NCLEX STYLE QUESTIONS CH 46 SPIRITUALITY

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1. 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.

1. 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.

10. 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

10. 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.

11. 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

11. 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.

12. 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.

12. 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.

13. 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.

13. 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.

14. 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

14. 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.

15. 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.

15. 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.

2. 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

2. 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.

3. 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?

3. 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.

4. 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.

4. 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.

5. 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

5. 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.

6. 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.

6. 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.

7. 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

7. 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.

8. 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

8. 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.

9. 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.

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

What spiritual need is believed to underlie all religious traditions and is common to all people? A) Love and relatedness B) Physical hygiene C) Religious education D) Church services

Ans: A Feedback: According to Shelly and Fish (1988), there are three spiritual needs underlying all religious traditions and common t people: (1) the needs for meaning and purpose, (2) love and relatedness, and (3) forgiveness.

While admitting a clilent who is having elective surgery tomorrow, the nurse asks if he has a preferred religion or faith. The client indicates that he does not believe in a higher power and therefore has no preferred religion. The nurse knows that which of the following terms describes the client's feelings about religion? A) Atheist B) Jehovah's Witness C) Agnostic D) Spiritualist

Ans: A Feedback: An atheist is a person who denies the existence of a higher power. An agnostic is one who holds that nothing can be known about the existence of a higher power. Jehovah's Witnesses are an organized religion. A spiritualist is one who believes in spirituality.

A nurse has developed a plan of care to meet the needs of a client with the nursing diagnosis of Spiritual Distress. What would be an expected outcome? A) Identify factors in life that challenge spiritual beliefs. B) Attend church services on a weekly basis. C) Share feelings about religion with other health care providers. D) Commit to reading passages from the Bible daily.

Ans: A Feedback: Goals and expected outcomes for clients in spiritual distress do not need to be individualized. An appropriate expected outcome would be that the client will identify factors in life that challenge spiritual beliefs.

The nurse caring for a Native American client should inquire if the client utilizes which of the following? A) Medicine man or woman B) Priest C) Rabbi D) Preacher

Ans: A Feedback: Many Native Americans utilize a medicine men and women, who have specialized spirits from whom they receive the mission to cure. Priest is a term used for holy men in the Roman Catholic religion; rabbi in the Jewish religion; preacher in the protestant faiths.

A nurse fills the following roles in the community: health educator, personal health counselor, referral agent, trainer of volunteers, developer of support groups, integrator of faith and health, and health advocate. What is the term for this type of nurse? A) Parish nurse B) Religious nurse C) Visiting nurse D) Home health nurse

Ans: A Feedback: Parish nurses are not "visiting nurses" or "home health nurses" who provide direct bedside care. The key roles of the parish nurse are health educator, personal health counselor, referral agent, trainer of volunteers, developer of support groups, integrator of faith and health, and health advocate.

While reviewing the chart for an assigned client before beginning care, a student notes that the client does not belong to a specific religion. Based on this information, what should the student interpret about the client? A) A person may be deeply spiritual but not profess a religion. B) Belonging to an organized religion is essential to spirituality. C) The student will not have to consider the spiritual dimension. D) The client should be referred for spiritual counseling.

Ans: A Feedback: Religion refers to an organized system of beliefs about a higher power. A nurse should not interpret the fact that a client does not belong to an organized religion to mean the client has no spiritual needs; a person may be deeply spiritual yet not profess a religion.

How can religious, life-affirming influences be compared with basic human needs? A) Life-affirming influences encourage self-actualization. B) Life-affirming influences enhance life. C) Life-affirming influences meet basic physiologic needs. D) Life-affirming influences cultivate wisdom.

Ans: A Feedback: Religious influences may be life affirming or life denying. Life-affirming influences encourage self-actualization, the highest level of basic human needs.

The nurse is caring for a client today who asks to have the coffee removed from his tray. The client informs the nurse that his religion precludes the intake of caffeine. The nurse is aware that religions often guide daily living habits in which of the following ways? Choose all that apply. A) Diet B) Medical treatments C) Clothing D) Education E) Automobile makes

Ans: A, B, C Feedback: Many religions have significance in regard to daily life. For instance, some religions have dietary requirements and restrictions. The Mormons have special undergarments that are worn by some members. Some religions restrict medical treatments, such as blood products. Education and automobile makes are not restricted by most religions.

