Foundations Chapter 45: PrepU

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Individuals who are Christian Scientists may not approve of: -expensive treatments. -circumcisions. -contraception. -immunizations.

-immunizations. Some groups, such as Christian Scientists and the Amish, have been legally exempted from immunizations; however, many medical decisions are reviewed on a case-by-case basis depending on the client's age and imminence of death.

The nurse's client states that his pastor is coming in a few hours to pray with him and offer sacrament. The nurse plans to do the following things in preparation for this. Select all that apply. -Clear the bedside table; cover with clean towel. -Complete your work so you may join them. -Have a chair available near the bed. -Clear the room of unnecessary items. -Keep the bed curtains open so as to allow others to join in prayer

-Clear the bedside table; cover with clean towel. -Have a chair available near the bed. -Clear the room of unnecessary items.

The nurse is differentiating beliefs of atheists from agnostics. Which statement is accurate? -Both deny the existence of God. -Nurses offer religious counseling to change the beliefs of both groups. -Both are guided by a philosophy of living that does not include a religious faith. -Both have religious influences that are life denying.

-Both are guided by a philosophy of living that does not include a religious faith. 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. Nurses do not offer religious counseling for any reason. Neither belief is life denying.

A teenage client comes to the clinic and tells the nurse that she has not had a period for the last 2 months. After assessment and lab work, the client is told that she is 3 months' pregnant. She begins to sob and says she is too young to have a baby. When the nurse offers counseling for an abortion, the client gets even more upset and says that she cannot have an abortion as it is not permitted in her church. This client is most likely which of the following? -Protestant -Adventist -Catholic -Jewish

-Catholic In the Catholic religion, only natural means of birth control are allowed; abortion, euthanasia, and sterilization are forbidden. Reform and Liberal schools of Judaism allow birth control for a wide range of reason. Orthodox Judaism is more restrictive. The methods of contraception allowed are the contraceptive pill and the IUD. The Adventists and Protestants do not have a position on abortion.

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 love and relatedness -need for comfort and money -need for forgiveness -need for complete health and freedom

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

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: -express feelings of anger and despair to God. -meet with a minister daily. -reflect on past accomplishments in life. -participate in supportive spiritual practices.

-participate in supportive spiritual practices. The goal for the client should focus on supporting the client's strengths

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. -Religion and spirituality are synonymous. -Spirituality is the behavioral manifestation of religious beliefs. -Spirituality is a recently developed alternative to traditional religious belief.

Religion is a collection of spiritual beliefs and practices.

Mr. Field is a 45-year-old man who has suffered a myocardial infarction. Mr. Field provided for his family by working in the construction industry, which he will no longer be able to do. He tells his nurse that he fears he will be of no use to anyone now. 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 -Need for love and relatedness -Need basic necessities of life -Need for forgiveness

-Need for meaning and purpose

A client scheduled for outpatient surgery is requesting that the operating room be sprayed with holy water. Which is an appropriate response? -"This is not possible since not everyone in the room will allow to it." -"The operating room must be kept free of any infection." -"Are you concerned how the surgery will go?" -"Surgical aseptic technique requires that fluids used must be sealed from the manufacturer."

-"Are you concerned how the surgery will go?" When providing spiritual care, nurses should listen to for cues either verbally or nonverbally. In this situation, the client is expressing a verbal cue about spirituality. The nurse should address the behavior with an open ended statement to allow for a flow of communication and feelings. Telling the client that the operating room personnel will not adhere to the request and stating about surgical aseptic technique requires fluids to be sealed are all correct, but nontherapeutic.

When asked about his religious preference, the client becomes very upset with the nurse. Which response is appropriate for this situation? -"There is nothing to be upset about. This is part of my assessment." -"I can see that this upsets you. Let me come back later when you are feeling better." -"You need to understand that I am just doing my job here." -"I can see that this question upsets you. Do you have any questions about this?"

-"I can see that this question upsets you. Do you have any questions about this?"

A nurse is preparing to give medications to an elderly client who, due to a recent stroke, needs help putting them in her mouth. The family member appears anxious and tells the nurse not to touch the client's mouth. Which religion does the nurse assume this client practices? -Buddhism -Hinduism -Islam -Judaism

-Hinduism

When asked about his religious preference, the client becomes very upset with the nurse. Which response is appropriate for this situation? -"There is nothing to be upset about. This is part of my assessment." -"I can see that this upsets you. Let me come back later when you are feeling better." -"You need to understand that I am just doing my job here." -"I can see that this question upsets you. Do you have any questions about this?"

