Chapter 46: Spirituality PrepU

Lakukan tugas rumah & ujian kamu dengan baik sekarang menggunakan Quizwiz!

Which question would be appropriate for the F in the FICA spiritual assessment tool? -"Do you use your church family for support? -"How would you like me to address this issue in your health care?" -"Are you actively involved with a church community? -"Do you consider yourself a spiritual person?"

"Do you consider yourself a spiritual person?" "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 client's life. Assessment questions might include asking how often the client 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 a support? "A" is for the practitioner to address these concerns with the client, such as to ask, how would you like me to address these issues in your health care?

The nurse is assessing a 27-year-old Navajo male who is being admitted for surgery. The client requests a visit from the spiritual healer. Which is the best response from the nurse? -"Do you have a preference as to which spiritual leader you would like to visit?" -"I will get a phone number for you so you can call a healer to ask for a visit." -"I will see who is available and ask him or her to come by and visit with you." -"Would you like me to contact the hospital chaplain to come and visit with you?"

"Do you have a preference as to which spiritual leader you would like to visit?" Although many Native Americans and many Southeast Asian groups seek spiritual leadership from a traditional tribal healer, the nurse should not assume that this is true with each client. The other choices would be inappropriate and not provide the best nursing care.

The nurse overhears a client, who is scheduled to begin chemotherapy, tell a family member that everything will eventually be okay and the cancer will be in remission. Which question will the nurse ask to begin a conversation about hope with the client? -"What has the health care provider told you about your treatment?" -"What is the most important thing in your life right now?" -"What provides you with strength to deal with this health situation?" -"What role does a higher power play in your life?"

"What provides you with strength to deal with this health situation?" Hope is demonstrated by a positive outlook. It enables a person to consider a future and to work to actively bring that future into being. Asking the client, "What provides you strength?..." is an open-ended question and allows a conversation to begin about hope. Asking what the health care provider has told the client is seeking information, not initiating a conversation about hope. Asking about the most important thing in the client's life is beginning a discussion about meaning and purpose and not specifically about hope. Asking about the role of a higher power would begin a discussion on faith.

The nurse is caring for a critically ill client who informs the nurse that there is a conflict between the client's spiritual beliefs and a proposed health option. Which question does the nurse ask to begin a conversation about the conflict that the client is experiencing? -"What, specifically, are you asking me to do for you?" -"Would you like to talk to someone to help you make an informed decision?" -"Do you want to refuse the proposed health care option?" -"Shall I call the health care provider for you to discuss the conflict?"

"Would you like to talk to someone to help you make an informed decision?" The nurse's role in resolving conflicts between spiritual beliefs and treatments is to assist the client in obtaining the information needed to make an informed decision and to support the client's decision making. The client may not know specifically what to ask of the nurse and the client needs assistance in making an informed decision. The nurse is instrumental in advocating for the client's needs. The health care provider is not usually involved as a client advocate. Asking if the client wishes to refuse the treatment option does not provide the client with information to make an informed decision.

The nurse receives a "do not resuscitate" (DNR) order for a dying client. What should the nurse do next? -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 -Inform the client that a priest will be in to see her very soon.

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 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? -Perform a detailed spiritual assessment of the client. -Organize a meeting between the chaplain, the son, and the client to achieve a resolution. -Contact the chaplain to arrange a visit with the client. -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 dying male client who practices Islam. What is the most appropriate action for the nurse after the client's death? -Ensure that no one is in the room when the client dies. -Place the body on the floor to facilitate the soul's journey. -Ensure that someone performs the anointing of the sick sacrament prior to the client's death. -Ensure that a male washes the client's body.

Ensure that a male washes the client's body. 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 a variety of other rituals are performed. Hinduism beliefs include placing the body on the floor to facilitate the soul's journey. The anointing of the sick sacrament is part of the Roman Catholic faith.

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 -Religion -Love

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.

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? -Judaism -Christianity -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, beef is forbidden and other meats must meet ritual requirements.

The nurse is taking care of a client who is scheduled for a mastectomy. The client tells the nurse that the client is apprehensive about the operation and asks the nurse to read a passage from the Koran to help prepare the client for surgery. Which action by the nurse is the most appropriate? -Ask the client whether it would be okay to call a minister to pray with client. -Read the Koran passage to the client. -Gently inform the client that nurses cannot practice religion with clients. -Attempt to find someone on staff who is the same religion as the client.

Read the Koran passage to the client. According to Maslow's hierarchy, self-actualization is a need related to the spiritual and intellectual dimension of a client. Reading a religious passage to a client is not practicing a religion, and asking to call a minister or another staff member to address this spiritual need is deferring the client's needs to someone else.

