who has been diagnosed with a terminal illness. The patient states, "I just don't feel like going to work. I have no energy, and I can't eat or sleep." The patient shows no interest in taking part in the care by saying, "What's the use?" Which response by the nurse is best? a. It sounds like you have lost hope. b. It sounds like you have lost energy. c. It sounds like you have lost your appetite. d. It sounds like you have lost the ability to sleep.
ANS: A All of the patient's description are describing a loss of hope. While losses of energy, appetite, and sleep are indicated, they only address a part of patient's problems. A loss of hope encompasses the holistic view of the patient. DIF:Apply (application)REF:735 | 744 | 746 OBJ:Explain the importance of establishing caring relationships with patients to provide spiritual care.TOP:CaringMSC:Psychosocial Integrity
A nurse is providing spiritual care to patients. Which action is essential for the nurse to take? a. Know one's own personal beliefs. b. Learn about other religions. c. Visit churches, temples, mosques, or synagogues. d. Travel to other areas that do not have the same beliefs.
ANS: A Because each person has a unique spirituality, you need to know your own beliefs so you are able to care for each patient without bias. While learning about religions, visiting other religious areas of worship, and traveling to areas that do not have the same beliefs are beneficial, they are not essential. DIF:Understand (comprehension)REF:737 OBJ: Explain the importance of establishing caring relationships with patients to provide spiritual care. TOP: Implementation MSC: Psychosocial Integrity
The nurse is caring for a patient with a chronic illness who is having conflicts with beliefs. Which health care team member will the nurse ask to see this patient? a. The clergy b. A psychiatrist c. A social worker d. An occupational therapist
ANS: A Other important resources to patients are spiritual advisors and members of the clergy. Spiritual care helps people identify meaning and purpose in life, look beyond the present, and maintain personal relationships, as well as a relationship with a higher being or life force. A psychiatrist is for emotional health. A social worker focuses on social, financial, and community resources. An occupational therapist provides care with vocational issues and functioning within physical limitations. DIF:Understand (comprehension)REF:735 | 743-744 OBJ:Explain the importance of establishing caring relationships with patients to provide spiritual care.TOP:ImplementationMSC:Management of Care
In caring for the patient's spiritual needs, the nurse asks 20 questions to assess the patient's relationship with God and a sense of life purpose and satisfaction. Which method is the nurse using? a. The spiritual well-being scale b. The FICA assessment tool c. Belief tool d. Hope scale
ANS: A The spiritual well-being scale (SWB) has 20 questions that assess a patient's relationship with God and his or her sense of life purpose and life satisfaction. The FICA assessment tool evaluates spirituality and is closely correlated to quality of life. This does not describe belief or hope. DIF:Understand (comprehension)REF:738 OBJ: Assess a patient's spirituality. TOP: Assessment MSC: Psychosocial Integrity
A nurse is evaluating a patient's spiritual care. Which areas will the nurse include in the evaluation process? (Select all that apply.) a. Review the patient's view of the purpose in life. b. Ask whether the patient's expectations were met. c. Discuss with family and friends the patient's connectedness. d. Review the patient's self-perception regarding spiritual health. e. Impress on the patient that spiritual health is permanent once obtained.
ANS: A, B, C, D In evaluating care include a review of the patient's self-perception regarding spiritual health, the patient's view of his or her purpose in life, discussion with the family and friends about connectedness, and determining whether the patient's expectations were met. Attainment of spiritual health is a lifelong goal; it is not permanent once obtained. DIF:Apply (application)REF:746 OBJ: Evaluate patient outcomes related to spiritual health. TOP: Evaluation MSC:Management of Care
Spiritual distress has been identified in a patient who has been diagnosed with a chronic illness. Which interventions will the nurse add to the care plan? (Select all that apply.) a. Offer to pray with the patient. b. Avoid time with the support group. c. Have the patient avoid church attendance. d. Develop activities to heal body, mind, and spirit. e. Teach relaxation, guided imagery, and meditation.
ANS: A, D, E Interventions that are appropriate for spiritual distress include (1) helping the patient develop/identify activities to heal body, mind, and spirit; (2) offering to pray with the patient; and (3) teaching relaxation, guided imagery, and medication. Attendance at church should be encouraged as well as spending time with a support group. DIF:Apply (application)REF:736 | 743 OBJ: Discuss nursing interventions designed to promote a patient's spiritual health. TOP:PlanningMSC:Management of Care
The patient is having a difficult time dealing with an AIDS diagnosis. The patient states, "It's not fair. I'm totally isolated from God and my family because of this. Even my father hates me for this. He won't even speak to me." What should the nurse do? a. Tell the patient to move on and focus on getting better. b. Use therapeutic communication to establish trust and caring. c. Assure the patient that the father will accept this situation soon. d. Point out that the patient has no control and that he or she must face the consequences.
