Nclex/ end of chapter questions: Spirituality chpt 41
An 88-year-old woman has just been admitted to the SNF. She tells the nurse she has been a Sunday school teacher for many church projects. what nursing DX is appropriate? 1. potential for spiritual disruption 2. potential for religious struggle 3. spiritual health enhancement 4. religious struggle
2
The mother of a pediatric client states," I can't understand why god would allow this to happen to my innocent child !" what nursing SX is most accurate? 1. spiritual disruption related to search for meaning of Childs illness 2. religious struggle r/t anger at god 3. impaired coping r/t anger 4. potential for spiritual disruption r/t threatened sense of hope
1
When planning care for an older client in a skilled nursing facility who is searching to make life meaningful, which nursing action is most beneficial? 1. assess for depression 2. diagnose and document that the client has "spiritual disruption" 3. keep the client busy with social activities 4. explore with the client desired legacy
4
Research evidence that supports providing spiritual care to older adults suggest that? 1. older adults are not very religious, but are very spiritual 2. older adults who are more religious have more illnesses 3. spiritual and mental health are correlated 4. increased spiritual well being is found among older adults with depression
3
a client in the emergency department needs a blood transfusion of RBC's. He is a Jehovah witness and they are not permitted. what statement may lead to resolution for this conflict? 1. you must accept it or else leave 2. don't worry, you'll be forgiven 3. may I please call a representative of your religion so that I can understand your position better 4. I understand your decision; I'll be here with you as you die
3
a client is experiencing severe pain that can't be controlled by analgesics. an appropriate intervention is full presencing, which involves what? 1. physical presence 2. physical presence with mental awareness of client 3. physical, mental emotional presence 4. physical, mental, emotional, spiritual presence
3
a client reports ,"Cancer was the best thing that happened to me! it is making me appreciate life so much more. what nursing DX does this statement fit? 1. spiritual disruption 2. potential for spiritual disruption 3. spiritual health enhancement 4. cognitive denial
3
a clients wife asks the nurse to pray with her. what is the best response for the nurse who believes in prayer? 1. may I call the chaplain to come and pray with you? 2. i know your faith is important to you. it is to me too, lets pray 3. I'm happy to do that, for what would you like me to pray? 4. Isn't it wonderful that we have a god with whom we can share our concerns
3
A dying client states, "Part of what makes dying hard is that I don't know for sure where I'm going. Nurse, what do you believe in the hereafter?" which ethical guideline should guide your response? a. never share personal spiritual beliefs b. share all spiritual beliefs, favoring none c. share only your beliefs d. first assess for what prompts the client's question
4
which of the following thoughts made by the nurse illustrate a "wounded healer"? 1. I didn't need that much analgesics when I had abdominal surgery 2. No pain, no gain 3. If clients would chose a more positive attitude, they'd feel better 4. I felt scared when I had surgery; maybe this client feels similarly
4
The nurse is engaging in an activity to develop spiritual self-awareness. What activities can aid the nurse in achieving this goal? (Select all that apply.) 1. Write a will. 2. Complete an advance directives form. 3. Explore personal end-of-life issues. 4. Create a personal loss history. 5. List significant values.
answer: 3, 4, 5
) The 70-year-old client with terminal lung cancer tells the nurse, "I am dying because I sinned by smoking cigarettes." What is the nurse's best response to this dying client? 1. "You are correct, but it is too late to do anything about it now." 2. "When you started smoking cigarettes we didn't know about the problems they cause. It is not your fault." 3. "Why don't we call the hospital chaplain and you can pray about your sins." 4. "Smoking cigarettes isn't a sin. There are many worse habits you could have."
answer: 2
A client says that a treatment plan is against religious beliefs. Which nursing diagnosis problem statement should the nurse identify as appropriate for this client? 1. Ineffective Coping 2. Decisional Conflict 3. Impaired Religiosity 4. Anxiety
answer : 2
A client who is devoutly Jewish is hospitalized during Yom Kippur and wants to fast. How should the nurse respond to this wish? 1. Support the client's desires to the extent possible. 2. Remind the client that most religions excuse persons who are ill from fasting. 3. Attempt to convince the client to ignore the tradition due to illness. 4. Tell the client that the physician must make this decision.
answer: 1
The nurse assesses that a client is experiencing spiritual distress. What should be the nurse's primary intervention? 1. Establish a trusting nurse-client relationship. 2. Have the client describe the basic problem. 3. Ask the client what religion is practiced in the home. 4. Identify the client's belief in a Supreme Being.
answer: 1
The nurse determines that a middle-aged client has developed spiritually. What client statement caused the nurse to come to this conclusion? 1. "I listen to and learn from others who talk about beliefs in God or a Supreme Being." 2. "The tales in the Bible are real to me." 3. "I attend service with my friends on most Sundays." 4. "I attend the same church as my parents and follow the customs of my culture."