While studying religion and spirituality, the nursing student exhibits an understanding of the concepts when making which of the following statements? -Spirituality is a recently developed alternative to traditional religious belief. -Religion is a collection of spiritual beliefs and practices. -Religion and spirituality are synonymous. -Spirituality is the behavioral manifestation of religious beliefs.

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 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 loss -Spiritual guilt -Spiritual alienation -Spiritual anger

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.

The nurse enters a client's room as the client and family are praying. Which is the most appropriate action of the nurse? -Walk up to the client's bedside and stand quietly. -Step outside the door until the prayer is finished. -Stand quietly by the inside the room until the prayer is finished. -Walk up to the client's bedside and join in the prayer.

Step outside the door until the prayer is finished. By stepping outside the door, the family and client will not be rushed to finish the prayer. Stepping up to the bedside may distract the client and or family.

A new nurse observes a priest visiting the clients every Saturday afternoon and praying with them. This activity supports which of the nursing outcomes? -The client uses a type of spiritual experience that provides comfort. -The client will experience alternate venues of spiritual expression. -The client expresses satisfaction with life. -The client expresses hope and sense of meaning.

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.

Mr. V. is recovering from pneumonia. The nurse understands that a well-balanced diet will help him to recover. However, Mr. V. informs the nurse that it is Ramadan and he must fast from sunrise to sunset. What is the nurse's most appropriate nursing action? -Encourage Mr. V. to speak with a religious leader to grant a medical exception. -Tell Mr. V. he must eat to maintain his health. -Provide liquid nutrition only as this does not interfere with religious practice. -Work with the nutrition staff to provide nutritious meals at off hours.

Work with the nutrition staff to provide nutritious meals at off hours. The most appropriate action is to work with Mr. V to maintain practice that is important to him. If Mr. V decided to suspend religious practice for medical reasons, it would be appropriate to support this decision. Asking to speak with a religious leader to grant a medical exception disregards Mr. V's religious practice. Liquid nutrition may interfere with the fasting rules. Telling Mr. V to eat despite his religious convictions is inappropriate and not empathetic.

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

agnostic. Beliefs may range from atheism (denial of God's existence) to agnosticism (belief that God's reality is unknown and unknowable) to theism (belief that God's reality is personal, without a body, perfect in all things, and creator and sustainer of the universe).

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

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.

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. -faith. -forgiveness. -love and relatedness.

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.

A nurse is assisting a terminally ill female client with bathing. The client tells the nurse that she has great respect and faith in a particular spiritual leader. The nurse interprets this information as fulfilling which need for the client? -living a longer life -power to perform miracles -sense of security for present and future -financial strength and support

sense of security for present and future Whatever the spiritual or religious beliefs the person holds and practices, these beliefs contribute to a sense of security for the present and future; give meaning to life, illness, other crises, and death; guide daily living habits; drive acceptance or rejection of other people; furnish psychosocial support within a group of like-minded people; provide strength in meeting life's crises; and give healing strength and support. However, spiritual beliefs do not guarantee that a person gains financial power and strength, the power to perform miracles, or the ability to live longer.

Which client statement most clearly suggests the potential of a nursing diagnosis of Spiritual Anxiety? -"I've never been a religious man, and all these Catholic crosses and pictures in the hospital make me a bit uncomfortable." -"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." -"I always tried to do the right thing, so I don't understand why I have to suffer so much now."

"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.

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? -"Spiritual beliefs and practices do not give strength when a person is in crisis." -"Spiritual beliefs and practices give healing strength and support." -"Spiritual beliefs can help give a person meaning in their life." -"A person's daily living habits can be guided by their spiritual beliefs.

"Spiritual beliefs and practices do not give strength when a person is in crisis." Spiritual beliefs and habits can give meaning to life, illness, other crises, and death; can contribute a sense of security for present and future; can guide daily living habits; can provide strength in meeting life's crises; and can give healing strength and support.

Upon assessment, the client reports not belonging to an organized religion. Which assessment question would the nurse ask to assess the client's spirituality? -"Can I set up an appointment for you with our hospital chaplain?" -"Why do you not belong to an organized religion?" -"Tell me about spiritual or religious beliefs that are important to you." -"Do you think of yourself as a religious person?"

