NCLEX Q&A Chp 46
An 80-year-old woman who identifies herself as a devout Catholic has recently relocated to an assisted living facility. The woman is pleased with most aspects of her new living situation, but laments the fact that she is no longer close to the church where she was in the Habit of attending daily mass each morning. What nursing diagnosis may apply to this problem that the woman has identified?
A: hopelessness B: impaired religiosity C: spiritual pain D: spiritual distress B: impaired religiosity rationale the nursing diagnosis of impaired religiosity encompass the inability to participate in rituals of particular faith tradition. Spiritual distress involves the inability to integrate meaning and purpose in life, while spiritual pain involves angst over the nature and actions of higher power. The woman's statements do not directly reflect an outlook of hopelessness.
Which of the following patients statement is most clearly suggests the potential for a nursing diagnosis of spiritual anxiety?
A: "I always try to do the right pain, so' I don't understand why I have to suffer so much now" B: "I've never been a religious man, and all these Catholic crosses and pictures in the hospital make me a bit uncomfortable." C: "Now that I am nearing the end, I'm worried that God wont think I lived a good enough life" D; "I guess I should have taken a lot more time to go to church when I was younger" C: "now that I'm nearing the end, I'm worried that God wont think I lived a good enough life" rationale worry about one spiritual condition it indicative of the nursing diagnosis of spiritual anxiety. Unfamiliarity with the religious character of a care setting suggests spiritual alienation, while questions of suffering often indicate spiritual pain or spiritual despair. Regrets over previous religious or spiritual apathy may suggest a nursing diagnosis of spiritual guilt.
Which description best describes the role of a parish nurse?
A: A nurse who works to reintegrate the healing tradition into the life of a faith community. B: A trained layperson who provides the spiritual needs of the congregation or parish. C: Spiritual leader, such as a minister, who is also a registered nurse. D: A nurse who provides home health services similar to a visiting nurse. A: a nurse who works to reintegrate the healing tradition into the life of a faith community. Rationale Parish nurses and health ministry teams work to reintegrate the healing tradition into the life of the faith community. The key roles of the parish nurse and health educator, personal health counselor, referral agent, trainer of volunteers, developer of support group, integrator of faith and health, and health advocate. Parish nurses are not visiting nurses or home health nurses.
The nurse is caring for a critically ill patient, who informs the nurse that there is a conflict between her spiritual beliefs and a proposed health option. What is the nurse's role in this situation?
A: Assist the patient in obtaining information to make a informed decision B: The nurse has little role in this situation because it is best managed by the physician C: Provide a subjective opinion on the appropriate course of action D: The nurse should provide examples of ways other patients from various religions handle the situation. Rationale A: Assist the patient in obtaining information to make an informed decision The nurses role in resolving conflict between spiritual beliefs and treatment is to assist the patient in obtaining information needed to make an informed decision and to support the patient's decision making.
Members of which of the following religious tradition are likely to have the most stringent restrictions and parameters placed on their medical care?
A: Christian scientism B: Hinduism C: Protestantism D: Buddhism A: Christian scientism. Rationale Christian scientism places significant restriction of the use of drugs, medical procedures, therapies, and surgeries. The scope of these restrictions greatly exceeds that dictated by Hinduism, Protestant, Christianity and Buddhism.
A nurse who provides care on a palliative unit of a hospital is aware of the importance of spiritual assessment and the integration of spirituality into patient's care. What assessment questions should the nurse use in an effort to determine the patient's spiritual beliefs?
A: Do you hold a belief in the afterlife? B: what church do you normally attend? C: are there any spiritual or religious beliefs or practices that are important to you? D: if you had to identify yourself as either a religious person or spiritual person, which would you choose? C: are there any spiritual or religious beliefs or practices that are important to you? Rationale an open ended yet clear question about a person spiritual beliefs is most likely to elicit information about the patient in a thoughtful manner. Asking the patient to choose between identifying as religious or spiritual is not an accurate dichotomy, while asking about the afterlife is not a direct way of assessing religion and spirituality. Not every religious or spiritual group situates their practices in a church.
