GERO (VNSG 1126) CH. 14 "Values and Beliefs" NCLEX-STYLE QUESTIONS
An older bedridden patient tells the nurse, "I wish I could attend church service. I think it would make me feel better." The nurse contacts the hospital chaplain, and he visits the patient, but afterwards the patient continues to express a desire to attend services. What should the nurse do first? A) Document that the hospital chaplain attended to spiritual needs B) Obtain an order to allow the patient to attend church service C) Assess the patient for special spiritual practices and beliefs D) Ask the family to bring items related to the church service
C) Assess the patient for special spiritual practices and beliefs The nurse should first assess the patient's spiritual beliefs and try to determine how he or she perceives the church service. Possibly, there are rituals, relics, music, specific persons, etc. that are part of the church service. Once the assessment has been made, the nurse can further consult the hospital chaplain for advice. Documentation is always important, but the mere presence of the chaplain has not met the patient's needs. Bringing items may be sufficient, but the nurse must first assess the patient's beliefs. It is unlikely that the bedridden patient can attend church service, but alternatives should be explored. (p. 241)
The nurse is caring for a Jewish patient who has died. The nurse knows which burial practice is common in the Jewish community? A) Cremation B) Embalming C) Burial in a wooden coffin D) Lying in state for 7 days before burial
C) Burial in a wooden coffin Typically, those of the Jewish faith are buried in a wooden coffin within 24 hours of death; they are neither embalmed nor cremated.REF: Page 236
The nurse in the long term care facility is planning care for a patient whose religion demands prayer at certain times during the day. The nurse finds these prayer times interfere with passing medication. What is the best course of action by the nurse? A) Work with the patient to find different times for prayer B) Bring the medication to the patient's room and leave it for him to take when convenient C) Collaborate with the prescribing provider to determine alternate times for medication administration D) Inform the patient the medications are more important than prayer and must be administered at the correct time
C) Collaborate with the prescribing provider to determine alternate times for medication administration The nurse should recognize the importance of the patient's faith and faith rituals to his overall health and well-being and collaborate with the provider to determine alternate times to administer the medication. The patient's religion requires prayers be said at a specific time that should be respected; the nurse should not try to work with the patient to change those times. It is not safe to leave the medications in the patient's room for him to take when convenient.REF: Page 241
The nurse is caring for an older patient who has end-stage renal disease. The patient says he is an atheist and expresses hopelessness, failure, and guilt because of past mistakes. What should the nurse do? A) Suggest that the patient talk to the hospital chaplain to find God and make peace with God B) Tell the patient that everything will be okay, because God loves him even if he doesn't love God C) Encourage the patient to talk about personal beliefs and to express feelings about the past D) Respect the patient's beliefs and feelings and provide privacy for meditation on personal thoughts
C) Encourage the patient to talk about personal beliefs and to express feelings about the past By encouraging the patient to talk about personal values and beliefs, the nurse is assessing for alternative ways to help the patient renew hope and integrity of self. The nurse and patient may decide that the atheist position does not exclude talking to the chaplain. The nurse should avoid false reassurance and platitudes. At this point, leaving the patient alone is likely to exacerbate his feelings of hopelessness. (pp. 241-242)
The home health nurse cares predominantly for patients who were born in the 1930s. The nurse knows these patients have been most affected during their formative years by which event in history? A) World War I B) World War II C) The Great Depression D) 1987 stock market crash
C) The Great Depression Patients born in the 1930s grew up during the Great Depression, which created a generation of individuals taught to be frugal and waste as little as possible. World War I would have affected their parents. World War II would affect their children. The 1987 stock market crash would affect their grandchildren.REF: Page 238
An older Latino woman comes to the clinic for flulike symptoms. The patient's daughter tells the nurse that her mother likes to use a Curandero for health problems. Which question is the nurse most likely to ask the patient? A) "Are you currently using any folk remedies or home treatments?" B) "Are there special rituals that you would like us to use?" C) "Would you prefer to see a female health care provider?" D) "Did you bring the curandero? If so, would you allow me to look at it?"
A) "Are you currently using any folk remedies or home treatments?" A curandero (curandero, male; curandera, female) is a traditional Mexican healer who helps patients using prayer and rituals. Some curanderos also suggest folk remedies, and the nurse should assess for all treatments that the patient may have tried or is currently using. (p. 236)
The nurse is caring for a female patient who identifies herself as an atheist. Which statement made by the nurse indicates that nurse understands the nature of spirituality? A) "Do you have any spiritual practices we can assist you with?" B) "Would you like me to call our on-call priest to see if he can help you?" C) "Would you like me to remove Gideon's bible from your room?" D) "I guess you won't be needing services of our spiritual care department."