-"I can see that this question upsets you. Do you have any questions about this?" The nurse should assist the client in understanding that his nursing history is a review of the whole human being and that questions will be wide ranging, including spiritual health, physical health, and emotional health. A client who appears angry, anxious, depressed, or defensive when asked spiritual questions may need to hear something like, "I can see from your response that you might not have expected these questions; however, they do let you know that we are interested in how you are experiencing your current situation. Do you have a question or concern in this area?" Telling the client that the nurse is just completing his or her job or telling the client that it is part of the assessment is not appropriate or therapeutic.

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." -"I've never been a religious man, and all these Catholic crosses and pictures in the hospital make me a bit uncomfortable." -"I always tried to do the right thing, so I don't understand why I have to suffer so much now." -"I guess I should have taken a lot more time to go to church when I was younger."

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

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." -"I've never been a religious man, and all these Catholic crosses and pictures in the hospital make me a bit uncomfortable." -"I always tried to do the right thing, so I don't understand why I have to suffer so much now." -"I guess I should have taken a lot more time to go to church when I was younger."

-"Now that I'm nearing the end, I'm worried that God won't think I lived a good enough life." Worry about one's spiritual condition is 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.

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." -"Spirituality and religion have distinctions." -"Spirituality is anything that pertains to a person's relationship with a higher power." -"Spirituality and faith are the same thing."

-"Spirituality and religion are the same thing."

Members of which religious tradition are likely to have the most stringent restrictions and parameters placed on their medical care? -Christian Scientist -Hinduism -Protestantism -Buddhism

-Christian Scientist Christian Science places significant restrictions of the use of drugs, medical procedures, therapies, and surgeries. Hindu religious belief begins with the assumption that all living things have a soul, which passes through successive cycles of birth and rebirth. Hinduism includes ideas of karma and rebirth, collective versus individual identity, an emphasis on purity and a preference for sons. Buddism and Protestants have very few if any health care restrictions.

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." -"Spirituality and religion have distinctions." -"Spirituality is anything that pertains to a person's relationship with a higher power." -"Spirituality and faith are the same thing."

-"Spirituality and religion are the same thing." Although some people use the words spirituality, faith, and religion interchangeably, there are distinctions. Spirituality is anything that pertains to a person's relationship with a higher power. Religion may be defined as a cultural system of designated behaviors and practices, worldviews, texts, sanctified places, prophecies, ethics, or organizations, that relates humanity to supernatural, transcendental, or spiritual elements. Faith is a strong belief in God or in the doctrines of a religion, based on spiritual apprehension rather than proof.

Upon assessment, the nurse is addressing the beliefs of a newly admitted man who reports practicing the Seventh Day Adventist religion. Based upon the nurse's familiarity with this religion, the nurse appropriately asks the client: -"What are your beliefs about the use of narcotics for pain?" -"What are your beliefs about blood transfusions?" -"Do you receive care from a medicine man or woman?" -"Is it acceptable for the health care team to remove undergarments in an emergency?"

-"What are your beliefs about the use of narcotics for pain?" The Seventh Day Adventist religion prohibits the taking of narcotics and stimulants because the body is a "temple." Jehovah's Witnesses prohibit blood transfusions because it violates God's law. Native American religions incorporate medicine men or women for health care needs. Members of the Church of Jesus Christ of Latter-Day Saints (Mormons) are required to wear special undergarments that should be removed only in an emergency.

Based on religious customs, for which client would the nurse administering medicines avoid touching the client's lips? -A Hindu client -An Islamic client -A client who is a member of the Baha'i International Community -A Roman Catholic client

-A Hindu client The nurse caring for a client with Hindu beliefs should avoid touching the client's lips when administering medicines. This is not a belief practiced by Islamic, Baha'i, or Catholics.

A client who is admitted with severe back pain rates it a 10 on a scale of 1 to 10. After assessing the client for pain, the nurse tells the client that the physician had ordered pain medication and its effect should be felt 10 to 15 minutes after its administration. However, the client refuses the pain medication and informs the nurse that narcotics are contrary to his religion. Which religion does this client practice? -Roman Catholic -Jewish -Adventist -Muslim

-Adventist The taking of all narcotics and stimulants is prohibited in the Adventist religion because it is believed that the body is the temple of the Holy Spirit and should be protected. The other religions allow narcotics.

The nurse admits a new client to the unit for elective surgery. What would be the best way for the nurse to facilitate the practice of religion for this client? Choose all that apply. -Offer to pray with the client whenever she likes. -Discuss similarities and differences between the nurse's religion and the client's religion. -Arrange for the client's pastor to visit if desired. -Attempt to meet religious dietary restrictions. -Respect the need for privacy during periods of prayer.