answer: 1
The nurse has identified that many of the clients in the long-term care facility have spiritual concerns and distress. What is the nurse's first step in becoming a competent provider for these clients? 1. The nurse must possess a healthy spiritual self-awareness. 2. The nurse must learn about diverse spiritual beliefs and practices. 3. The nurse should start going to church more often. 4. The nurse should establish regular religious services in the facility.
answer: 1
The nurse is determining whether interventions to address the diagnosis of Spiritual Distress for a client newly diagnosed with a chronic illness have been effective. What outcome would indicate that interventions have been effective for this client? 1. The client has talked with the church priest twice during the hospitalization. 2. The client states that there is nothing that can be done spiritually to improve her current outlook on life. 3. The client plans to make an appointment with a psychologist after discharge. 4. The client thanks the nurse for trying to help improve her feelings. Answer: 1
answer: 1
The nurse is planning to conduct a spiritual self-assessment. What questions would the nurse include in this assessment? (Select all that apply.) 1. "What makes me joyful?" 2. "What causes me to feel despair?" 3. "What possessions do I value the most?" 4. "What is my purpose in life?" 5. "What feeds my spirit?"
answer: 1, 2, 4, 5
The nurse is concerned that the spouse of a recently deceased client is experiencing spiritual distress. What did the nurse observe to come to this clinical decision? (Select all that apply.) 1. Expressing anger toward God 2. Crying softly in the client's room 3. Hugging family members 4. Talking with caregivers about the client's personal items 5. Refusing comfort from family
answer: 1, 5
) The emergency department nurse contacts the admissions office to request a bed for a bed-bound client who is a practicing Muslim. In acting as an advocate for the client, what request should the nurse make of the admission clerk? 1. Please try to find a private room. 2. A bed that faces east will be best. 3. Have the bed stripped, as the client will provide special sheets. 4. If the only available room is semi-private, the other client should be Muslim.
answer: 2
) The nurse is caring for a 5-year-old child. How can the nurse best support the spiritual development of this client? 1. Ask the child who God is. 2. Listen to the child's routine bedtime prayer. 3. Encourage the child to pray before each meal. 4. Bring a Bible storybook in to read to the child at bedtime.
answer: 2
As a part of care planning, the nurse considers the client's spiritual needs. What is the rationale for this concern? 1. Nurses are the only health professionals who provide this type of holistic care. 2. Meeting the client's spiritual needs can decrease suffering. 3. Until spiritual needs are met, physical needs cannot be healed. 4. It is important that the nurse's idea of spirituality matches the client's ideas.
answer: 2
During labor, it becomes apparent that the male infant will survive only a short time after birth. Because this baby's parents are Catholic, what planning should the nurse consider? 1. Arrange to have the baby circumcised immediately after birth. 2. Ask the hospital chaplain to be present in the delivery room. 3. Ask the nursing supervisor to find a Catholic nurse to attend the birth. 4. Consider emergency transport of the mother to a Catholic hospital.
answer: 2
The family of a dying client has informed the nurse that their religion requires that a ritual bath be given after death by members of the faith. In which way should the nurse respond to this request? 1. Notify the mortuary of the family's request. 2. Arrange for supplies and privacy for the family. 3. Tell the family that the bath will have to take place after the body is removed from the hospital. 4. Allow the family to give the bath but give a 1-hour deadline for completion.
answer: 2
The nurse caring for wheelchair-dependent residents of a long-term care environment has developed a care plan that includes taking the clients outside and assisting them in planting and maintaining a garden. What is the best rationale for this plan? 1. Accreditation agencies require that the residents have regular outings. 2. Keeping in touch with nature is a form of spiritual care. 3. Fresh vegetables from the garden are good sources of nutritional fiber. 4. Sunshine helps activate vitamin D.
answer: 2
The nurse is caring for an older client with end-stage renal disease. What actions should the nurse take to support this client's spiritual development? (Select all that apply.) 1. Support the client to have hope for a cure. 2. Suggest the client view losses as liberations. 3. Encourage the client to reminisce about life events. 4. Ask open-ended questions about the client's life purpose. 5. Remind the client that time is running out to make any life changes.
answer: 2, 3, 4
) During assessment, the client says that it has been "a long time" since she has thought very much about religion. The nurse caring for this client has a strong belief in God and the healing power of prayer. What action should be taken by the nurse? 1. Mention the nurse's belief and offer to pray with the client for forgiveness. 2. Tell the client that the nurse will pray for her often. 3. Ask the client if there are any spiritual needs with which the staff can assist. 4. Refer the client for spiritual counseling.
