Chapter 41-Spirituality

The nurse is planning to conduct a spiritual self-assessment. What questions would the nurse include in this assessment? Standard Text: 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?

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? Standard Text: Select all that apply. 1. Expressing anger toward God 2. Crying softly in the clients room 3. Hugging family members 4. Talking with caregivers about the clients personal items 5. Refusing comfort from family

1,5

The nurse assesses that a client is experiencing spiritual distress. What should be the nurses primary intervention? 1. Establish a trusting nurseclient relationship. 2. Have the client describe the basic problem. 3. Ask the client what religion is practiced in the home. 4. Identify the clients belief in a Supreme Being.

1. Establish a trusting nurseclient relationship.

The nurse determines that a middle-aged client has developed spiritually. What client statement caused the nurse 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.

1. I listen to and learn from others who talk about beliefs in God or a Supreme Being.

A client who is devoutly Jewish is hospitalized during Yom Kippur, a time when many of the Jewish faith fast. The client expresses a desire to follow this religious pattern. How should the nurse respond to this wish? 1. Support the clients 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.

1. Support the clients desires to the extent possible.

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.

1. The client has talked with the church priest twice during the hospitalization.

The nurse has identified that many of the clients in the long-term care facility have spiritual concerns and distress. What is the nurses 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.

1. The nurse must possess a healthy spiritual self-awareness.

The nurse is caring for an older client with end-stage renal disease. What actions should the nurse take to support this clients spiritual development? Standard Text: 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 clients life purpose. 5. Remind the client that time is running out to make any life changes.

2,3,4

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.

2. A bed that faces east will be best.

The family of a dying client has informed the nurse that their religion requires that a ritual bath be given by members of the faith after death. Because the hospital unit is very busy and there is an acute need for every bed, how should the nurse respond to this request? 1. Notify the mortuary of the familys 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.

2. Arrange for supplies and privacy for the family.

During labor, it becomes apparent that the male infant will survive only a short time after birth. Because this babys 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.

2. Ask the hospital chaplain to be present in the delivery room.

The client tells the nurse, I dont know what to do. The treatment plan my physician has suggested is against some of my religious beliefs. What nursing diagnosis problem statement should the nurse identify as appropriate for this client? 1. Ineffective Coping 2. Decisional Conflict 3. Impaired Religiosity 4. Anxiety

2. Decisional Conflict

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.

2. Keeping in touch with nature is a form of spiritual care.

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 childs 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.

2. Listen to the childs routine bedtime prayer.

As a part of care planning, the nurse considers the clients 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 clients spiritual needs can decrease suffering. 3. Until spiritual needs are met, physical needs cannot be healed. 4. It is important that the nurses idea of spirituality matches the clients ideas.

2. Meeting the clients spiritual needs can decrease suffering.

The 70-year-old client with terminal lung cancer tells the nurse, I am dying because I sinned by smoking cigarettes. What is the nurses 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 didnt know about the problems they cause. It is not your fault. 3. Why dont we call the hospital chaplain and you can pray about your sins. 4. Smoking cigarettes isnt a sin. There are many worse habits you could have

2. When you started smoking cigarettes we didnt know about the problems they cause. It is not your fault.

The nurse is engaging in an activity to develop spiritual self-awareness. What activities can aid the nurse in achieving this goal? Standard Text: 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.

3,4,5

The client states, I dont know what all this fuss is about religion. God died years ago. The nurse does believe in God and has a strong inclination to share reasons for that belief with the client. What is the best question for the nurse to consider before responding to the clients remark? 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 clients? 4. How can I best make this client understand?

3. Am I meeting my needs or the clients?

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 nurses 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.

3. Ask the client if there are any spiritual needs with which the staff can assist.

The nurse has developed a strong rapport with a client whose medical care necessitates transfusion of multiple units of blood. The client has a religious objection to this treatment even though it is necessary to sustain life. What action should the nurse take? 1. Use the rapport established 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 clients 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.

3. Encourage the client, the physician, and the clients spiritual adviser to discuss this conflict and any possible alternative therapies.

The newly hired nurse notices that coworkers routinely pray with clients and their families. The nurse has never been particularly religious or spiritual and is unaccustomed to praying, but holds no strong feeling against prayer. What is the best strategy for the nurse to plan for such situations? 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.

3. Memorize two or three short, formal prayers to use when prayer is requested.

The nurse and client have spent several minutes praying together that the clients 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.

3. Stay with the client until the emotion evoked by the prayer dissipates.

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.

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.

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 nurses personal life is none of the clients 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?

3. Will sharing this information positively contribute to the relationship?

A client who is facing a final surgery to save his life asks the nurse to stay and pray with him until the surgery begins. In which ways should the nurse demonstrate presencing with this client? Standard Text: 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

4, 5

The female client belongs to a religious community that requires women to dress conservatively in clothing that covers the arms and the knees. This client expresses concern that her 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 peoples bodies that they dont even notice any longer. 2. Make a note in the clients chart that she is particularly modest. 3. Explain to the client that in order to perform the study, her body must be exposed. 4. Ask the cath lab charge nurse to come to the clients room to talk with her about the concerns.

4. Ask the cath lab charge nurse to come to the clients room to talk with her about the concerns.

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.

4. Interventions for Spiritual Distress have been effective.

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 clients family. 3. The assessment can now move on to physical assessment. 4. No further specific spiritual assessment is currently necessary.

4. No further specific spiritual assessment is currently necessary.

When arriving to a clients 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.

4. Quietly shut the door and wait in the hall until asked to enter.

The client diagnosed with diabetes mellitus develops diabetic ketoacidosis after a religious fast. The client tells the nurse, I have fasted during this season every year since I became an adult. I am not going to stop now. The nurse is not knowledgeable about this particular religion. What is the best action for this nurse? 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.

4. Request a consult from a diabetes educator.

During assessment, the client tells the nurse, I dont believe that the existence of God has been proven. I dont 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.

4. The client is agnostic.