Then nurse is caring for a female client today. As the nurse is giving the client her morning medications, she begins a conversation about her belief in a higher power. The nurse knows that this can be interpreted as which of the following? Choose all that apply. A) Faith B) Spirituality C) Religion D) God E) Atheism

Ans: A, B, C, D Feedback: Spirituality is anything that pertains to a person's relationship with a nonmaterial life force or higher power. An atheist is a person who denies the existence of a higher power. Faith generally refers to a confident belief in something for which there is no proof or material evidence, such as a higher power. God is defined as a higher power. Religion refers to an organized system of beliefs about a higher power.

Then nurse is caring for a hospice client who tells the nurse that she is worried about how she has treated a younger sister. She asks the nurse how to make things right. The nurse recognizes this as which of the following spiritual needs? A) Meaning B) Forgiveness C) Purpose D) Love

Ans: B Feedback: According to Shelly and Fish (1988), there are three spiritual needs underlying all religious traditions and common to all people: (1) the need for meaning and purpose, (2) the need for love and relatedness, and (3) the need for forgiveness.

A client tells the nurse, "I am an atheist. I do not believe in God." What would be an appropriate response by the nurse? A) "Well, I believe in God and you should, too." B) "I respect what you choose to believe in." C) "How can you deny the existence of God?" D) "What makes you think you are an atheist?"

Ans: B Feedback: An atheist is a person who denies the existence of God, guided by philosophies of living that do not include a religious faith. The atheist deserves respect for what he or she chooses to believe.

What statement or question is useful for a nurse if a client asks the nurse to pray with him or her? A) "I'm sorry, I am just too busy." B) "How would you like us to pray?" C) "You will have to talk to your minister." D) "Why would you want me to do that?"

Ans: B Feedback: Clients accustomed to regular periods of prayer but who feel too ill to pray may ask the nurse to pray with them. Because there are many forms of prayer, the nurse can take the lead by asking "How would you like us to pray?"

Which of the following religious groups believe in divine healing through the "laying on of hands?" A) Judaism B) Mormons C) Buddhism D) Christian Scientist

Ans: B Feedback: Devout Mormon adherents believe in divine healing through the "laying on of hands," though many do not prohibit medical therapy. The Church maintains an extensive and well-funded welfare system, including financial support for the sick.

Each of the major religions has several characteristics in common. What is one of those characteristics? A) Ministers are addressed as "Reverend." B) An ethical code defines right and wrong. C) Communion is delivered the same way. D) Men and women are viewed as equals.

Ans: B Feedback: Each of the major religious groups has several characteristics in common. One of those characteristics is an ethical code that defines right and wrong.

A client scheduled for complex heart surgery has been reading the Bible for hours each day, cries often, and is not sleeping well. What might these observations cue the nurse about the client? A) These behaviors are expected before major surgery. B) These behaviors are signs of spiritual distress. C) Family members live far away and the client is lonely. D) The client is naturally emotional and reactive.

Ans: B Feedback: Many clients find it difficult to talk about their spiritual beliefs and problems but may have behavioral indicators of spiritual distress. Significant behavioral observations include sudden changes in spiritual practices, mood changes, sudden interest in spiritual matters, and disturbed sleep.

Some religious beliefs may conflict with prevalent health care practices. For example, what type of treatment is prohibited by the doctrine of Jehovah's Witnesses? A) Using narcotics to treat pain B) Administering blood transfusions C) Minor surgical procedures D) Diagnostic x-ray examinations

Ans: B Feedback: Sometimes religious beliefs conflict with prevalent health care practices. For example, the doctrine of Jehovah's Witnesses prohibits blood transfusions.

Which of the following group of terms best defines spiritual distress? A) Spirituality, religion B) Alienation, despair C) Faith, prayer D) Forgiveness, purpose

Ans: B Feedback: Terms that define spiritual distress include spiritual pain, alienation, anxiety, guilt, anger, loss, and despair.

This is the nurse's third day of caring for a client who recently underwent a colectomy that resulted in a colostomy. As the nurse goes about the physical assessment, a discussion about spirituality develops. The client tells the nurse that his religion believes in a basic harmony between religion and science. You interpret this as which of the followinggroups? A) Buddhism B) Baha'i International Community C) Mormon D) Jehovah's Witness

Ans: B Feedback: The Baha'i International Community believe in a basic harmony between religion and science. Jehovah's Witnesses oppose the false teachings of other sects; opposition often extends to modern science, including medicine. Buddhists believe in the Four Noble Truths and the Noble Eightfold Path. Mormons believe in divine healing through the laying on of hands."

A client tells a nurse that he does not think he can have the recommended heart surgery because transfusions are against his religion. What is the best response of the nurse in this situation? A) Tell the client that the surgery is necessary to keep him alive and is the only choice. B) Obtain all the information needed for the client to make an informed decision. C) Prepare the client for a visit from his spiritual advisor. D) Have the client sign a form stating his refusal of the treatment.