-Arrange for the client's pastor to visit if desired. -Attempt to meet religious dietary restrictions. -Respect the need for privacy during periods of prayer.

The nurse admits a new client to the unit for elective surgery. What would be the best way for the nurse to facilitate the practice of religion for this client? Choose all that apply. -Offer to pray with the client whenever she likes. -Discuss similarities and differences between the nurse's religion and the client's religion. -Arrange for the client's pastor to visit if desired. -Attempt to meet religious dietary restrictions. -Respect the need for privacy during periods of prayer.

-Arrange for the client's pastor to visit if desired. -Attempt to meet religious dietary restrictions. -Respect the need for privacy during periods of prayer. The following are means the nurse can use to help the client continue normal spiritual practices in the unfamiliar environment of the hospital or care center: • Familiarize the client with the religious services and materials available within the institution. • Respect the client's need for privacy or quiet during periods of prayer. • Assist the client to obtain devotional objects and protect them from loss or damage. • Arrange for the client wishing to receive the sacraments to do so. • Attempt to meet the client's religious dietary restrictions. • Arrange for the client's minister, priest, or rabbi to visit if the client so wishes. Proselytizing is never acceptable in professional settings. Addressing spiritual issues should not be coercive. Praying with clients should not be initiated by the nurse unless there is no pastoral care available and the client requests it. Comparing and contrasting religious beliefs is not likely to benefit the client.

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 -Inform the client that a priest will be in to see her very soon. -Avoid talking about suicide and its effects. -Inform the family that this order does not keep the nurse from doing her job.

-Assess the client's spiritual needs Conducting a spiritual assessment is an essential aspect of maintaining health and providing holistic and sensitive nursing care especially in a DNR. Following the spirituality assessment, if the client has additional questions or concerns related to spirituality, the nurse may suggest follow-up with a chaplain or a priest, but there is no indication the client requested spiritual guidance. A nurse should not discuss suicide and its affects as that is inappropriate. The order may impact the nurse's interventions but this is not the priority at this point.

The nurse is differentiating beliefs of atheists from agnostics. Which statement is accurate? -Both deny the existence of God. -Nurses offer religious counseling to change the beliefs of both groups. -Both are guided by a philosophy of living that does not include a religious faith. -Both have religious influences that are life denying.

-Both are guided by a philosophy of living that does not include a religious faith.

While interviewing a client, a nurse is told that the client practices Catholicism. This client is identifying: -his spirituality. -his faith. -his values. -his culture.

-his faith.

The nurse's client states that his pastor is coming in a few hours to pray with him and offer sacrament. The nurse plans to do the following things in preparation for this. Select all that apply. -Clear the bedside table; cover with clean towel. -Complete your work so you may join them. -Have a chair available near the bed. -Clear the room of unnecessary items. -Keep the bed curtains open so as to allow others to join in prayer

-Clear the bedside table; cover with clean towel. -Have a chair available near the bed. -Clear the room of unnecessary items. When expecting a visit from a client's spiritual counselor, preparations may vary, but the following are usually recommended: • 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. • The bed curtains should be drawn for privacy if the client can't be moved to a more private setting. The nurse should not expect or plan to join a private group such as described.

The school nurse is concerned about the week-long absence of Jerry, a third grader. The nurse visits the home and learns that Jerry has been diagnosed with appendicitis by a local clinic doctor. The parents, who are Christian Science church members, have had several church groups in to pray over Jerry. He is not improving and is getting worse. The nurse should do which of the following? -Allow the parents their religious rights -Insist that the parents take Jerry to the hospital -Threaten the parents with a lawsuit -Contact Child Protection Services

-Contact Child Protection Services

The school nurse is concerned about the week-long absence of Jerry, a third grader. The nurse visits the home and learns that Jerry has been diagnosed with appendicitis by a local clinic doctor. The parents, who are Christian Science church members, have had several church groups in to pray over Jerry. He is not improving and is getting worse. The nurse should do which of the following? -Allow the parents their religious rights -Insist that the parents take Jerry to the hospital -Threaten the parents with a lawsuit -Contact Child Protection Services

-Contact Child Protection Services Child Protective Services can intervene immediately, and have the child hospitalized and treated against the parents' wishes. Allowing the parents to make life/death decisions about their minor child could place the child in harm's way. Insisting the parents take the child to a hospital or threatening them will a lawsuit will only cause ill feelings toward you and will not likely change the parents' minds

The son of a dying female client is surprised at his mother's adamant request to meet with the 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? -Contact the chaplain to arrange a visit with the client. -Perform a detailed spiritual assessment of the client. -Organize a meeting between the chaplain, the son, and the client to achieve a resolution. -Document the client's request and wait to see if the client reiterates the request.

