Chapter: 35: Spiritual Health
The nurse is performing a spiritual assessment on a new admission and is using the FICA spiritual assessment tool to assist with the process. Which questions are specific to the FICA assessment tool? Select all that apply. "Do you consider yourself spiritual or religious?" "Do your spiritual beliefs influence your health or medical decisions?" "Are you a part of a spiritual community or church?" "Where do you find your source of hope?" "How would you like me to address your health care concerns?"
"Where do you find your source of hope?" The HOPE assessment tool, not FICA, asks about source of hope. The FICA assessment tool asks questions specific to faith beliefs, importance of faith to the patient, whether the patient is part of a larger spiritual community, and how the patient would like to have his or her health care needs addressed. Correct "Do you consider yourself spiritual or religious?" The FICA assessment tool includes questions specific to faith beliefs and the importance of spirituality to the patient. "Do your spiritual beliefs influence your health or medical decisions?" The FICA assessment tool asks questions specific to faith beliefs, importance of spirituality, and how the patient would like to have his or her health care needs addressed. "Are you a part of a spiritual community or church?" The FICA assessment tool asks questions specific to faith beliefs, including whether the patient is part of a larger spiritual community. "How would you like me to address your health care concerns?" The FICA assessment tool asks questions specific to faith beliefs, importance of spirituality, and how the patient would like to have his or her health care needs addressed.
For which reasons is it important for the nurse to have knowledge about different religious and spiritual health practices? Select all that apply. Allows understanding of rationales behind specific behaviors Improves communication between cultures Improves the patient's confidence in the nurse's skill Allows for more tailored nursing care Often improves medical treatment adherence
Allows understanding of rationales behind specific behaviors Knowledge about diverse religious and spiritual practices enables the nurse to understand the rationale behind patient or family behaviors and allow for better understanding of requests. Improves communication between cultures Having knowledge about diverse religious and spiritual practices improves cultural communication and decreases miscommunication associated with cultural differences. Allows for more tailored nursing care A vast knowledge of diverse religious and spiritual practices enables the nurse to understand the rationale behind patient behaviors and provide more tailored nursing care. Often improves medical treatment adherence Understanding and having knowledge of diverse religious and spiritual practices improves cross-cultural communication, leading to improved treatment adherence. Wrong Improves the patient's confidence in the nurse's skill Having spiritual or religious knowledge does not affect nursing skill. The nurse's ability to interact with the patient may be improved, but not the nurse's clinical skills.
Match the term associated with spirituality with its description. Connecting to one's inner self, which allows one to connect to others Being connected to oneself, others, and a higher power An energy source that inspires motivation Peace during times of great stress Connectedness Inner strength Meaning/Life purpose Self-transcendence Faith/hope
Connecting to one's inner self, which allows one to connect to others - Self-transcendence Being connected to oneself, others, and a higher power - Connectedness An energy source that inspires motivation - Inner strength Peace during times of great stress - Faith/hope
The nurse is performing wound care on a patient after a double mastectomy. The patient quietly asks, "Do you think my husband will still love me after he sees how I look now?" Which nursing intervention encourages open reflection by the patient? Continue performing tasks while the patient is speaking. Tell the patient you are busy but you will send a psychologist to talk with her. Be physically present and actively listen when the patient is talking. Call the hospital chaplain who also had a mastectomy to meet with the patient.
Continue performing tasks while the patient is speaking. Continuing to perform tasks while the patient is speaking may give the impression to the patient that the nurse is uninterested and does not care. Tell the patient you are busy but you will send a psychologist to talk with her. Forcing the patient to speak to someone that she has not asked to speak to does not promote reflection. Call the hospital chaplain who also had a mastectomy to meet with the patient. Bringing in the hospital chaplain without the request of the patient, regardless of the chaplain's health history, does not promote reflection. The patient may not be ready or may not want to speak to someone of the clergy. Correct Be physically present and actively listen when the patient is talking. Being physically present and actively listening when the patient is speaking encourages the patient to open up with her feelings and emotions.