"Tell me about spiritual or religious beliefs that are important to you." The nurse should not interpret the fact that a client does not belong to an organized religion to mean that the client has no spiritual needs. A person may be highly spiritual yet not profess a religion. The nurse should invite the client to tell the nurse about spiritual or religious beliefs that are important to the client. "Why" questions are not therapeutic. The reason why the client does not belong to an organized religion will not provide the nurse with information about the client's spirituality. Asking an open-ended question rather than the close-ended "Do you think of yourself as a religious person?" will provide more information about the client's spirituality. The client may seek spiritual counseling or ask to see the hospital chaplain during the hospitalization related to spiritual needs, but this is not the best way for the nurse to assess the client's spirituality.

A nursing instructor, after teaching about the importance of spirituality, identifies a need for further teaching when overhearing a student make which of the following statements? -"You can provide quality nursing care to clients even though you ignore the spiritual dimension of health." -"You can help clients meet spiritual needs by assisting in their struggle to find meaning in suffering." -"Nurses can meet spiritual needs by offering a compassionate presence." -"Nurses can better assist clients by meeting their spiritual needs."

"You can provide quality nursing care to clients even though you ignore the spiritual dimension of health." It is impossible to provide quality nursing care to clients while ignoring the spiritual dimensions of health. Nurses can assist clients to meet spiritual needs by offering a compassionate presence; assisting in the struggle to find meaning and purpose in the face of suffering, illness, and death; and fostering relationships with a higher being that nurture their spirit.

When conducting a spiritual assessment, the nurse must be sensitive to the client's personal beliefs. Which questions should the nurse ask? Select all that apply. -"Do you feel your faith is helpful to you?" -"Why do you still not believe in God?" -"Is religion or God significant to you?" -"Why can't you share your feelings with me? I am your nurse." -"Is there anyone from your church you would like to talk to?"

-"Is religion or God significant to you?" -"Do you feel your faith is helpful to you?" -"Is there anyone from your church you would like to talk to?" Several nurses have developed spiritual assessment tools. Stoll's (1979) Guidelines for Spiritual Assessment is an early widely recognized spiritual assessment tool. This tool is built around a definition of spirituality that encompasses religion and belief in a higher power. It identifies four areas and suggests questions for each: (a) concept of God or deity, (b) source of hope and strength, (c) religious practices and rituals, and (d) relationship between spiritual beliefs and state of health. "Is religion or God significant to you?" is a question asking about the concept of God or deity. "Do you feel your faith is helpful to you?" focuses on the relationship between spiritual beliefs and state of health. "Is there anyone from your church you would like to talk to?" asks about their source of hope and strength. Asking the client why they do not believe in God and why they will not share their belief are questions focusing on belittling and degrading the client.

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 room of unnecessary items. -Keep the bed curtains open so as to allow others to join in prayer -Have a chair available near the bed. -Complete your work so you may join them. -Clear the bedside table; cover with clean towel.

-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.

According to Shelly and Fish (1988), which of the following are spiritual needs underlying all religious traditions that are common to all people? Select all that apply. -Love and relatedness -Power -Meaning and purpose -Formal religion -Forgiveness

-Meaning and purpose -Love and relatedness -Forgiveness According to Shelly and Fish (1988), there are three spiritual needs underlying all religious traditions and common to all people: need for meaning and purpose, need for love and relatedness, and need for forgiveness.

An older adult client who identifies 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. The client is quite upset by this restriction and states, "Going to daily mass was my life." Which action would the nurse take to address the client's spiritual distress? -Describe to the client how the nurse only goes to church on Sundays. -Tell the client about the other activities available at the facility. -Explain to the client that a local church group conducts a service at the facility on Wednesday nights. -Actively listen to the client to explore the client's feelings.

Actively listen to the client to explore the client's feelings. Spiritual distress involves the inability to integrate meaning and purpose in life. The client is in distress over not being able to attend daily mass. The nurse would actively listen to the client with empathy to further explore the client's feelings. Explaining about other facility activities and informing the client that a local church group conducts a service once a week will not relieve the client's distress. The nurse should not interject the nurse's personal feelings into the client's situation.

The nurse is caring for a Roman catholic client who is dying. What would be an appropriate action for the nurse? -Contact a local priest to provide special care to the body after death. -Ensure that a person of the same sex as the deceased clean the body. -Contact a local priest to complete the anointing of the sick ritual. -After death, place the client's body on the floor to facilitate the soul's journey.

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

The nurse is caring for a 55-year-old client admitted to the hospital for liver failure. The client states being an active member of The Church of Jesus Christ of Latter-day Saints. The client tells the nurse about strictly adhering to the religious practices that are condoned by the Church. However, the nurse overhears two health care providers discussing that the client's liver failure is likely due to chronic alcohol use. The nurse suspects that the health care providers are incorrect. Which nursing nursing action is appropriate? -Know that the health care providers are incorrect; the restored gospel of Jesus Christ does not permit alcohol use. -Accuse the client of lying and find out why the client lied. -Order several laboratory tests looking for genetic defects that affect the liver. -Engage the client in a discussion about past and present religious practices.