-Contact the chaplain to arrange a visit with the client.

The son of a dying female client is surprised at his mother's adamant request to meet with the 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? -Contact the chaplain to arrange a visit with the client. -Perform a detailed spiritual assessment of the client. -Organize a meeting between the chaplain, the son, and the client to achieve a resolution. -Document the client's request and wait to see if the client reiterates the request.

-Contact the chaplain to arrange a visit with the client. The nurse's primary responsibility is to honor the client's request for a meeting with a spiritual advisor. Completing a spiritual assessment is not necessary at this time. Organizing a meeting between the chaplain, the son, and the client is not an accurate intervention at this time unless requested by the client. Documentation of the conversation with the client and calling for a spiritual advisor should be recorded in the client's health record. It is not necessary to document and wait for the client to ask again before the nurse considers the request. Afterall, she is dying and waiting for her to ask again is not warranted.

The nurse is caring for a 6-year-old child who was in a motor vehicle accident and has lost a lot of blood through an open leg wound. The parents tell inform the nurse that the child cannot have blood transfusions due to their religious beliefs. What decision does the nurse determine that the court will support regarding the child's blood transfusion? -Supported the parents' right to refuse treatment for the child -Allowed the child to accept treatment or not -Did not support the parents' right to refuse treatment for the child -Allowed the church pastor to accept or refuse treatment for the child

-Did not support the parents' right to refuse treatment for the child

The nurse is caring for a 6-year-old child who was in a motor vehicle accident and has lost a lot of blood through an open leg wound. The parents tell inform the nurse that the child cannot have blood transfusions due to their religious beliefs. What decision does the nurse determine that the court will support regarding the child's blood transfusion? -Supported the parents' right to refuse treatment for the child -Allowed the child to accept treatment or not -Did not support the parents' right to refuse treatment for the child -Allowed the church pastor to accept or refuse treatment for the child

-Did not support the parents' right to refuse treatment for the child The courts have not supported the right of Jehovah Witness parents to refuse life-saving treatment for their children such as in traumatic accidents. The courts do not allow child to make health care decisions nor allow the church pastor to accept or refuse treatment over the parents.

A nurse overhears a client telling a family member that a belief in God is the only thing helping in the fight against a terminal illness. What is this client demonstrating? -Faith -Hope -Love -Religion

-Faith Faith 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 it is usually followed by action related to the ideals or values of that belief. Hope is a feeling of expectation and desire for a certain thing to happen. Love is an intense feeling of deep affection. Religion is a particular system of faith and worship.

A nurse is reviewing the history of a client admitted to the health care facility. The nurse notes that the client reports that he is an atheist. The nurse interprets this information as indicating that the client believes that: -God's reality is unknown. -God does not exist. -God's reality is personal. -God is the creator of the universe.

-God does not exist. An atheist believes that God does not exist. A person who follows agnosticism believes that God's reality is unknown and unknowable. A person following theism believes that God's reality is personal, without a body, perfect in all things, and creator and sustainer of the universe.

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 -Tell the family member you wish you could help but don't know how -Contact the family church group members for assistance -Give the family member some spiritual reading materials -Ignore the family member's concerns

-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? -Check on this client every hour. -Sit in the chair on the other side of the room for 10 minutes each hour. -Hold the client's hand and sit by the bedside as often as possible. -Tell the client that you are there when needed and to just ring the call bell.

-Hold the client's hand and sit by the bedside as often as possible. The nurse can offer supportive presence by holding the patient's hand to show that he or she is sincerely concerned, or simply by being present to communicate value and respect. The other options do not show that the nurse truly cares. Checking on the client every hour demonstrates the nurse wanting to take care of physical needs rather than spiritual needs. Sitting in the chair on the other side of the room is not a caring behavior. Telling a client who is close to death to use the call bell demonstrates a nurse's inability to give caring behaviors.

A nurse is caring for a client who is spiritually distressed. Which of these are factors that affect the spiritual distress of a client? Select all that apply. -Inability to reconcile a current life situation with spiritual beliefs -Separation from the religious community or supports -Seeking a religious leader -Ability to introspect

-Inability to reconcile a current life situation with spiritual beliefs -Separation from the religious community or supports

A nurse is caring for a client who is spiritually distressed. Which of these are factors that affect the spiritual distress of a client? Select all that apply. -Inability to reconcile a current life situation with spiritual beliefs -Separation from the religious community or supports -Seeking a religious leader -Ability to introspect

-Inability to reconcile a current life situation with spiritual beliefs -Separation from the religious community or supports Factors affecting spiritual distress include inability to reconcile a current life situation with spiritual beliefs and separation from the religious community or supports. Disconnectedness to self can be expressed through an inability to seek a religious leader or an inability to introspect