answer: 3
A client who needs multiple units of blood belongs to a religion where blood transfusions are prohibited. What action should the nurse take? 1. Use rapport to influence the client to accept the blood transfusions. 2. Explain the scientific reasons that blood transfusions are necessary and why refusal is dangerous. 3. Encourage the client, the physician, and the client's spiritual adviser to discuss this conflict and any possible alternative therapies. 4. Suggest to the client that as the illness progresses, the blood will probably be transfused despite religious objections.
answer: 3
During the morning bath, the client asks if the nurse is religious and believes in God. What would be most helpful for the nurse to consider in formulating a response to this question? 1. The nurse's personal life is none of the client's business. 2. Religion and politics are two subjects not discussed in polite interactions. 3. Will sharing this information positively contribute to the relationship? 4. What is the culture of the facility regarding self-disclosure?
answer: 3
The client being prepared for a procedure asks to be allowed to wear a religious medal. The client states, "I have worn this medal and have not removed it since I was a teenager." What action should the nurse take? 1. Tell the client that the medal must be removed, as it is policy to remove all jewelry for these procedures. 2. Tell the client that the medal can be worn. 3. Tell the client that the nurse will explain to the procedure staff about the medal and will request that they allow the client to wear it. 4. Remove the medal and place it on the head of the bed where the client will be able to see it during the procedure.
answer: 3
The nurse and client have spent several minutes praying together that the client's upcoming surgery will be successful. What action should the nurse take at this point? 1. Gently tell the client that the nurse must take care of other duties. 2. Smile and pat the client and silently leave the room. 3. Stay with the client until the emotion evoked by the prayer dissipates. 4. Ask the client if there is anything else the nurse can do.
answer: 3
The nurse has never been particularly religious or spiritual and is unaccustomed to praying but holds no strong feeling against prayer. Which action should the nurse take when asked to pray with a client and family? 1. Try to ensure assignment to clients who are unlikely to request prayer. 2. Arrange to have a coworker substitute for the nurse in these prayer situations. 3. Memorize two or three short, formal prayers to use when prayer is requested. 4. Just stand silently at the bedside and let others in the room do the praying.
answer: 3
The nurse, who believes in God, is caring for a client that does not follow any particular religion. Which question should the nurse consider when responding to the client? 1. "Will I get into trouble if I say anything?" 2. "How much longer will I be caring for this client?" 3. "Am I meeting my needs or the client's?" 4. "How can I best make this client understand?"
answer: 3
A client newly diagnosed with a terminal illness asks to talk with the hospital chaplain and requests a Bible to read. What do these client behaviors indicate to the nurse? 1. The client does not have any family members to discuss spiritual issues. 2. The client is searching for answers. 3. The client wants to talk with someone other than the nurse about spiritual concerns. 4. Interventions for Spiritual Distress have been effective. Answer: 4
answer: 4
A client with diabetes mellitus who develops diabetic ketoacidosis after a religious fast reports fasting every season and has no plans to stop now. Which action should the nurse take? 1. Tell the client that it is different now because of the diabetes. 2. Do some research into the meaning of fasting in this religion. 3. Ask family members of the same religion to discuss fasting with the client. 4. Request a consult from a diabetes educator.
answer: 4
A female client who follows a religious order where clothing is worn that covers the arms and the knees is concerned that the body will be exposed during a scheduled cardiac catheterization. How should the nurse respond to this concern? 1. Tell the client that medical personnel have seen so many people's bodies that they don't even notice any longer. 2. Make a note in the client's chart that she is particularly modest. 3. Explain to the client that in order to perform the study, the body must be exposed. 4. Ask the cath lab charge nurse to come to the client's room to talk about the concerns. Answer: 4
answer: 4
After asking general assessment questions regarding spirituality, the nurse finds the client content and satisfied. How should the nurse conduct the rest of the assessment? 1. Specific questions regarding beliefs should be included. 2. The nurse should validate spiritual information with the client's family. 3. The assessment can now move on to physical assessment. 4. No further specific spiritual assessment is currently necessary.
answer: 4
During assessment, the client tells the nurse, "I don't believe that the existence of God has been proven. I don't see the scientific evidence I need to be certain." How should the nurse document this finding? 1. The client demonstrates polytheism. 2. The client is an atheist. 3. The client has beliefs that support monotheism. 4. The client is agnostic.
answer: 4
When arriving to a client's room to provide care, the client is praying with family. What action should the nurse take? 1. Stand quietly just inside the room door until the prayer is completed. 2. Come to the bedside and join in with the prayer. 3. Politely ask the client to allow care to proceed. 4. Quietly shut the door and wait in the hall until asked to enter.
answer: 4
A client who is facing a final life-saving surgery asks the nurse to stay and pray until the surgery begins. In which ways should the nurse demonstrate presencing with this client? (Select all that apply.) 1. Adjusting the intravenous infusion 2. Talking with the client about the surgery 3. Sitting next to the client in the holding area 4. Praying with the client for divine intervention 5. Focusing on the client and fulfilling his needs
answer: 4, 5