A patient recently diagnosed with cancer informs the nurse that she values faith and finds comfort in her faith. The nurse is aware that faith is best defined as which of the following?
A: Practice associated with all aspects of a person Iife. B: An organized belief system about a higher power C: I believe in something for which there is no proof or material of evidence D: a positive outlook even in the bleakest moment C: a belief in something for which there is no more material evidence. Rationale Faith is a belief in something for which there is no proof or material evidence. Hope is a positive outlook even in the bleakest moments. Religion is an organized belief system about a higher power. Spiritual beliefs are practices associated with all aspects of a person's life.
The family members of a dying patients asked for the patient have asked for the chaplain to help in having a member of the clergy to come the patients bedside to perform the anointing of the sick. The nurse who is providing care for the patient should recognize the family is likely:
A: Roman Catholic B: Jehovah's Witness C: Jewish D: Christian scientist A: Roman Catholic rationale among the sacrament of the Roman Catholic Church is the anointing of the sick. The specific right is not a component of Jehovah witness, Christian scientist, or Jewish religious beliefs.
A 79-year-old man is in the late stages of lung cancer with bone metastases. Since receiving his terminal diagnosis, the patient has often made mention of the fact that he has a long estranged daughter admits he was a "miserable father". The patient has recently asked for the social worker's assistance in locating his daughter before his death. What spiritual need likely underlies the patient's request?
A: a need for purpose B: a need for meaning C; a need for forgiveness D; a need for love C: a need for forgiveness rationale While a need for love may be a factor in the man's request, the fact that he admits is a parental failings and wishes to rekindle a relationship with his child suggest that he may feel the need for forgiveness. The need for purpose and meaning are not directly evidence in this scenario.
What preparing a spiritual counselor to visit a hospitalized patient, the nurse should:
A: ask spiritual counselor to summarize the visit in the patient's medical record. B: take measures to ensure privacy during the counselors visit. C: ensure that the counselor is approved by the hospital administration. D: asked to be present during a visit in order to explain any medical information or answer questions about the patient's care. B: take measures to ensure privacy during the counselors visit. Rationale Visits between a patient and a spiritual counselor require privacy. The details of the meeting are not typically documented in the patient's chart, though the fact that the visit took place often noted. The nurse may be present during the meeting, but they should take place at the patient's request. Spiritual counselers do not require administrative approval; patient and families are normally able to seek spiritual help from whoever they prefer.
American Muslim patient seeks care in the emergency room for dehydration related to a prolonged period of diarrhea and vomiting. The nurse manager has been contacted because the patient has requested that his health care be provided by:
A: men older than himself B: Females younger than himself C: physicians only D: members of the black community D: members of the black community Rationale American Muslims are encouraged to obtain healthcare provided by members of the black community.
The son of a dying patient surprised at his mother's adamant request to meet with hospital chaplain and has taken the nurse aside and said, "I don't think that's what she really wants. She's never been a religious person in the least." What is the nurse's best action in this situation?
A: perform a detailed spiritual assessment of the patient B: organize a meeting between the chaplain, the son, and the patient to achieve a resolution. C; contact the chaplain to arrange a visit with the patient D: document the patient's request and wait to see if she reiterates request. C: contact the chaplain to arrange a visit with the patient rationale The nurses primary duty is to honor the patient's request for a meeting with a spiritual advisor.
Which of the following statements about religion and spirituality is most accurate?
A: religion is an organized system of spiritual beliefs and practices. B: spirituality is the behavioral manifestation of religious beliefs. C: spirituality is a recently developed alternative to traditional religious beliefs. D: religion and spirituality are synonymous. A: religion is an organized system of spiritual practices. Rationale spirituality may or may not include religion, which is a codified system of spiritual beliefs. The two terms are not interchangeable and spirituality is not solely concerned with outward behavior. Spirituality is not necessarily an "alternative" to religion, nor is it in recent development.
A college foreign-exchange student is living with a family in England and is confused about the daily Catholic prayers and rituals of the family. The student longs for the comfort of her fundamentalist Protestant practices and reports to the campus nurse the direction. The nurse recognizes the student is experiencing which type of spiritual distress?
