Chapter 46

A client scheduled for outpatient surgery is requesting that the operating room be sprayed with holy water. Which is an appropriate response?

"Are you concerned how the surgery will go?"

The nurse caring for a bedridden hospitalized client who states that this will be the first time that he has missed a Methodist church service in 50 years plans care based on which of the following NANDA-I diagnoses?

Spiritual Distress related to inability to attend church services evidenced by verbal states of guilt

The nurse is creating a plan of care for a client experiencing spiritual distress. What is the priority outcome for this care plan?

The client expresses meaning and purpose in life.

common characteristics of religion

Basis of authority or source of power Portion of scripture or sacred word Ethical code defining right or wrong A psychology and identity Aspirations or expectations Some ideas about what follows death

Three spiritual needs

1. need for meaning and purpose 2. need for love and relatedness 3. need for forgiveness

Which religious groups would the nurse anticipate to regard Saturday as the Sabbath? (Select all that apply.)

Adventist Judaism

beliefs related to faith

Agnostic—one who holds that nothing can be known about the existence of a higher power Atheist—person who denies the existence of a higher power

The nurse is caring for a Roman catholic client who is dying. What would be an appropriate action for the nurse?

Contact a local priest to complete the anointing of the sick ritual.

The nurse is caring for Mr. Z., a 55-year-old man admitted to the hospital for liver failure. He is an active member in the Latter-Day Saints (Mormon) church. Mr. Z. tells the nurse that he strictly adheres to the religious practices that are condoned by the church. However, the nurse overhears two of his physicians discussing that Mr. Z.'s liver failure is likely due to chronic alcohol use. The nurse suspects that they are wrong. Which of the following is an appropriate nursing activity?

Engage Mr. Z. in a discussion about past and present religious practices.

A nurse working in a facility that cares for clients with Alzheimer's includes spirituality in client care. A family caregiver tells the nurse that faith has been broken and asks about help in getting through the day. What approaches can the nurse use to help the family member? Select all that apply.

Help the family member get relief so church services can be attended Contact the family church group members for assistance Give the family member some spiritual reading materials

A client who is on hospice care and has no immediate family has been given less than 1 week to live. The nurse caring for the client recognizes that providing presence is most important, especially when a client is dying. What would be the best way for this nurse to provide presence to this client?

Hold the client's hand and sit by the bedside as often as possible.

A client who is admitted to the ER with severe right-sided abdominal pain is diagnosed with appendicitis. The surgeon is called and proceeds to explain the procedure to the client and asks her to sign the consent. The client refuses and informs the doctor that her husband needs to be called to do this. Which of the following religions does this client likely practice?

Islam

Mr. Baker is an 81-year-old patient who can no longer live alone safely and is being admitted to a long-term-care facility. He grew a large garden every summer and took pleasure in sharing the produce with neighbors. He now tells the nurse that he feels he is of no use to anyone. The nurse knows that this is related to which of the following spiritual needs believed to be common to all people?

Need for meaning and purpose

Meeting spiritual needs

Offering a compassionate presence Assisting in the struggle to find meaning in the face of suffering, illness, and death Fostering relationships that nurture the spirit Facilitating patient's expression of religious or spiritual beliefs and practices

An older adult client who is very sick but very spiritual and has a deep faith asks the nurse to say a prayer for her. The nurse, who is not very comfortable praying out loud, wants to honor the client's request. What would be the best action by the nurse?

Read a passage from the Bible to the client

While studying religion and spirituality, the nursing student exhibits an understanding of the concepts when making which of the following statements?

Religion is a collection of spiritual beliefs and practices.

A dying client requests that the nurse pray with him. The nurse is not accustomed to praying aloud but is comfortable praying silently. What is the best approach for this nurse to follow to pray with this client?

The nurse should select a formal prayer or Bible passage to use to pray aloud.

Faith

a confident belief in something for which there is no proof or evidence

Spirituality

anything that pertains to a person's relationship with a nonmaterial life force or higher power

When a client informs the nurse that he is a Jehovah's Witness, the nurse must recognize and validate that the client will not accept:

blood transfusions.