Which statements comply with The Joint Commission's (TJC) requirements to incorporate spiritual health into patient care? Select all that apply. Do you belong to a faith community? How often do you attend religious gatherings? Do you require a special diet because of spiritual beliefs? Do you and your spouse share the same spiritual beliefs? Do you have family members that you are close to and that live nearby?
Do you belong to a faith community? Addressing the patient's preferred faith practice is important in TJC's requirements for a spiritual assessment. Do you require a special diet because of spiritual beliefs? Addressing any nutritional needs related to spiritual beliefs is important in TJC's requirements for a spiritual assessment. Do you have family members that you are close to and that live nearby? Addressing the patient's sense of community is important in TJC's requirements for a spiritual assessment. Wrong How often do you attend religious gatherings? How often a patient attends a religious service is irrelevant to the patient's care and is not part of a spiritual assessment of the patient. Do you and your spouse share the same spiritual beliefs? The spouse's spiritual beliefs are irrelevant to the patient's care and are not part of a spiritual assessment of the patient.
Which concept does the "I" represent in the FICA Assessment Tool? Inclusion of family in medical decision making Integration in a community Importance of faith Inspiration and hope
Importance of faith In the FICA assessment tool, the "I" prompts the health care provider to ask the patient about the importance of faith in his or her life. Wrong Inclusion of family in medical decision making In the FICA assessment tool, the "I" prompts the health care provider to ask the patient about the importance of faith in his or her life. The "C" in the assessment tool addresses community involvement, which would include the family's participation in medical decisions. Integration in a community In the FICA assessment tool, the "I" prompts the health care provider to ask the patient about the importance of faith in his or her life. The "C" in the assessment tool addresses community involvement. Inspiration and hope In the FICA assessment tool, the "I" prompts the health care provider to ask the patient about the importance of faith in his or her life. The "F" in the FICA assessment tool addresses where the patient receives inspiration and hope by asking about faith and beliefs.
Which activities would be recommended for nurses who wish to explore their own spirituality more thoroughly? Select all that apply. Journaling specific beliefs and thoughts Questioning why someone believes the way they do Learning from others with different beliefs Identifying which spiritual beliefs are most important Attending a spiritual service different from one's own
Journaling specific beliefs and thoughts Journaling specific thoughts and beliefs is a great way to identify one's own spiritual beliefs. Learning from others with different beliefs Learning about other spiritual and religious beliefs helps nurses to explore their own spirituality. Identifying which spiritual beliefs are most important Identifying which spiritual beliefs are most important helps nurses explore their own spirituality. Attending a spiritual service different from one's own Attending a spiritual service different from one's own is a way to learn about others' beliefs and explore one's own spirituality. Wrong Questioning why someone believes the way they do Questioning someone's beliefs may be seen as intrusive. It is better to ask to learn from someone else, not question their beliefs.
A patient is a Jehovah's Witness and does not want a blood transfusion, but her health care provider has indicated that her life is at risk without it. According to the ICNP nursing analysis during times of spiritual distress, the nurse would expect to provide support to the patient for which need? Moral Distress Spiritual Distress Decisional Conflict Hopelessness
Moral Distress Moral Distress occurs when a conflict exists between medical treatment and religious beliefs. Wrong Spiritual Distress Spiritual Distress occurs when a patient questions his or her belief in a higher being. Confusion about having a blood transfusion because it goes against one's religious beliefs is an example of Moral Distress. Decisional Conflict Decisional Conflict occurs when one questions their personal beliefs while making decisions. Confusion about having a blood transfusion because it goes against one's religious beliefs is an example of Moral Distress, not Decisional Conflict. Hopelessness Hopelessness occurs when an individual sees limited or no alternatives or personal choices available and feels as if life will never get better. Confusion about having a blood transfusion because it goes against one's religious beliefs is an example of Moral Distress, not Hopelessness.
A patient who has battled lung cancer for 5 years states that he has not prayed since the diagnosis because he did not believe it would help. He now wants to start praying and going to church. Which spiritual goal would be appropriate for this patient? Patient will attend church every Sunday for the next 6 weeks. Patient will speak to a spiritual counselor within 1 week of discharge. Patient will consult with family members about his desire to start attending church. Patient will start praying this afternoon.