A: spiritual anger B; spiritual alienation C: spiritual guilt D: spiritual loss B: spiritual alienation rationale spiritual alienation occurs when an individual is separated from his/her a community. Spiritual guilt is the failure to live according to religious rules. Their anger is the inability to accept illness. Spiritual loss occurs when one is not able to find comfort in religion.
The nurse caring for a patient with Parkinson's disease. The patient informs the nurse that he has been angry with God because of his worsening health, but after talking to the hospital chaplain, he is ready to return to church choir and become active again in the men's group at the church. Why is an appropriate nursing diagnosis for this patient?
A: spiritual distress B: impaired religiosity C: readiness for enhanced spiritual well-being D; risk for loneliness C: readiness for enhanced spiritual well-being Rationale The most appropriate diagnosis for this patient is readiness for enhanced spiritual well-being. The patient's desire to experience and integrate meaning and purpose in life through connectesness with self , others, art, music, literature, nature, or a power greater than himself.
The parents of a three children ages four, seven, and 11 years are interested in fostering spiritual development in their children. A nurse informs the parents that the development of the child spirituality is best accomplished by:
A: teaching through parental behaviors B: teaching the child about religion C: teaching through religious based schools D: teaching the child about God A: teaching through parental behaviors rationale a child's parents play a key role in the development of the child's spirituality. What is important is not so much what parents teach a child about God and religion, but rather what the child learned about God, life, and self from the parents behavior.
The following factors should be the primary factor in a nurse's decision whether to pray with a patient?
A: the nature and course of the patient's current diagnosis B: the patient's openness to being prayed for C: the nurses familiarity with a prayer traditions of different faiths D: the availability of a hospital chaplain or other spiritual counselor. B: the patient's openness to being prayed for rationale Many factors influence the nurse's decision to pray with the patient. Central among theses, however, is the question of whether the patient is open to this possibility. This factor is more important than the nurses familiarity with specific prayer tradition, the patient's medical condition, or the presence or absence of a chaplain.
A dying patient request that the nurse pray with him. The nurse is not accustomed to praying out loud but is comfortable praying silently. What is the best approach for this nurse to follow to pray with this patient?
A: the nurse should select a formal prayer or Bible passage to use to pray out loud. B: the nurse should defer to the patient's request to pray. C: the nurse should inform the patient that she pray for the patient but not with him. D: the nurse had asked the patient's roommate to pray with the patient A; the nurse should a formal prayer or Bible passage to use to pray out loud. Rationale a nurse unaccustomed to praying out loud or in public may find it helpful to have a Bible passage or formal prayer readily available for praying. If the nurse is not the praying the patient, she should call the hospital chaplain or find another individual who is comfortable.
Upon assessment, patient report does not belong to organized religion. The nurse is correct interpret this statement of which of the following?
A: the patient spiritual needs are met B: the patient is not affiliated with a specific system of belief regarding a higher power C: the patient will experience conflict between religious beliefs and healthcare option. D: the patient will not request to see the hospital chaplain or seek spiritual counseling. B: the patient is not affiliated with a specific system of belief regarding a higher power. Rationale the nurse should not interpret the fact that the patient does not belong to an organized religion to mean that the patient has no spiritual need; a person may be highly spiritual yet not profess a religion. The patient may seek spiritual counseling during hospitalization related to spiritual needs.
Upon assessment, the nurse is addressing the beliefs of a newly admitted man who reports practicing the Adventist religion. Based on the nurses familiarity with his religion, she appropriately asks the patient:
AA: what are your beliefs about the use of narcotics for pain? B: is that acceptable for the healthcare team to remove undergarments in an emergency? C: what are your beliefs about blood transfusions? D: do you receive care from a medicine man or woman? A: what are your beliefs about the use of narcotics for pain? Rationale the Adventist religion prohibits the taking of narcotics and stimulant because the body the Temple. Jehovah witnesses prohibits blood transfusions because it violates God's law. Native American religions incorporate medicine men or women healthcare needs. Members of the Church of Jesus Christ of Latter Day Saints are required to wear special undergarments that should be removed only an emergency.
