43: Spiritual Health

27. When a patient informs the nurse that he is a Jehovahs Witness, the nurse must recognize and validate that the patient will not accept A) Blood transfusions B) Traditional health practices C) Pain medication D) Disease causation from germs

Ans: A

2. The nurse is caring for a patient diagnosed with HIV 10 years ago. The patient states that her relationship with God has helped her survive this long. The nurse understands that spiritual well-being is a condition in which a person is at peace with which of the following? Select all that apply. A) God B) Self C) Community D) Environment

Ans: A, B, C, D Feedback: Spiritual well-being is the condition in which a person is at peace with God, self, community, and environment.

9. The nurse is caring for a patient with a nursing diagnosis of Spiritual Distress. Which assessment finding would support this nursing diagnosis? A) Views illness as punishment B) Offers to forgive others C) Is nonjudgemental of others D) Accepts help from others

Ans: A Feedback: Adaptive expressions of spiritual needs include offers to forgive others, is nonjudgemental, and accepts help from others. Maladaptive expressions include viewing illness as a punishment and not trusting others.

11. The nurse is caring for a patient who states, Why are you asking me all these questions about religion? There is no God. The nurse would document this belief as_______? A) Atheism B) Agnostic C) Theism D) Faith

Ans: A Feedback: Atheism is the denial of Gods existence. Agnosticism is the belief that Gods reality is unknown and unknowable and theism is the belief that Gods reality is personal, without a body, perfect in all things, and creator and sustainer of the universe. Faith is the way that a person acts out beliefs in his or her life.

7. Which of the following questions would be appropriate for the F in the FICA spiritual assessment tool? A) Do you consider yourself a spiritual person? B) Are you actively involved with a church community? C) Do you use your church family for support? D) How would you like me to address this issue in your healthcare?

Ans: A Feedback: F is for questions of faith. Some examples of questions to ask would include the following: Do you consider yourself a spiritual person? What gives your life meaning? I represents the importance of this resource in the patients life. Assessment questions might include asking how often the patient attends worship services. Do your beliefs strongly influence your decisions with regards to your medical practices? C is for community. Are you actively involved with a church community, and do you use this as support? A is for the practitioner to address these concerns with the patient, such as to ask, how would you like me to address these issues in your healthcare?

19. An appropriate nursing diagnosis for a bedridden hospitalized patient who tells the nurse that he has not missed a Methodist church service in 50 years would be A) Spiritual distress related to inability to attend church services evidenced by verbal states of guilt B) Spiritual need as evidenced by verbalizations and distress at missing Methodist church services C) Dysfunctional grieving related to inability to attend church services as a result of his medical condition D) Potential for enhanced spiritual well-being related to distress at missing Methodist church services

Ans: A Feedback: Persons suffering spiritual dysfunction or distress may verbalize such distress or express a need for help.

8. The nurse is preparing to complete a spiritual assessment of a patient. What step should the nurse complete first? A) Perform a self-assessment of their own spiritual beliefs B) Provide for privacy during the assessment C) Determine if the patient would like any family members present during the assessment D) Gather the needed paperwork for the assessment

Ans: A Feedback: Prior to assessment, nurses should be aware of their own spiritual condition. Acknowledging and recognizing select spiritual beliefs as personal will allow the nurse to discern and focus on the specific needs of the patient.

5. The nurse is caring for a Roman Catholic patient who is dying. Which of the following would be an appropriate action of the nurse? A) Contact a local priest to complete the anointing of the sick ritual. B) Contact a local priest to provide special care to the body after death. C) After death, place the patients body on the floor to facilitate the souls journey. D) Ensure that a person of the same sex as the deceased clean the body.

Ans: A Feedback: Roman Catholics believe that people should have the anointing of the sick as well as the Eucharist and penance by a priest before death. There are no special care rituals for the body after death.

23. When providing care to the Native American culture, it is important to elicit help from the A) Spiritual healer B) Priestess C) Rabbi D) Preacher

Ans: A Feedback: Shamans and spiritual healers are found among Native Americans and many Southeast Asian groups.

10. The nursing instructor has been discussing spirituality with a group of nursing students. Which statement by a student would indicate a need for further education? A) Spiritual beliefs and practices do not give strength when a person is in crisis. B) Spiritual beliefs and practices give healing strength and support. C) A persons daily living habits can be guided by their spiritual beliefs. D) Spiritual beliefs can help give a person meaning in their life.

Ans: A Feedback: Spiritual beliefs and habits can give meaning to life, illness, other crises, and death, contribute a sense of security for present and future, guide daily living habits, provide strength in meeting lifes crises, and give healing strength and support.

12. A question that would be appropriate for the E in the HOPE spiritual assessment tool would be? A) Do you have a living will? B) Do you want to experience a Catholic mass? C) Do you expect to go to heaven when you die? D) Do you want to end your drug addiction?

Ans: A Do you have a living will? Feedback: In the HOPE spiritual assessment, the H addresses spiritual resources, such as hope, with direct focus on religion or spirituality. The O represents importance of organized religion in their lives. The P represents inquiry with regards to personal practices. The E is to remind the practitioner to work with the patient to discuss end-of-life issues, such as living wills.

22. When discussing spirituality with the mother of an 8-year-old child, the nurse instructs the mother that children of this age A) Enjoy lore and legends of religious groups B) Are influenced by their peer groups C) Are moved deeply by spirituality D) May question religious authority

Ans: A Enjoy lore and legends of religious groups Feedback: Childhood is the period when lore, legends, language, and symbols of a particular religious group are best presented.