ANS: B Application of therapeutic communication principles and caring helps you establish therapeutic trust with patients. The nurse should not offer false hope (father will accept the situation soon). The nurse should help the patient maintain feelings of control, not no control. The nurse should encourage renewing relationships if possible and establishing connections with self, significant others, and God. DIF:Apply (application)REF:736 OBJ: Discuss nursing interventions designed to promote a patient's spiritual health. TOP: Implementation MSC: Psychosocial Integrity
The nurse is caring for a patient with a terminal disease. The nurse sits down and lightly touches the patient's hand. Which technique is the nurse using? a. "Doing for" b. Establishing presence c. Offering transcendence d. Providing health promotion
ANS: B Establishing presence by sitting with a patient to attentively listen to his or her feelings and situation, talking with the patient, crying with the patient, and simply offering time are powerful spiritual care approaches. Benner explains that presence involves "being with" a patient versus "doing for" a patient. Transcendence is the belief that a force outside of and greater than the person exists beyond the material world. In settings where health promotion activities occur, patients often need information, counseling, and guidance to make the necessary choices to remain healthy. DIF:Apply (application)REF:744 OBJ:Identify approaches for establishing presence with patients. TOP: Implementation MSC: Psychosocial Integrity
A nurse hears the following comments from different patients. Which patient comment does the nurse identify as faith? a. I go to church every Sunday. b. I believe there is life after death. c. I have something to look forward to each day. d. I get a feeling of awe when looking at the sunset.
ANS: B Faith allows people to have firm beliefs despite lack of physical evidence (life after death). Religion refers to the system of organized beliefs and worship that a person practices to outwardly express spirituality (go to church). When a person has the attitude of something to live for and look forward to, hope is present (look forward to each day). Self-transcendence is the belief that there is a force outside of and greater than the person (awe when looking at a sunset). DIF:Analyze (analysis)REF:734 OBJ: Describe the relationship among faith, hope, and spiritual well-being. TOP: Assessment MSC: Psychosocial Integrity
A nurse makes a connection with the patient when providing spiritual care. Which type of connectedness did the nurse experience? a. Intrapersonal b. Interpersonal c. Transpersonal d. Multipersonal
ANS: B Interpersonal means connected with others and the environment. Intrapersonal means connected within oneself. Transpersonal means connected with God or an unseen higher power. There is no such term as multipersonal for connectedness. DIF:Apply (application)REF:734 OBJ:Explain the importance of establishing caring relationships with patients to provide spiritual care.TOP:CaringMSC:Psychosocial Integrity
The nurse is caring for an Islam patient who wants a snack. Which action by the nurse is mostappropriate? a. Offers a ham sandwich b. Offers a beef sandwich c. Offers a kosher sandwich d. Offers a bacon sandwich
ANS: B Islam religion does allow beef. Islam does not allow pork or alcohol. Ham and bacon are pork. Kosher is allowed for Judaism. DIF:Apply (application)REF:745 OBJ: Discuss nursing interventions designed to promote a patient's spiritual health. TOP: Implementation MSC: Psychosocial Integrity
A co-worker asks the nurse to explain spirituality. What is the nurse's best response? a. It has a minor effect on health. b. It is awareness of one's inner self. c. It is not as essential as physical needs. d. It refers to fire or giving of life to a person.
ANS: B Spirituality is often defined as an awareness of one's inner self and a sense of connection to a higher being, to nature, or to some purpose greater than oneself. Spirituality is an important factor that helps individuals achieve the balance needed to maintain health and well-being and to cope with illness. Florence Nightingale believed that spirituality was a force that provided energy needed to promote a healthy hospital environment and that caring for a person's spiritual needs was just as essential as caring for his or her physical needs. The word spirituality comes from the Latin word spiritus, which refers to breath or wind. The spirit gives life to a person. DIF:Understand (comprehension)REF:733 OBJ:Discuss the influence of spirituality on patients' health practices. TOP:Teaching/LearningMSC:Management of Care
A male patient in stable condition is in the intensive care unit (ICU) and is asking to see his spouse and two daughters. What should the nurse do? a. Allow only 5 to 10 minutes with the family. b. Allow the wife and daughters to visit at the patient's request. c. Allow the two daughters to visit, and let the wife visit when they leave. d. Allow the wife and one daughter to enter the ICU but not the other daughter.