While interviewing a hospitalized client, he states, "The holy days of Ramadan are coming soon. I am not to have any food or drink from sunrise to sunset during this time." Further assessment reveals that the client's request is associated with which religion? -Christianity -Judaism -Islam -Hinduism

-Islam According to the Islamic religion, neither food nor drink is taken between sunrise and sunset during the holy days of Ramadan. There are no special or universal food beliefs common to Christianity. According to Judaism, Kosher food is eaten, meat cannot be mixed with dairy, and separate cooking and eating utensils are used for food preparation and consumption. According to Hinduism, pork and alcohol are forbidden and other meats must meet ritual requirements.

The nurse is on the third day of caring for a client who recently underwent a colectomy. During the physical assessment, a discussion about spirituality develops. The client reports feeling some guilt about being in the hospital because her religion opposes modern science, including medicine. The nurse recognizes this as a belief of which of the following groups? -Buddhism -Baha'i International Community -Mormon -Jehovah's Witnesses

-Jehovah's Witnesses Jehovah's Witnesses oppose the "false teachings" of other sects; opposition often extends to modern science, including medicine. The Baha'i International Community believes in a basic harmony between religion and science. 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 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? -Autonomy -Love -Self-reliance -Belonging

-Love

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? -Autonomy -Love -Self-reliance -Belonging

-Love Love develops from the basic human need to love and be loved, and we cannot be spiritually whole, spiritually healthy, unless this need is met. Autonomy is freedom from external control or influence. Self reliance is reliance on one's own powers and resources rather than those of others. Autonomy and self reliance are higher level of needs. A sense of belonging is a human need, just like the need for food and shelter but love is more important.

A nurse is caring for Mr. Glanden, who recently underwent a lung resection. As the nurse is completeing the physical assessment, he asks to have the elders from his church perform a "laying on of hands". The nurse interprets this as a healing process associated which of the following religions? -Buddhism -Baha'i International Community -Mormon -Jehovah's Witnesses

-Mormon Mormons believe in divine healing through the "laying on of hands. The Baha'i International Community believes 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.

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. -Christian Scientist. -Adventist. -Muslim.

-Mormon.

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. -Christian Scientist. -Adventist. -Muslim.

-Mormon. Members of the Church of Jesus Christ of Latter-Day Saints (Mormons) wear a special undergarment that should only be removed in emergencies, or when absolutely necessary. The other religions have no special undergarments related to their beliefs.

A nursing student is studying spirituality and completing a report on the Mormon faith. Which fact about Mormonism should the student include in the report? -Mormons are not allowed to practice birth control. -Mormons are not allowed to use tobacco or alcohol. -Mormons are not allowed to have blood transfusions. -Mormons are not allowed to have a physician of a different sex.

-Mormons are not allowed to use tobacco or alcohol.

A nursing student is studying spirituality and completing a report on the Mormon faith. Which fact about Mormonism should the student include in the report? -Mormons are not allowed to practice birth control. -Mormons are not allowed to use tobacco or alcohol. -Mormons are not allowed to have blood transfusions. -Mormons are not allowed to have a physician of a different sex.

-Mormons are not allowed to use tobacco or alcohol. Mormons disapprove of alcohol, tobacco, and caffeinated beverages. Jehovah's witnesses are not allowed to have blood transfusions. Catholics do not adhere to birth control measures. Muslims do not allow opposite sexed physicians to care for them, especially women.

Mrs. Dopson is a 75-year-old widow who lost her last offspring to cancer last month. She shares with the nurse that she fears being alone. 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 -Need for love and relatedness -Need basic necessities of life -Need for forgiveness

-Need for love and relatedness According to Shelly and Fish (1988), the three spiritual needs underlying all religious traditions and common to all people are the need for meaning and purpose, the need for love and relatedness, and the need for forgiveness. The client is experiencing a loss of love and relatedness. A need for meaning and purpose can be related to loss of a job or function. Need for forgiveness is reconciling differences with other persons. Basic necessities are something necessary or indispensable such as food, water, and shelter.

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 -Need for love and relatedness -Need for basic necessities of life -Need for forgiveness

-Need for meaning and purpose According to Shelly and Fish (1988), the three spiritual needs underlying all religious traditions and common to all people are the need for meaning and purpose, the need for love and relatedness, and the need for forgiveness. The client is experiencing the need for meaning and purpose. The garden provided a needed element for the client to provide for others. The need for love and relatedness is have a sense of companionship. The need for forgiveness is reconciling with others. Basic necessities are something necessary or indispensable such as food, water, and shelter.