4. The nurse is caring for a dying male patient who is Islamic. What is the most appropriate action for the nurse after the patients death? A) Ensure that a male washes the patients body. B) Place the body on the floor to facilitate the souls journey. C) Ensure that no one is in the room when the patient dies. D) Ensure that someone performs the anointing of the sick sacrament prior to the patients death.

Ans: A Ensure that a male washes the patients body. Feedback: Islamic beliefs about death are that the family should be with the dying person so they can read the Koran and pray. There are also special procedures for care of the body after death; men wash male bodies and women wash female bodies and perform a variety of other rituals. Hinduism beliefs include placing the body on the floor to facilitate the souls journey. The anointing of the sick sacrament is part of the Roman Catholic faith.

25. The best definition of a spiritual need is A) Universal belief in truth, justice, and compassion B) Expression of a persons inner being and meaning C) A quest to discover lifes meaning D) An affirmation of life, peace, and harmony

Ans: B Feedback: A spiritual need represents a normal expression of a persons 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.

1. The nurse is caring for a patient who states, No one can understand God. The nurse would document the patients spiritual belief as which of the following? A) Atheist B) Agnostic C) Theist D) Holistic

Ans: B Feedback: Beliefs may range from atheism (denial of Gods existence) to agnosticism (belief that Gods reality is unknown and unknowable) to theism (belief that Gods reality is personal, without a body, perfect in all things, and creator and sustainer of the universe).

6. Using the FICA spiritual assessment tool, which would be an appropriate question for the C? A) Do you consider yourself a spiritual person? B) Do you attend a specific church? C) How do these concerns effect your health? D) Can I discuss your concerns with your family?

Ans: B Feedback: In the FICA model, C is for community. Topics to ask about in this area would include whether the patient is actively involved with a church community and if she uses that community as support.

21. An 80-year-old woman does not believe certain religions should allow gay marriage. However, her grandchildren support this view. The grandmother is experiencing A) Moral dilemma B) Conjunctive faith C) Value clarification D) Unethical behavior.

Ans: B Feedback: Older adults notice the polarities or extremes in life such as young and old, rich and poor, masculine and feminine, constructive and destructive, and self-awareness and self-denial. These tensions, enhanced or precipitated by personal and environmental situations, demand integration and resolution. This is referred to as conjunctive faith.

15. Children who are hospitalized may view hospitalization as A) The work of the devil B) Punishment for wrongdoing C) A lack of faith in God D) Poor parental bonding

Ans: B Punishment for wrongdoing Feedback: Young children are very sensitive to goodbad issues. Do not tell them that painful or scary treatments are in any way a punishment.

13. The nurse is caring for a patient who is recovering from a suicide attempt. Which of the following nursing interventions would be inappropriate for this patient? A) Utilize active listening techniques. B) Allow for expression of negative feelings. C) Implement all-new coping mechanisms. D) Include the patients family and friends.

Ans: C Feedback: Active listening, expression of both positive and negative feelings and inclusion of family and friends builds trust, safety, and a sense of acceptance, love, and belonging. Building on past positive coping mechanisms enhances a sense of self-control and self-esteem.

18. To obtain subjective data related to a 16-year-old patients spirituality, the nurse should A) Ask the patients parents if the patient attends services B) Observe whether the patient reads religious material C) Ask the patient if religion or a higher being is significant D) Document the number of times a minister visits

Ans: C Feedback: In a spiritual assessment, the nurse may ask if religion or God is significant to the patient.

26. When a nurse asks himself or herself questions such as Why am I here?, the nurse is attempting to A) Develop the concepts of holism and integration B) Become a more spiritual being for other people C) Develop a philosophical base for clearer thinking D) Strive toward unity with the higher power

Ans: C Feedback: In terms of spiritual care, your own background, family, culture, and religion are integral parts of interactions with patients. For this reason, taking a step back and examining your own spirituality, values, and beliefs is essential.

3. The nurse is assisting a patient with his meal selection for the next day. The patient states, I cant have meat tomorrow, its a Holy Day. The nurse recognizes that the patient is a member of which religious organization? A) Orthodox Jewish B) Reform Jewish C) Roman Catholic D) Islamic

Ans: C Feedback: Roman Catholics observe fasting and abstinence from meat on certain Holy Days.

14. When a 76-year-old patient diagnosed with terminal cancer expresses hopelessness and despair to the nurse, the nurse should A) Notify the physician B) Contact the religious leader at his church C) Encourage him to think positively D) Listen empathetically and attentively

Ans: D Feedback: As with other age groups, listening and support are essential as patients deal with healthillness.

16. Which of the following food groups would be appropriate to suggest to a patient who practices tenets of the Islamic faith? A) Salad with crumbled bacon and cheese with a cup of tea B) Barbecued pork sandwich with a milkshake C) Sliced ham and cheese sandwich and 2% milk D) Broiled chicken sandwich with skimmed milk

Ans: D Feedback: Members of the Islamic faith are forbidden to eat pork or drink alcohol.

20. Individuals who are Christian Scientists may not approve of A) Expensive treatments B) Circumcisions C) Contraception D) Immunizations

Ans: D Feedback: 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 patients age and imminence of death.

17. An appropriate goal for the patient with a nursing diagnosis of spiritual distress related to intense pain and suffering as verbalized by the patient would be that the patient will A) Express feelings of anger and despair to God B) Have a minister meet with the patient daily C) Reflect on past accomplishments in life D) Participate in supportive spiritual practices

Ans: D Feedback: The goal for the patient should focus on supporting the patients strengths.

24. When the patient tells the nurse that she believes Gods reality is personal, and that God is the creator of all beings, the nurse determines the patient is expressing A) Faith B) Agnosticism C) Atheism D) Theism

Ans: D Feedback: Theism is the belief that Gods reality is personal, without a body, perfect in all things, and creator and sustainer of the universe.