Patient will attend church every Sunday for the next 6 weeks. A spiritual plan of care should include realistic and patient-centered goals and desired outcomes. Attending church every Sunday for the next 6 weeks may be an overwhelming goal to achieve. Patient will consult with family members about his desire to start attending church. Consulting with family members is not an appropriate goal, as praying and attending church is a personal decision, and the opinions of the family are not important. Patient will start praying this afternoon. A spiritual plan of care should include realistic and patient-centered goals and desired outcomes. Beginning to pray that very day may be an overwhelming goal to achieve. Correct Patient will speak to a spiritual counselor within 1 week of discharge. A spiritual plan of care should include realistic and patient-centered goals and desired outcomes. Often, short-term goals are required to help the patient achieve desired long-term goals of spiritual health.
Which spirituality-related outcome written by a student nurse suggests the need for additional learning? After consulting with the dietician, the patient will identify acceptable ways to blend dietary restrictions with religious customs. Patient will discuss treatment choices with a trusted confidant to explore acceptable options before beginning treatment. Patient will contact a spiritual counselor within 2 weeks of discharge. Patient will start attending church every Sunday immediately after discharge.
Patient will start attending church every Sunday immediately after discharge. This outcome is difficult to achieve and does not start with a shorter-term goal first. The student nurse should receive additional training to understand short-term and long-term achievable goals. Wrong After consulting with the dietician, the patient will identify acceptable ways to blend dietary restrictions with religious customs. This is an achievable and realistic outcome for a patient with cultural beliefs that differ from dietary restrictions for medical purposes. Patient will discuss treatment choices with a trusted confidant to explore acceptable options before beginning treatment. A patient discussing treatment choices with someone he or she trusts is a reachable, realistic, and attainable outcome. Patient will contact a spiritual counselor within 2 weeks of discharge. Contacting a spiritual counselor within 2 weeks of discharge is realistic and achievable.
Which statements are true about religion? Select all that apply. Religion usually follows specific rituals or rules. Religion is linked to a defined system of worship or faith-based organization. Spirituality is viewed the same regardless of one's identified religion. Religious beliefs can affect medical decisions. People from the same religion all follow the same beliefs.
Religion usually follows specific rituals or rules. Religion is an organized system of beliefs, practices, rituals, and symbols. Organized religions often celebrate life events such as marriages, births, and deaths with specific ritualistic celebrations. Religion is linked to a defined system of worship or faith-based organization. Religion has an organized system of rules, beliefs, and values that are followed by the majority of the followers of the religion. It is a defined system of worship or faith-based organization. Religious beliefs can affect medical decisions. Religious beliefs can also affect medical decisions, so it is important for the nurse to ask specific questions rather than make assumptions based on common knowledge of a religion. For instance, the nurse would clarify with a parent who is a Jehovah's Witness as to whether she would allow her child to have a blood transfusion if it was medically recommended but not a lifesaving necessity. Wrong Spirituality is viewed the same regardless of one's identified religion. People from different religions view spirituality differently. During times of stress or difficulty, a Christian will pray to God for guidance or support, whereas a Buddhist believes that a person is responsible for whatever consequences are occurring in life. People from the same religion all follow the same beliefs. Religious rituals and beliefs can vary among the same religion. It is important not to make assumptions of a patient based on your knowledge of their religious preference.
The nurse is caring for a patient recently diagnosed with stage 4 breast cancer. The nurse is amazed because the patient always has a smile on her face, frequently talks about her future goals, and often states "I know God has a plan for me." Which characteristics of spirituality is the patient showing based on these behaviors? Select all that apply. Connectedness Self-transcendence Inner strength Faith and hope Meaning/purpose in life
Self-transcendence Self-transcendence is connecting to your inner self so you can feel a connectedness to others around you. The patient's behaviors reflect faith and hope, connectedness, meaning/purpose in life, and inner strength to a higher being. The patient's behaviors do not reflect self-transcendence. Correct Connectedness Connectedness includes being connected to oneself, to others, and to a higher power. This allows a person to find hope and peace during times of increased stress. The patient's behaviors reflect faith and hope, connectedness, and inner strength to a higher being, which provides calm, positive emotions and a positive outlook on life during times of great distress. Inner strength Inner strength is an energy source that inspires motivation and encouragement. Faith and hope The patient's behaviors reflect faith and hope, connectedness, and inner strength to a higher being, which provides calm, positive emotions and a positive outlook on life during times of great distress. Meaning/purpose in life With spirituality, a purpose in life can be identified during times of positive and negative life events.