Ans: B Feedback: The nurse's role is to assist the client in obtaining the information needed to make an informed decision and to support the client's decision making. Because what the nurse says, and the way it is said, may powerfully influence the client's decision, it is important to maintain objectivity. Conflicts that resist resolution may be referred to an ethics committee or consult team.

The nurse's client today informs her that he receives regular visits from a parish nurse, who helps him with his diet- controlled diabetes. The nurse is aware that parish nurses do which of the following? Choose all that apply. A) Provide medicine at no charge B) Refer clients to appropriate resources C) Perform physical assessments D) Promote personal responsibility for health E) Provide health education

Ans: B, D, E Feedback: Parish nurses are not visiting nurses or home health nurses who provide direct bedside care. The key roles of the parish nurse are health educator, personal health counselor, referral agent, trainer of volunteers, developer of support groups, integrator of faith and health, and health advocate.

The U.S. Religious Landscape Survey of 35,000 Americans by the Pew Research Center's Forum on Religion & Public Life (2008) finds that most Americans are religious and they have a nondogmatic approach to faith. Which of the following statements accurately describes religion in America? Select all that apply. A) A majority of Americans who are affiliated with a religion believe their religion is the only way to salvation. B) More than half of Americans rank the importance of religion very highly in their lives, attend religious services regularly, and pray daily. C) A plurality of adults who are affiliated with a religion want their religion to adjust to new circumstances or adopt modern beliefs and practices. D) Significant minorities across nearly all religious traditions see a conflict between being a devout person and living in a modern society. E) While more than 50% of Americans believe in the existence of God or a universal spirit, there is considerable variation in the nature and certainty of this belief. F) Sixty percent of adults believe that God is a person with whom people can have a relationship; but one out of four— including about half of Jews and Hindus—see God as an impersonal force.

Ans: B, D, F Feedback: A majority of Americans who are affiliated with a religion do not believe their religion is the only way to salvation. And almost the same number believes that there is more than one true way to interpret the teachings of their religion. More than half of Americans rank the importance of religion very highly in their lives, attend religious services regularly, and pray daily. A plurality of adults who are affiliated with a religion want their religion to preserve its traditional beliefs and practices, rather than adjust to new circumstances or adopt modern beliefs and practices. Significant minorities across nearly all religious traditions see a conflict between being a devout person and living in a modern society. While 92% of Americans believe in the existence of God or a universal spirit, there is considerable variation in the nature and certainty of this belief. Six out of 10 adults believe that God is a person with whom people can have a relationship; but one out of four—including about half of Jews and Hindus—see God as an impersonal force.

Which of the following health care practices may be influenced by a young woman's religion? A) Yearly mammograms B) Annual physicals C) Birth-control measures D) Health assessments

Ans: C Feedback: Certain practices associated with health care may have religious significance for a client. For example, acceptable birth- control measures are determined by some religious faiths.

A client states that his life has meaning and purpose, he feels loved, and has experienced forgiveness in his life. What is the term that describes this state of spirituality? A) Spiritual belief B) Spiritual alienation C) Spiritual health D) Spiritual bliss

Ans: C Feedback: Defined most simply, spiritual health or well-being is the condition that exists when the universal spiritual needs for meaning and purpose, love and belonging, and forgiveness are met.

A client expresses confidence in his traditional healer to relieve symptoms of an illness. What is the client demonstrating? A) Hope B) Spirituality C) Faith D) Charity

Ans: C Feedback: Faith generally refers to a confident belief in something for which there is no proof or material evidence. It can involve a person, idea, or thing and is usually followed by action related to the ideals and values of the belief. A client who has faith in a health care provider is more likely to follow the plan of care, and experience benefits.

A nurse is caring for a hospitalized client. What intervention can the nurse use to help the client continue normal spiritual practices? A) Discuss the nurse's own religious beliefs with the client. B) Tell the client that spiritual practices can be resumed later. C) Request dietary consultation for the client's dietary restrictions. D) Request medication from the physician to calm the client.

Ans: C Feedback: It is a responsibility of the nurse to help the client in an unfamiliar environment continue normal spiritual practices. One intervention that can facilitate the practice of religion is to attempt to meet the client's dietary restrictions.

A nurse is using Anandarajah and Hight's (2001) HOPE acronym to assess a client's spirituality and religious beliefs. Which of the following is a component of this acronym? A) H = heaven B) O = openness C) P = personal spirituality D) E = eternity

Ans: C Feedback: One simple guide is Anandarajah and Hight's (2001) HOPE acronym: H—Sources of hope, meaning, comfort, strength, peace, love, and connection; O—Organized religion; P—Personal spirituality and practice; E—Effects on medical care and end-of-life issue.