Which nursing title is being recognized by the American Association of Nursing that aids and assists the clients with spiritual needs in the community setting? -Nurse minister -Parish nursing -Client advocate -Specialized nurse

-Parish nursing Parish nursing, or faith community nursing, is considered a specialty area of practice, recognized by the American Association of Nursing and having its own standards of practice. Parish nurses work in churches across the country providing health promotion and health screening activities to individuals in the community. Parish nurses view clients holistically, addressing spiritual issues as well as health issues that arise for individuals in their faith community. Some clients want nurses to prearrange visits from pastors, priests, or other members of the religious community after their return home or transfer to another health care facility. In some areas of the United States, faith communities have developed various health ministries such as nurse minister. A client advocate can be a nurse or another health care professional who advocates for a client they are providing care for. A specialized nurse is a nurse who specializes in a special care area like the intensive care unit or hospice.

The nursing diagnosis Spiritual Distress related to crisis of illness as evidenced by loss of meaning in life and overuse of pain medication is created for a client who attempted to take his life. Which intervention is appropriate for these problems? -Plan and coordinate a multidisciplinary team conference including the chaplain. -Provide client education on negative spiritual implications on suicide. -Encourage the client to watch movies when alone. -Explore past negative coping mechanisms used.

-Plan and coordinate a multidisciplinary team conference including the chaplain. The nurse should facilitate a care-planning conference involving the social support network including family and friends. Initiating a multidisciplinary social network of conferences facilitates a sense of acceptance, love, and belonging. The nurse should work with the client to explore and build on past positive coping mechanisms, which helps enhance a sense of self-control and self-esteem. Encouraging the client to watch movies when alone does not allow the client to interact and find positive elements of his or her life. Although spiritual review can be helpful, the nurse should not "scare" the client away from action by mentioning negative spiritual outcomes.

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? -Tell the client that they are not comfortable praying out loud -Read a passage from the Bible to the client -Inform the client that they will try to get another nurse to pray with the client -Tell the client the nurse is busy at the moment and hope the client will forget

-Read a passage from the Bible to the client A nurse unaccustomed to praying aloud or in public may find it helpful to have a Bible passage or formal prayer readily available. The other options are not therapeutic.

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. -Religion and spirituality are synonymous. -Spirituality is the behavioral manifestation of religious beliefs. -Spirituality is a recently developed alternative to traditional religious belief.

-Religion is a collection of spiritual beliefs and practices. 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 a recent development.

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 make caring for clients interesting. -Religious practices and beliefs can directly influence a client's self-care practices. -Religious practices and beliefs are not that important in relation to the client's illness. -Religious practices and beliefs are difficult to understand.

-Religious practices and beliefs can directly influence a client's self-care practices. Nurses are better able to meet clients' spiritual needs when they understand their religious beliefs. These beliefs can directly influence clients' responses to illness and suffering, self-care practices such as diet and hygiene, spiritual practices, and moral codes. Religious practices and beliefs can be easy to understand and if asking a client about them, a nurse is exemplifying care and compassion in the client and their beliefs.

The family members of a dying client have asked for the hospital chaplain's help in having a member of the clergy come to the client's bedside to perform the anointing of the sick. The nurse who is providing care for the client should recognize that the family is likely which religion? -Roman Catholic -Christian Scientist -Jehovah's Witnesses -Jewish

-Roman Catholic Among the sacraments of the Roman Catholic Church is the anointing of the sick or the sacramental anointing with blessed oil. This specific rite is not a component of Jehovah's Witnesses, Christian Science, or Judiasm.

When a nurse supports the client's spiritual needs, the nurse supports which level of the Maslow's hierarchy of needs? -Physiologic needs -Security needs -Ego needs -Self-actualization needs

-Self-actualization needs

When a nurse supports the client's spiritual needs, the nurse supports which level of the Maslow's hierarchy of needs? -Physiologic needs -Security needs -Ego needs -Self-actualization needs

-Self-actualization needs In the hierarchy of human needs, spiritual well-being appears to connote fulfillment of needs beyond the self-actualization level. Spiritual well-being has been associated with health and general well-being. Safety needs in Maslow's hierarchy refer to the need for security and protection. When we have our physiological needs for food and water met, our safety needs dominate our behavior. Physiological needs deal with the maintenance of the human body. This lowest category includes the most basic needs that are vital to survival, such as the need for water, air, food, and sleep. There are no ego needs in the hierarchy.