Which set of terms best reflects nursing's view of clients as holistic beings?

mind, body, spirit

love

connectedness with others

The parents of three children ages 4, 7, and 11 years are interested in fostering spiritual development in their children. The nurse informs the parents that the development of a child's spirituality is best accomplished by:

educating through parental behaviors.

Life affirming

enhance life, give meaning and purpose to existence, strengthen self, are health giving and life sustaining

A nurse is educating staff members about the importance of meeting the spiritual needs of clients on the unit. What spiritual needs should be met in the delivery of care? Select all that apply.

need for meaning and purpose need for forgiveness need for love and relatedness

An appropriate goal for the client with a nursing diagnosis of Spiritual Distress related to intense pain and suffering as verbalized by the client would be that the client will:

participate in supportive spiritual practices.

The nurse is caring for a client that practices Islam in the hospital. When dietary brings the client a food tray for supper, which food on the tray should the nurse remove that is against the dietary laws for a practicing Muslim?

pork chop

Spirituality and everyday living

present in health and illness

A recently graduated nurse is working with a client who is suffering from excruciating pain with no relief. The client tells the nurse that religion and spirituality are a big part of her life. The nurse wants to help nurture this client's spirituality and can do so in which of the following ways? Select all that apply.

promoting meaning and purpose promoting forgiveness promoting love and relatedness

life denying

restrict or enclose life patterns, limit experiences and associations, place burdens of guilt on individuals, are health denying and life inhibiting

A recently graduated nurse is talking to the charge nurse about spirituality and tells the charge nurse that it is difficult to understand why people have a hard time giving spiritual care to clients. The charge nurse identifies the new nurse's lack of understanding when the new nurse makes which statement?

"Spirituality and religion are the same thing."

Mrs. Dupree is a 55-year-old patient with end-stage renal failure who has asked to be taken off dialysis. She now shares with the nurse that she has mistreated her only daughter in the past and would like to reconcile this before she dies. The nurse knows that this is related to which of the following spiritual needs believed to be common to all people?

Need for forgiveness

A nurse is conducting a spiritual assessment on a client recently admitted to the hospital unit. Which questions would be appropriate to ask the client about his religious and spiritual practices? Select all that apply.

"Is religion a significant part of your life?" "Are there any spiritual practices that you would like to continue while hospitalized?" "Does the present situation interfere with any spiritual or religious practice?"

Which client statement most clearly suggests the potential of a nursing diagnosis of Spiritual Anxiety?

"Now that I'm nearing the end, I'm worried that God won't think I lived a good enough life."

When conducting a spiritual assessment, the nurse must be sensitive to the client's personal beliefs. Which questions should the nurse ask? Select all that apply.

"Do you feel your faith is helpful to you?" "Is there anyone from your church you would like to talk to?" "Is religion or God significant to you?"

Religious beliefs

-guide to daily living habits -source of support -source of strength and healing -source of conflict

A new nurse observes a priest visiting the clients every Saturday afternoon and praying with them. This activity supports which of the nursing outcomes?

The client uses a type of spiritual experience that provides comfort.

Mr. J. is a 78-year-old man, who is actively dying of unknown causes. Mr. J. is a practicing Muslim. His wife, children, and grandchildren are present. The physician in charge of Mr. J.'s care plans to discuss Mr. J.'s impending death with the family. Based on the nurse's knowledge of the Muslim faith, which of the following is not true?

The family will likely want an autopsy.

The nurse is caring for a client who states, "No one can understand God." The nurse would document the client's spiritual belief as:

agnostic.

While interviewing a client, a nurse is told that the client practices Catholicism. This client is identifying:

his faith.

spiritual health and healing

spiritual needs are met

When preparing for a spiritual counselor to visit a hospitalized client, the nurse should:

take measures to ensure privacy during the counselor's visit.

The nurse receives a "do not resuscitate" (DNR) order for a dying client. What should the nurse do next?