ANS: B Use of support systems is important in any health care setting. Allowing the family to visit is appropriate since the patient is in stable condition. When patients depend on family and friends for support, encourage them to visit the patient. As long as no interference with active patient care is involved, there is no reason to limit visitation. Limiting the visit is not necessary since the patient is stable. Breaking the family apart is not needed; the patient is stable and can see all three at once. DIF:Apply (application)REF:744 OBJ: Discuss nursing interventions designed to promote a patient's spiritual health. TOP: Implementation MSC: Psychosocial Integrity
The patient is admitted with chronic anxiety. Which action is most appropriate for the nurse to take? a. Focus on finding quick remedies for the anxiety. b. Realize that the patient's only goal is relief of the anxiety. c. Look at how anxiety influences the patient's ability to function. d. Help the patient realize that there is little hope of relief from anxiety.
ANS: C Do not just look at the patient's anxiety as a problem to solve with quick remedies, but rather look at how the anxiety influences the patient's ability to function and achieve goals established in life (not just anxiety relief). Mobilizing the patient's hope is central to a healing relationship. DIF:Apply (application)REF:744 OBJ: Assess a patient's spirituality. TOP: Caring MSC: Psychosocial Integrity
The nurse and the patient have the same religious affiliation. Which action will the nurse take? a. Must use a formal assessment tool to determine patient's beliefs. b. Assume that both have the same spiritual beliefs. c. Do not impose personal values on the patient. d. Skip the spiritual belief assessment.
ANS: C It is important not to impose personal value systems on the patient. This is particularly true when the patient's values and beliefs are similar to those of the nurse because it then becomes very easy to make false assumptions. It is not a must to use a formal assessment tool when assessing a patient's beliefs. It is important to conduct the spiritual belief assessment; conducting an assessment is therapeutic because it expresses a level of caring and support. DIF:Apply (application)REF:738 OBJ: Explain the importance of establishing caring relationships with patients to provide spiritual care. TOP: Implementation MSC: Psychosocial Integrity
The nurse is caring for a patient who is an agnostic. Which information should the nurse consider when planning care for this patient? a. The patient is devoid of spirituality. b. The patient does not believe in God. c. The patient believes there is no known ultimate reality. d. The patient finds no meaning through relationship with others.
ANS: C Some people do not believe in the existence of God (atheist), or they believe that there is no known ultimate reality (agnostic). Nonetheless, spirituality is important regardless of a person's religious beliefs. Agnostics discover meaning in what they do or how they live because they find no ultimate meaning for the way things are. They believe that people bring meaning to what they do. DIF:Understand (comprehension)REF:734 OBJ:Discuss the influence of spirituality on patients' health practices. TOP:PlanningMSC:Management of Care
The nurse is admitting a patient to the hospital. The patient is a very spiritual person but does not practice any specific religion. How will the nurse interpret this finding? a. This indicates a strong religious affiliation. b. This statement is contradictory. c. This statement is reasonable. d. This indicates a lack of hope.
ANS: C The patient's statement is reasonable and is not contradictory. Many people tend to use the terms spirituality and religion interchangeably. Although closely associated, these terms are not synonymous. Religious practices encompass spirituality, but spirituality does not need to include religious practice. When a person has the attitude of something to live for and look forward to, hope is present. DIF:Apply (application)REF:733 | 735 OBJ:Compare and contrast the concepts of religion and spirituality. TOP: Assessment MSC: Psychosocial Integrity
A nurse is teaching a patient how to meditate. Which information from the patient indicates effective learning? a. I will lie on the floor. b. I will breathe quickly. c. I will focus on an image. d. I will do this for 10 minutes every day.
ANS: C The steps of meditation include sitting in a comfortable position with the back straight; breathe slowly; and focus on a sound, prayer, or image. Meditation should occur for 10 to 20 minutes twice a day. DIF:Apply (application)REF:745 OBJ: Discuss nursing interventions designed to promote a patient's spiritual health. TOP: Teaching/Learning MSC: Psychosocial Integrity
A nurse is caring for a Hindu patient. Which action will the nurse take? a. Allow time to practice the Five Pillars. b. Allow time to practice Blessingway. c. Allow time for Holy Communion. d. Allow time for purity rituals.
ANS: D Hindus practice prayer and purity rituals. Blessingway is a practice of the Navajos that attempts to remove ill health by means of stories, songs, rituals, prayers, symbols, and sand paintings. Islams must be able to practice the Five Pillars of Islam. Holy Communion is practiced in the Christian religion. DIF:Apply (application)REF:739 OBJ: Discuss nursing interventions designed to promote a patient's spiritual health. TOP: Implementation MSC: Psychosocial Integrity