A) "Do you have any spiritual practices we can assist you with?" When someone has identified himself or herself as an atheist, it is a mistake to assume that he or she is not spiritual simply because he or she is not religious. Persons who refuse to identify with religious beliefs may merely indicate that they do not subscribe to beliefs of recognized religious systems. Nurses must be aware of the personal nature of spirituality and respect patients' choices. REF: Page 239
Which actions indicate that the nurse is providing culturally competent care? (Select all that apply.) A) Assists an older Muslim man to wash before praying and then provides privacy B) Picks up the patient's Koran and expresses an interest in learning more about the book C) Contacts a Spanish translator to assist in taking a history from an older Latino woman D) Assists an older Jewish patient to eat breakfast by cutting the ham into bite-sized pieces E) Ensures that an older Muslim woman is cared for by female health care workers
A) Assists an older Muslim man to wash before praying and then provides privacy, C) Contacts a Spanish translator to assist in taking a history from an older Latino woman, E) Ensures that an older Muslim woman is cared for by female health care workers The nurse is correct in helping the Muslim patient to wash before praying, contacting a translator to speak to the Latino patient, and ensuring that the Muslim female patient is cared for by female team members. The Koran should not be casually handled by persons who are unfamiliar with the religious rituals. Meal trays for Jewish patients should not generally include any pork, without first asking the patient about dietary preferences. (pp. 236-237)
The nurse is caring for a patient who has recently learned his lung cancer is terminal. The nurse knows the patient identifies as protestant, attends church weekly, and has been visited multiple times by the hospital chaplain. The nurse asks the patient if he would like to speak with the hospital chaplain today, but the patient exclaims, "Why would I want to speak with a chaplain? God has abandoned me!" What is the best action on the part of the nurse? A) Contact the hospital chaplain B) Request a prescription for an anxiolytic C) Respect the patient's wishes and refrain from calling the chaplain D) Say to the patient, "I know you don't mean that. God would never abandon you."
A) Contact the hospital chaplain The patient is clearly in spiritual distress. The nurse should contact the hospital chaplain even though the patient denies wanting one because the patient has interacted frequently with the chaplain. An anxiolytic may be helpful, but this is not the best action. The nurse should avoid contradicting the patient.REF: Page 239
The community health nurse works with individuals of many cultural backgrounds. The nurse knows which is most important for providing culturally competent care? A) Continuously assessing her own values and biases B) Focusing on the patient instead of the patient's culture C) Provide the same care to all patients regardless of their cultural background D) Research each patient's culture prior to beginning therapeutic communication with that patient
A) Continuously assessing her own values and biases The most important part of providing culturally competent care is remaining aware of one's own values and biases and how they may affect care. The nurse must recognize that the patient's culture is a huge part of the patient's well-being and must not be ignored. The nurse should provide the same quality of care to all patients but recognize that, due to each culture, each patient may require different care. Being knowledgeable of the patient's culture is important, but it is more important to be aware of one's own values and biases in order to provide culturally competent care.REF: Page 237
The nurse notes the patient was holding a Koran when he was admitted to the hospital. The nurse knows this patient ascribes to which faith? A) Islam B) Judaism C) Buddhism D) Christianity
A) Islam The Koran is the holy book of Islam. The Torah is the holy book of Judaism. The Bible is the holy book of Christianity. The Tipitaka is the holy book of Buddhism.REF: Page 236
The nurse cares for patients who were raised during the Great Depression. The nurse knows these patients may demonstrate which similarities due to their upbringing? (Select all that apply.) A) Tendency to hoard items B) Seeking medical care as soon as symptoms appear C) Taking the entirety of a prescription regardless of need D) Living in cluttered homes instead of throwing away excess items E) Easily transitioning to assisted living and long term care facilities F) Having difficulty accepting financial assistance from the state or family
A) Tendency to hoard items, D) Living in cluttered homes instead of throwing away excess items, F) Having difficulty accepting financial assistance from the state or family Individuals who were raised during the Great Depression tend to value frugality and minimizing waste. This may present as hoarding, delaying attending to symptoms and medical needs, refusing to buy prescriptions or taking less than the prescribed dose, refusing to dispose of clutter, having difficulty transitioning to a smaller living space that is not their own, and having difficulty accepting financial assistance.REF: Page 238
The nurse cares for an older adult in an extended-care facility. Which statement indicates possible spiritual distress? A) "I made some mistakes, but my life turned out pretty well." B) "I feel that God abandoned me and that I will die all alone." C) "My relationship with my children has not been perfect, but I think we finally managed to iron our differences." D) "My husband died 19 years ago and is waiting for me to join him."