Engage the client in a discussion about past and present religious practices. A client's current religious practice is not necessarily indicative of lifelong practices. The nurse should talk with the client about lifelong religious practice. As a result, useful information may be uncovered that will help to guide the plan of care.

A nurse is caring for a client with terminal illness who believes that death and reincarnation are the ultimate gifts from a higher power. What would be most appropriate to integrate into this client's plan of care when providing spiritual support? -Provide support that builds on the client's faith. -Only provide foods that are halal. -Document "no blood or blood products due to religious beliefs" on the care plan. -Consult the pastoral care department to assist the client.

Provide support that builds on the client's faith. The nurse should support and build on the client's faith. Nurses should not attempt to change the faith that a client already possess. Consulting the pastoral care department should only be done upon request of the client. Providing foods that are halal is assuming that the client is of Muslim faith, which is not indicated in the scenario. Documenting "no blood products..." on the client's plan of care is assuming the client is of the Jehovah's Witness faith, but again there is no clear indication of a specific faith identified in the scenario.

A client in a long-term care facility has recently begun to refuse to cooperate with the staff, is having difficulty agreeing with the treatment goals suggested by the nurse, and is showing more stress when the family goes home. What is the best response from the nurse? -Search the client's room for any drugs or other substances -Conduct a focused assessment to eliminate any potential infections -Question the client concerning spiritual concerns -Review the client's medication list for possible side effects

Question the client concerning spiritual concerns Refusing to cooperate with staff, not forming goals and being stressed or worried when separated from loved ones are signs of maladaptive behavior of spiritual needs and should be addressed by the nursing staff. These findings would not suggest an infection is occurring, nor are they signs of an addiction or use of a substance.

An older adult client is spiritual and has a deep faith. The client asks the nurse to say a prayer for the client. 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 the nurse is not comfortable praying out loud. -Read a printed interfaith prayer to the client. -Inform the client that the nurse will try to get another nurse to pray for the client. -Tell the client the nurse is busy at the moment and hope the client will forget the request.

Read a printed interfaith prayer to the client. A nurse unaccustomed to praying aloud or in public may find it helpful to have a printed interfaith prayer readily available. Interfaith prayers are designed for use regardless of the client's faith. The other action are not therapeutic.

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

Roman Catholic Roman Catholics observe fasting and abstinence from meat on certain Holy Days.

A nurse interviews a client and finds that, because of religious beliefs, the client's view on health care does not involve blood transfusions. How can the nurse best handle this client situation? -Record this information in the client's chart. -Praise the client for sticking to religious beliefs. -Explain to the client that there are times when a blood transfusion may be necessary. -Recommend that the client be transferred to another health care facility.

Record this information in the client's chart. Jehovah's Witnesses refuse blood transfusions due to the belief that they violate God's law. The nurse would make sure that this information is recorded in the client's chart. Explaining to the client that there may be times when a blood transfusion is necessary to save the client's life will not change the belief and will cause a loss of trust with the nurse. This belief is not a reason to transfer the client to another health care facility. The nurse should be accepting of the client's beliefs and should not praise or ridicule the client for these beliefs.

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

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

Separation from spiritual ties Separation from spiritual ties occurs when an individual changes location and does not have access to spiritual services, or feels uncomfortable joining a new group. This separation can be temporary or permanent.

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

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

Supportive presence

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? -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. -Tell the client that they are not comfortable praying out loud. -Take the lead from the client by asking, "How would you like us to pray?"

Take the lead from the client by asking, "How would you like us to pray?" Because there are many forms of prayer—quiet reflection, silent communion with God or a higher power, reading or recitation of formal prayers, silent or loud calling on God or a higher power or conversation with God or a higher power, lamentations, or reading a holy book or other religious materials—the nurse can take the lead from the patient by asking, "How would you like us to pray?" Consider the patient's religious background along with the type of prayers that have been meaningful in the past. Ask whether the patient has a particular prayer request. A nurse unaccustomed to praying aloud or in public may find it helpful to have a Bible passage or formal prayer readily available. The prayer may also be a simple expression aloud of the patient's needs and hopes. The other options are not therapeutic.

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

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.

When the client tells the nurse that she believes God's reality is personal, and that God is the creator of all beings, the nurse determines the client is expressing: -deism. -atheism. -theism. -agnosticism.

theism. Theism is the belief that God's reality is personal, without a body, perfect in all things, and creator and sustainer of the universe.


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