A nurse is preparing a client's room to accommodate a visit from a spiritual counselor. Which of the following is a recommended practice? A) Dim or turn off the lights. B) Place a candle on the bedside table. C) Remove any unnecessary equipment. D) Place a cross on the bedside table.

Ans: C Feedback: Preparations of the client's room for the visit may vary, but the following are generally recommended practices: the room should be orderly and free of unnecessary equipment and items; there should be a seat for the religious counselor at the bedside or near the client so that both can be comfortable; the bedside table should be free of items and covered with a clean, white cover if a sacrament is to be administered; and the bed curtains should be drawn for privacy if the client can't be moved to a more private setting.

Which of the following statements by a nurse would nurture spirituality by promoting love and relatedness? A) "I know you are angry about your diagnosis." B) "Tell me about what you do in your job." C) "Tell me about how you get along with others." D) "How often do you read the Bible each day?"

Ans: C Feedback: The nurse can help the client nurture his or her own spirituality by promoting meaning and purpose, love and relatedness, and forgiveness. To promote love and relatedness, encourage the client to talk about relationships with others and to identify the origin of negative beliefs about people.

The parents of an infant are members of a faith-healing group. They refuse to give the baby antibiotics for meningitis. What does the American Academy of Pediatrics recommend for cases such as this? A) Respect for the parents' wishes, even if the baby dies B) Exemption from child abuse charges C) Application of child abuse and neglect statutes D) Refusal to treat the child no matter how ill

Ans: C Feedback: Various faith-healing groups are asking for protection (under the veil of religious freedom) of their right to make decisions about medical care, even if those decisions result in the death of a family member, including a child. The American Academy of Pediatrics is urging that all child abuse, neglect, and medical neglect statutes be applied without potential or actual exemption for religious beliefs.

Nurses provide care to meet needs in all the human dimensions. What is one intervention nurses can implement to m spiritual needs? A) Refer all questions to a spiritual advisor. B) Remind clients that nurses are not ministers. C) Avoid any discussion of religion or spirituality. D) Offer a compassionate presence.

Ans: D Feedback: Although nurses may differ in their beliefs about how involved they should become in meeting spiritual needs, it is impossible to ignore the spiritual dimensions of health. Nurses can assist clients to meet spiritual needs through a variety of interventions, including offering a compassionate presence.

A nurse is caring for a hospitalized child. What would the nurse consider to meet the spiritual needs of the child? A) Nothing; children do not have a spiritual self. B) Complete information from the child's parents. C) Only terminally ill children believe in God. D) Children have definite perceptions of God.

Ans: D Feedback: Heller studied spirituality in children. In his study of 40 children between the ages of 4 and 12 years, he found that the children had definite perceptions of God.

A client requests the nurse not touch his lips when administering his oral medications. Based on the nurse's understanding of the major religions, the nurse identifies this request as reflecting which of the following? A) Judaism B) Christianity C) Islam D) Hinduism

Ans: D Feedback: In the Hindu religion, the nurse administering oral medications should avoid touching the client's lips. Judaism, Christianity, and Islam do not require this.

What factor is necessary to express and experience spirituality? A) Quiet time in isolation from others B) Membership in an organized religion C) Long-term suffering and pain D) Connectedness with other people

Ans: D Feedback: People express and experience spirituality through love and connectedness with other people. Love develops from the basic human need to love and be loved and is necessary to spiritual wholeness.

A client verbalizes to a mental health counselor that his life is meaningless since his wife divorced him and that he no longer wants to live. What nursing diagnosis, resulting from his spiritual distress, would be appropriate? A) Sexual Dysfunction B) Fear C) Powerlessness D) Risk for Self-Directed Violence

Ans: D Feedback: Spiritual distress may affect other areas of human functioning. Spiritual distress may be the etiology of the nursing diagnosis "Risk for Self-Directed Violence" related to feelings that life is meaningless.

A client informs the nurse that her physician has planned a procedure that may be in conflict with the client's personal spiritual belief. The client asks the nurse for assistance. The nurse is aware that her role should include assisting the client to do which of the following? A) Confront the physician and refuse to undergo the procedure. B) Explore and research alternative medicine therapies. C) Poll other physicians about alternate treatment options. D) Obtain accurate information in order to make a good decision.

Ans: D Feedback: The nurse's role is to assist the client in obtaining the information needed to make an informed decision, and to support the client's decision making. The nurse should never interfere between a client and the client's physician.


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