For which reasons is it important to encourage the practice of spirituality when caring for patients, regardless of whether the patient follows an organized religious community? Select all that apply. Spirituality has been shown to improve treatment adherence. Spirituality has been shown to have a positive impact on health and well-being. A strong sense of spirituality can help lower anxiety levels. Spiritual people have a greater tendency to find joy in life. Spiritual people believe in God, which provides hope.
Spiritual people believe in God, which provides hope. Spirituality is about meaning and purpose, life and love, hope and faith, and may or may not include a faith or belief in a god or other deity. Correct Spirituality has been shown to improve treatment adherence. Evidence shows that higher levels of spiritual health can increase compliance with treatment regimens, leading to better health outcomes. Spirituality has been shown to have a positive impact on health and well-being. Evidence shows that higher levels of spiritual health can increase compliance with treatment regimens, lower mortality rates, and increase quality of life. A strong sense of spirituality can help lower anxiety levels. Evidence shows that higher levels of spiritual health can decrease pain levels and lower anxiety. Spiritual people have a greater tendency to find joy in life. A spiritually healthy person has a greater tendency to find joy in life, offer forgiveness to others, find forgiveness for oneself, and experience an overall enhanced quality of life.
The nurse is caring for a newly diagnosed paraplegic patient after a car accident. The patient is angry, withdrawn, and not sleeping well. Which spiritual concept might the patient be experiencing? Spiritual distress Spiritual sensitivity Spiritual regret Spiritual adversity
Spiritual sensitivity Spiritual sensitivity is recognizing and responding to the spiritual needs of another person. It is not reflected by anger, withdrawn behavior, or insomnia. Spiritual regret Spiritual distress, not spiritual regret, can occur during times of impaired health or when learning of a life-changing health diagnosis and may be expressed as pain, insomnia, anger, depression, stoicism, or sadness. Regret would be clinging to memories or actions that one wishes he or she could change. Spiritual adversity Spiritual distress, not spiritual adversity, can occur during times of impaired health or when learning of a life-changing health diagnosis and may be expressed as pain, insomnia, anger, depression, stoicism, or sadness. Adversity can be a stepping stone in spiritual growth, but spiritual adversity is not a real term. Correct Spiritual distress Spiritual distress can occur during times of impaired health or when learning of a life-changing health diagnosis and may be expressed as pain, insomnia, anger, depression, stoicism, or sadness.
Which statements align with the concept of spirituality? Select all that apply. Spirituality is synonymous with religion. Spirituality is defined by belonging to an organized religion. Spirituality is the expression of meaning and purpose in life. Spirituality exists regardless of religious beliefs. Spirituality is a personal experience.
Spirituality is the expression of meaning and purpose in life. Spirituality is the expression of meaning and purpose in life. It can give people hope when facing a difficult time in their lives. Spirituality exists regardless of religious beliefs. Spirituality exists in everyone, regardless of their religious beliefs, and is a highly personal individual experience. Spirituality is a personal experience. Spirituality is a highly personal individual experience and can evolve and change over a person's lifetime. Wrong Spirituality is synonymous with religion. Spirituality is not synonymous with religion. Spirituality exists in everyone, regardless of their religious beliefs, and is a highly personal individual experience. Spirituality is defined by belonging to an organized religion. A person can be spiritual and not associate with a specific religion. Spirituality does not have to align with an organized religion.