An appropriate nursing diagnosis for a bedridden hospitalized client who tells the nurse that he has not missed a Methodist church service in 50 years would be: -Spiritual Distress related to inability to attend church services evidenced by verbal states of guilt -Spiritual Need as evidenced by verbalizations and distress at missing Methodist church services -Dysfunctional Grieving related to inability to attend church services as a result of his medical condition -Potential for Enhanced Spiritual Well-Being related to distress at missing Methodist church services

-Spiritual Distress related to inability to attend church services evidenced by verbal states of guilt Persons suffering spiritual dysfunction or distress may verbalize such distress or express a need for help.

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 -Spiritual Need as evidenced by verbalizations and distress at missing Methodist church services -Dysfunctional Grieving related to inability to attend church services as a result of his medical condition -Potential for Enhanced Spiritual Well-Being related to distress at missing Methodist church services

-Spiritual Distress related to inability to attend church services evidenced by verbal states of guilt Persons suffering spiritual dysfunction or distress may verbalize such distress or express a need for help. Developing a three-part nursing diagnosis consists of data analysis, problem identification, and the formulation of the nursing diagnosis. There are four different types of nursing diagnoses: actual nursing diagnosis, wellness (or health promotion) nursing diagnosis, risk nursing diagnosis, and syndrome diagnosis. The other three statements are missing part of the nursing diagnosis.

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 -Spiritual guilt -Spiritual anger -Spiritual loss

-Spiritual alienation Spiritual alienation occurs when an individual is separated from one's faith community. Spiritual guilt is the failure to live according to religious rules. Spiritual anger is the inability to accept illness. Spiritual loss occurs when one is not able to find comfort in religion.

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? -Tell the client she does not want to talk about this because she is not comfortable doing so -Change the subject to avoid focusing on the new diagnosis -Suggest to the client that she can call her spiritual advisor to help give her counsel -Tell the client that she will talk about this later

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

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 expresses hope and sense of meaning. -The client expresses satisfaction with life. -The client uses a type of spiritual experience that provides comfort. - The client will experience alternate venues of spiritual expression.

-The client uses a type of spiritual experience that provides comfort. As with other age groups, listening and support are essential as older adults deal with health and illness. Older adults used several religious or spiritual interventions with health professionals and also in isolation. 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. A client expressing a sense of hope, meaning in life, and satisfaction can only communicated but not witnessed. A client may tell a nurse this to be looked as having communicated happiness in their life. A client, if satisfied with religious influence, will not seek alternative venues for spiritual expression.

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. -The nurse should defer the client's request to pray. -The nurse should inform the client that she will pray for the client but not with him. -The nurse should ask the client's roommate to pray with the client.

-The nurse should select a formal prayer or Bible passage to use to pray aloud. A nurse unaccustomed to praying aloud or in public may find it helpful to have a Bible passage or formal prayer readily available for praying. If the nurse is not comfortable praying with the client, they should call the hospital chaplain or find another individual who is comfortable.

After being informed that his wife only has a few hours to live, the nurse hears the husband say; "If you take my wife now. I will never pray to you!" What should be the nurse's reply? -Tell the husband to think before saying anything negative. -Call the pastor into the room to speak with the husband. -Leave the room and do not be part of this situation. -Use silence and allow the husband to express his emotions.

-Use silence and allow the husband to express his emotions.

A client recently diagnosed with cancer informs the nurse that they value faith and finds comfort in their faith. The nurse is aware that faith is best defined as: -a belief in something for which there is no proof or material evidence. -a positive outlook even in the bleakest moments. -an organized belief system about a higher power. -practices associated with all aspects of a person's life.

-a belief in something for which there is no proof or material evidence. Faith is a belief in something for which there is no proof or material evidence. The client is expressing a sense of faith to the nurse. 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.

When a nurse asks herself questions such as "Why am I here?," the nurse is attempting to: -develop the concepts of holism and integration. -become a more spiritual being for other people. -develop a philosophical base for clearer thinking. -strive toward unity with the higher power.

-develop a philosophical base for clearer thinking.

When a nurse asks herself questions such as "Why am I here?," the nurse is attempting to: -develop the concepts of holism and integration. -become a more spiritual being for other people. -develop a philosophical base for clearer thinking. -strive toward unity with the higher power.

-develop a philosophical base for clearer thinking. In terms of spiritual care, the nurse's own background, family, culture, and religion are integral parts of interactions with clients. For this reason, taking a step back and examining spirituality, values, and beliefs is essential.

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. -educating the child about religion. -educating the child about God. -educating through religious-based schools.

-educating through parental behaviors. 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 learns about God, life, and self from the parents' behavior.

The best definition of a spiritual need is: -universal belief in truth, justice, and compassion. -expression of a person's inner being and meaning. -a quest to discover life's meaning. -an affirmation of life, peace, and harmony.