B) "I feel that God abandoned me and that I will die all alone." Many of today's older adults were strongly affected by the depression of the 1930s. They were taught the value of a dollar and to "waste not, want not." Many older people are dismayed when nurses or family members throw away food or medical supplies and may attempt to retrieve these items, particularly when they are left alone. They may store an excessive number of personal belongings and clutter up their homes until these belongings become a safety hazard. REF: Page 238
The nurse is caring for a patient of the Islamic faith who has died. Which action by the nurse shows cultural competency? A) Quickly and efficiently wash the body and wrap it in a cotton sheet B) Ask the patient's significant others if they would like to wash the body C) Remove all invasive lines and monitoring devices and wrap the body in white shrouds D) Provide water, soap, and washcloths to the women in the patient's family to wash the body
B) Ask the patient's significant others if they would like to wash the body The nurse knows, in the Islamic faith, the patient's body is washed and wrapped in a cotton shroud at death. However, the nurse should not assume the patient's family wishes to perform the washing, but should give them the opportunity.REF: Page 236
Sociologists have suggested that because the United States is made up of many different and unique peoples mixed together, it should be called a(n): A) Upside-down cake. B) Fruit salad. C) Mincemeat pie. D) Melted chocolate bar.
B) Fruit salad.
The nurse observes an older adult who saves unopened crackers, jelly, and juice packages from the meal tray. What does this behavior most likely indicate? A) That the person would like an additional snack. B) That the person is frugal and does not want to waste good, usable items. C) That the person has problems with hoarding that needs to be evaluated. D) A habit that means nothing in particular.
B) That the person is frugal and does not want to waste good, usable items. Many of today's older adults were strongly affected by the depression of the 1930s. They were taught the value of a dollar and to "waste not, want not." Many older people are dismayed when nurses or family members throw away food or medical supplies and may attempt to retrieve these items, particularly when they are left alone. They may store an excessive number of personal belongings and clutter up their homes until these belongings become a safety hazard. REF: Page 238
The patient is admitted to the unit wearing a yarmulke and holding a Torah. What is the best first action on the part of the nurse with regards to the patient's faith needs? A) Call the closest Jewish faith leader B) Contact the hospital's on-call chaplain C) Wait for the patient to request to speak with a faith leader D) Ask the patient if there is a specific faith leader with whom he would like to speak
D) Ask the patient if there is a specific faith leader with whom he would like to speak The nurse should not make assumptions regarding the patient's faith needs. The nurse should open a dialogue with the patient regarding his faith needs rather than waiting for the patient to make the request. Calling the closest Jewish faith leader or the on-call chaplain shows the nurse is making assumptions about the patient's faith.REF: Page 235
A nurse who considers himself an agnostic is assigned to be the primary care nurse for an older patient in hospice care. The patient asks the nurse if they could pray together at every visit. What should the nurse do first? A) Ask the hospice agency to reassign the patient to a nurse who has the same faith as the patient B) Pray with the patient, as requested, to help the patient meet spiritual needs related to dying C) Respectfully inform the patient that their personal beliefs are different, so praying is inappropriate D) Examine personal values and beliefs to determine if meeting the patient's request is possible
D) Examine personal values and beliefs to determine if meeting the patient's request is possible The nurse should first examine personal beliefs and evaluate the impact of personal beliefs and values on patient care. Being an agnostic, the nurse might agree to pray with the patient but may feel ambiguous about the power of prayer. The nurse might also decide that reassignment or being respectful and honest about religious differences would be in the best interest of the patient. (p. 237)
An older Latino patient wants his family to bring folk remedies to the long-term care facility. What is the nurse's best response? A) Tell them that these are harmful and to be avoided. B) Remind them that only the physician can order treatments. C) Encourage them to bring whatever is requested. D) Identify the risks of these remedies.
D) Identify the risks of these remedies Understanding the values and beliefs of others is not easy, yet the willingness to try to understand or empathize is an important part of nursing care. Increasing their personal knowledge about the beliefs and values of common cultural, religious, and social groups can help nurses change beliefs. Open-mindedness and understanding of the wide range of beliefs and values existing in an increasingly diverse world enable nurses to work effectively with a variety of people. REF: Page 238
The nurse is caring for a Jewish patient who has passed away in the hospital. The nurse knows which rituals may be important for this patient and his family? (Select all that apply.) A) An autopsy must never occur B) A metal coffin is required for burial C) The body must lay in state for 48 hours D) White shrouds must be used to cover the body E) The body must be buried without being embalmed F) A 12-hour prayer-filled vigil must occur before the body is moved
D) White shrouds must be used to cover the body, E) The body must be buried without being embalmed The Jewish faith holds the patient must be wrapped in white shrouds and buried within 24 hours of death in a wooden coffin. The patient must not be cremated or embalmed. Autopsy may or may not be allowed. Seven days of mourning begin with the patient's death, but do not necessarily include a twelve-hour prayer vigil.REF: Page 236
T/F: Older adults grew up in a more affluent world and are more likely to value material possession and spend rather than save.
False Many of today's older adults grew up or were brought up by parents affected by the Depression of the 1930s. They were taught to be frugal and mindful of resources. Some older adults save or hoard items. Baby boomers, however, grew up in a more affluent world and are more likely to value material possessions and spend rather than save. REF: page 238