The nurse is caring for a patient who is refusing an important medical treatment because of personal religious beliefs. Which action is best for the nurse to take? Talk to the patient's family about the importance of accepting the treatment. Respect the patient's right to refuse the treatment, and notify the prescribing health care provider. Explain again the risks associated with refusal of treatment. Talk to the patient about the need to incorporate the patient's beliefs into his or her care.
Talk to the patient's family about the importance of accepting the treatment. Involving the family may be appropriate for some cultures and religions but would not be the best choice for this patient because the nurse does not know which religion or culture the patient follows. Respect the patient's right to refuse the treatment, and notify the prescribing health care provider. The nurse should always respect a patient's right to refuse treatment, but notifying the health care provider without any intervention would not be the best course of action. Explain again the risks associated with refusal of treatment. The nurse has a duty to explain the risks and benefits to all patients, but this would not be the best action by the nurse at this time. Correct Talk to the patient about the need to incorporate the patient's beliefs into his or her care. Health care providers must incorporate the patient's beliefs into his or her treatment because this increases the likelihood that the patient will fully participate with the treatment.
Which actions by the nurse would be considered spiritual care interventions? Select all that apply. Encouraging the patient to practice deep breathing exercises Telling the patient that prayer helps and you want to pray with him or her Bringing a bible for the patient to read and learn about Jesus Asking if the hospital could provide a specific spiritual provider Encouraging therapeutic touch sessions such as massage
Telling the patient that prayer helps and you want to pray with him or her Telling the patient that you want to pray with him or her could be imposing your religious beliefs and would not be a spiritual care intervention. Offering to pray with the patient would be acceptable as long as the patient is receptive. Bringing a bible for the patient to read and learn about Jesus Bringing a bible for a patient to read and learn about Jesus could be imposing your religious beliefs and would not be a spiritual care intervention. The nurse should not make assumptions about another's spiritual beliefs. Correct Encouraging the patient to practice deep breathing exercises Encouraging deep breathing exercises would be an alternative medicine technique and would be considered a spiritual care intervention. Asking if the hospital could provide a specific spiritual provider Asking if the hospital could provide a specific spiritual provider such as a rabbi or imam would be considered a spiritual care intervention. Encouraging therapeutic touch sessions such as massage Encouraging therapeutic touch sessions such as massage would be an alternative medicine technique and would be considered a spiritual care intervention.
The nurse is providing care for a patient with a new breast cancer diagnosis. Which question by the nurse represents the spiritual connection practice of reflection? This is a tough thing to hear. Do you know anyone who has had breast cancer? Have you told your children yet? What are your thoughts about this new diagnosis? Have you decided whether you are going to have mastectomy?
What are your thoughts about this new diagnosis? Reflection is another component of spiritual interaction and expression. Discussion and questions initiated by the nurse may explore and search for meaningful aspects of a health care crisis and the subsequent effects on family and loved ones. Wrong This is a tough thing to hear. Do you know anyone who has had breast cancer? Yes and no questions do not promote the spiritual connection practice of reflection. Also, it is not beneficial to find out if the patient knows anyone who has been diagnosed with breast cancer. Have you told your children yet? It is important to reflect on how the new diagnosis will affect the patient's family, but yes and no questions do not promote the spiritual connection practice of reflection. Have you decided whether you are going to have mastectomy? Yes and no questions do not promote the spiritual connection practice of reflection. In addition, it may not be appropriate to ask about treatment-related decisions when a patient has just received a new diagnosis.
Which activities would most likely be considered a way to practice spirituality? Select all that apply. Prayer Meditation Reflection Working Yoga
Working Spiritual practices can usually be divided into one of three categories: connecting with oneself, connecting with others, or connecting with a higher being. Working would not fall into any of the three categories associated with the practice of spirituality. Correct Prayer Spiritual practices can usually be divided into one of three categories: connecting with oneself, connecting with others, or connecting with a higher being. Spirituality involves connecting with a higher being or power and may be illustrated by prayer. Meditation Mediation would be considered connecting with oneself to promote spirituality. Reflection Self-reflection would be considered connecting with oneself to promote spirituality. Yoga Yoga would be considered connecting with oneself to promote spirituality.