Assess the client's spiritual needs

Based on religious practices, which client would be most likely to defer to her husband when making health care decisions?

An Islamic woman

elements of spirituality

Experienced as a unifying force, life principle, and an essence of being Experienced in and through connectedness with nature, the earth, the environment, and the cosmos Expressed in and through connectedness with other people Shapes the self-becoming and is reflected in one's being, knowing, and doing Provides purpose, meaning, strength, and guidance to shape the journey

According to Shelly and Fish (1988), which of the following are spiritual needs underlying all religious traditions that are common to all people? Select all that apply.

Forgiveness Love and relatedness Meaning and purpose

A client who is admitted for a debilitating disease is talking to the nurse. The client relates that family is the only thing that matters, stating that family helps fulfill all the spiritual needs by first fulfilling the most basic of all needs. What is this basic need?

Love

A nurse is conducting online research for information related to spritiual needs and religious traditions. The nurse demonstrates understanding of the information by identifying which need as common to all? Select all that apply.

Meaning Love Forgiveness

The nurse is caring for a client who asks that his special undergarments not be removed for an upcoming procedure. The nurse is aware that these undergarments are related to the client's religion. This religion is:

Mormon.

A nurse caring for a client of the Jewish faith knows the importance of asking about any food preferences when discussing diet. This is important for which reason?

Religious practices and beliefs can directly influence a client's self-care practices.

The nurse is assisting a client with his meal selection for the next day. The client states, "I can't have meat tomorrow, it's a Holy Day." The nurse recognizes that the client is a member of which religious organization?

Roman Catholic

When a nurse supports the client's spiritual needs, the nurse supports which level of the Maslow's hierarchy of needs?

Self-actualization needs

O'Brien's Spiritual Assessment Guide

Spiritual pain Spiritual alienation Spiritual anxiety Spiritual guilt Spiritual anger Spiritual loss Spiritual despair

hope

ingredient in life responsible for a positive outlook

A nurse is assisting a terminally ill female client with bathing. The client tells the nurse that she has great respect and faith in a particular spiritual leader. The nurse interprets this information as fulfilling which need for the client?

sense of security for present and future

A new client is on the hospital unit. He was recently diagnosed with metastatic pancreatic cancer and was told that any treatment would be palliative. He tells a nurse that there is no God that he knows of who would subject someone to this. The client's statement is most reflective of:

spiritual crisis

Religion

term used to describe cultural or institutional religion

A terminally ill client tells the nurse that he does not belong to an organized religion. It is safe for the nurse to assume:

the client may still be deeply spiritual.

When the client tells the nurse that she believes God's reality is personal, and that God is the creator of all beings, the nurse determines the client is expressing:

theism.

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 for direction. The nurse recognizes the student is experiencing which type of spiritual distress?

Spiritual alienation

The nurse is caring for a dying male client who practices Islam. What is the most appropriate action for the nurse after the client's death?

Ensure that a male washes the client's body.

Allen is an 82-year-old retiree who recently relocated to senior apartments. The apartments are not affiliated with any religious beliefs. Allen was raised in the Roman Catholic church and has attended mass every Sunday since childhood. He has not attended mass for 3 weeks. What best describes Allen's situation?

Separation from spiritual ties

The nurse enters a client's room as the client and family are praying. Which is the most appropriate action of the nurse?

Step outside the door until the prayer is finished.

A recently graduated nurse is caring for a client who was just given the diagnosis of pancreatic cancer. The client asks the nurse to help her understand this death sentence and tell her why God did this to her, as she has lived a good life all along. The nurse, not being comfortable as a spiritual counselor, should do which of the following?

Suggest to the client that she can call her spiritual advisor to help give her counsel

A nurse is developing a plan of care to meet a client's spiritual needs. When identifying appropriate interventions, which concept would the nurse need to integrate as the foundation for all the interventions?

Supportive presence

The client states "I have lifted my cancer to God and am accepting of God's plan for me." This is an example of an adaptive expression of spiritual needs labeled:

faith.