-expression of a person's inner being and meaning. A spiritual need represents a normal expression of a person's inner being that seeks meaning in all experiences, and a dynamic relationship with self, others, and to the supreme other as the person defines it.

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: -trust. -forgiveness. -love and relatedness. -faith.

-faith. The nurse should be aware of adaptive behaviors of faith. These include: Faith depends on divine wisdom/God; faith is motivated toward growth; faith expresses satisfaction with explanation of life after death; faith expresses a need to enter into and/or understand the larger drama of human history; faith expresses a need for the symbolic, or ritual; faith expresses a need for sense of a shared faith/community. In this case, the client believes that he will depend on the divine wisdom of God for guidance. Trust is believing in the truth. Forgiveness is seeking out peace between two people. Love and relatedness is to support and cherish the relationship between two.

While interviewing a client, a nurse is told that the client practices Catholicism. This client is identifying: -his spirituality. -his faith. -his values. -his culture.

-his faith. Faith is a term also used to describe a cultural or institutional religion such as Judaism, Islam, Catholicism, or Confucianism. Spirituality refers to anything that pertains to a person's relationship with a higher power or force. Values refer to those beliefs most meaningful to a person. Culture pertains to a person's background.

Which set of terms best reflects nursing's view of clients as holistic beings? -physical, psychosocial, religious -mind, body, spirit -id, ego, superego -spiritual, egocentric, naive

-mind, body, spirit Nursing has a long history of incorporating spirituality into client care. References to spirituality underlie a primary idea in nursing, that clients are viewed as holistic beings in body, mind, and spirit. Id, ego, and superego are concepts associated with psychoanalytic theory. A holistic view is more than physical, psychosocial, religious, egocentric, and naïve.

A man age 79 years is in the late stages of lung cancer with bone metastases. Since receiving his terminal diagnosis, the client has often made mention of the fact that he has a long-estranged daughter and that he was a "miserable father." The client has recently asked for the social worker's assistance in locating his daughter before his death. What spiritual need likely underlies the client's request? -need for forgiveness -need for purpose -need for meaning -need for love

-need for forgiveness

Mrs Jones is an 81-year-old client who can no longer live alone safely and is being admitted to a long-term-care facility. She had to leave her elderly cat, Baby, with neighbors. She tells the nurse that her cat was the only family she had and that she misses her. 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 -need for love and relatedness -need for basic necessities of life -need for forgiveness

-need for love and relatedness According to Shelly and Fish (1988), the three spiritual needs underlying all religious traditions and common to all people are the need for meaning and purpose, the need for love and relatedness, and the need for forgiveness. The client is experiencing the need for love for her cat. The need for forgiveness is reconciliation for past relationship issues. The need for meaning and purpose is finding connectiveness with jobs or people. Basic needs are something necessary or indispensable such as food, water, and shelter.

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 love and relatedness -need for comfort and money -need for forgiveness -need for complete health and freedom

-need for meaning and purpose -need for love and relatedness -need for forgiveness There are three spiritual needs that underlie all religious traditions and are common to all people: need for meaning and purpose, need for love and relatedness, and need for forgiveness. Need for comfort and money, as well as need for complete health and freedom, are nice but are not part of spirituality.

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 love and relatedness -promoting pain relief -promoting forgiveness -promoting independence

-promoting meaning and purpose -promoting love and relatedness -promoting forgiveness

An older adult who identifies herself as a devout Catholic has recently relocated to an assisted-living facility. The client is pleased with most aspects of the living situation but laments the fact that the church is not nearby, so attending daily mass is not an option. She is quite upset by this restriction and states, "Going to daily mass was my life." The nurse recognizes that this client is suffering: -depression. -spiritual distress. -spiritual pain. -hopelessness.

-spiritual distress. Spiritual distress involves the inability to integrate meaning and purpose in life, while spiritual pain involves angst over the nature and actions of a higher power. The woman's statements do not directly reflect an outlook of hopelessness. A diagnosis of depression does not apply to this situation.

When providing care to an individual from the Native American/First Nations culture, it is important to elicit help from the: -spiritual healer. -priestess. -rabbi. -preacher.

-spiritual healer. Shamans and spiritual leaders are found among Native American/First Nations peoples and many Southeast Asian cultures.

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 is an atheist. -the client has no belief system. -the client is an agnostic. -the client may still be deeply spiritual.

-the client may still be deeply spiritual.

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 is an atheist. -the client has no belief system. -the client is an agnostic. -the client may still be deeply spiritual.

-the client may still be deeply spiritual. The nurse should not interpret the fact that a client does not belong to an organized religion to mean that he or she has no spiritual needs; a person may be deeply spiritual yet not profess to belong to an organized religion. 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.


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