PrepU Ch 43 Spiritual Health

The nurse admits a new client to the unit for elective surgery. What would be the best way for the nurse to facilitate the practice of religion for this client? Choose all that apply.

Arrange for the client's pastor to visit if desired. Attempt to meet religious dietary restrictions. Respect the need for privacy during periods of prayer.

The nurse is differentiating beliefs of atheists from agnostics. Which statement is accurate?

Both are guided by a philosophy of living that does not include a religious faith. Rationale: An atheist is a person who denies the existence of a higher power; an agnostic is one who holds that nothing can be known about the existence of a higher power. Nurses do not offer religious counseling for any reason. Neither belief is life denying.

A nurse determining the effects of religion on the lifestyle of clients considers that which religions prohibit the use of alcohol? Select all that apply.

Christian Science Church of Jesus Christ of Latter-Day Saints American Muslim Mission

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 parental behaviors. Rationale: 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.

A geriatric nurse practitioner is completing a health history for a newly admitted resident of a long-term care facility. Which question will elicit information about the client's spirituality?

"Are you angry at God for allowing you to be here?" Rationale: Because a person's spirituality and religious beliefs have the potential to influence every aspect of being, an assessment of the client's spirituality should be included in each nursing history. Data are gathered about the client's spiritual beliefs and practices and the effect of those practices on everyday living, spiritual distress, and spiritual needs. The nurse should not presume that the client's spirituality includes a role for a priest.

The nurse receives a "do not resuscitate" (DNR) order for a dying client. What should the nurse do next?

Assess the client's spiritual needs. Rationale: 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.

Members of which religious tradition are likely to have the most stringent restrictions and parameters placed on their medical care?

Christian Scientist Rationale: Christian Science places significant restrictions of the use of drugs, medical procedures, therapies, and surgeries. Hindu religious belief begins with the assumption that all living things have a soul, which passes through successive cycles of birth and rebirth. Hinduism includes ideas of karma and rebirth, collective versus individual identity, an emphasis on purity and a preference for sons. Buddism and Protestants have very few if any health care restrictions.

A nursing instructor is preparing a class presentation on spiritual care. What would the instructor include as an essential component? Select all that apply.

Empathy Trust Self-awareness Rationale: Essential elements in implementing spiritual care are commitment to the nurse-client relationship, good communication skills, trust, empathy, self-awareness, and acceptance of a broad definition of spirituality.

Which statement about religion and spirituality is most accurate?

Religion is an organized system of spiritual beliefs and practices. Rationale: 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.

When asked about his religious preference, the client becomes very upset with the nurse. Which response is appropriate for this situation?

"I can see that this question upsets you. Do you have any questions about this?" Rationale: The nurse should assist the client in understanding that his nursing history is a review of the whole human being and that questions will be wide ranging, including spiritual health, physical health, and emotional health. A client who appears angry, anxious, depressed, or defensive when asked spiritual questions may need to hear something like, "I can see from your response that you might not have expected these questions; however, they do let you know that we are interested in how you are experiencing your current situation. Do you have a question or concern in this area?" Telling the client that the nurse is just completing his or her job or telling the client that it is part of the assessment is not appropriate or therapeutic.

A nurse is preparing a presentation for a group of staff nurses about spirituality and the importance of meeting clients' spiritual needs. As part the presentation, the nurse plans to address the major religious groups. Which characteristic would the nurse identify as being common to the major religions? Select all that apply.

Ethical code for right and wrong Involvement of a sacred word or scripture An identity as a group Ideas related to after death Rationale: Each of the major religious groups shares several characteristics, including basis of authority or source of power; a scripture or sacred word; an ethical code that defines right and wrong; a psychology and identity, so that its adherents fit into a group, and the world is defined by the religion; aspirations or expectations; and ideas about what follows death.

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:

Faith Rationale: 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.

Mrs Jones is an 81-year-old client who can no longer live alone safely and is being admitted to a long-term-care facility. She had to leave her elderly cat, Baby, with neighbors. She tells the nurse that her cat was the only family she had and that she misses her. The nurse knows that this is related to which of the following spiritual needs believed to be common to all people?

Need for love and relatedness Rationale: According to Shelly and Fish (1988), the three spiritual needs underlying all religious traditions and common to all people are the need for meaning and purpose, the need for love and relatedness, and the need for forgiveness. The client is experiencing the need for love for her cat. The need for forgiveness is reconciliation for past relationship issues. The need for meaning and purpose is finding connectiveness with jobs or people. Basic needs are something necessary or indispensable such as food, water, and shelter.

A nurse is caring for a hospitalized client. Which intervention can the nurse use to help the client continue normal spiritual practices?

Request dietary consultation for the client's dietary restrictions. Rationale: It is a responsibility of the nurse to help the client in an unfamiliar environment continue normal spiritual practices. One intervention that can facilitate the practice of religion is to attempt to meet the client's dietary restrictions. The nurse should not discuss their own religious preference nor request medication for the client. Telling the client that the spiritual practices can be resumed later is inappropriate.

A client states that his life has meaning and purpose, he feels loved, and has experienced forgiveness in his life. What is the term that describes this state of spirituality?

Spiritual health Rationale: Defined most simply, spiritual health or well-being is the condition that exists when the universal spiritual needs for meaning and purpose, love and belonging, and forgiveness are met. Spiritual beliefs include the relationship to a superior being and are related to an existential perspective on life, death, and the nature of reality. Spiritual alienation is a nursing diagnosis, as evidenced by expressions of loneliness or the feeling that God seems very far away and remote from one's everyday life, verbalization that one has to depend upon one's self in times of trial or need, and/or a negative attitude toward receiving any comfort or help from God. Spiritual bliss comes from being totally connected with self, soul, body, and a higher power.

Which statement by a nurse would nurture spirituality by promoting love and relatedness?

Tell me how you get along with others. Rationale: The nurse can help the client nurture his own spirituality by promoting meaning and purpose, love and relatedness, and forgiveness. To promote love and relatedness, encourage the client to talk about relationships with others and to identify the origin of negative beliefs about people. Reading the bible and sharing about their job are not ways to promoting meaning and purpose for a client. Assuming that the client is angry about their diagnosis is not as appropriate way to discuss a client's spirituality.

A nurse is educating staff members about the importance of meeting the spiritual needs of clients on the unit. What spiritual needs should be met in the delivery of care? Select all that apply.

need for meaning and purpose need for love and relatedness need for forgiveness

A new client is on the hospital unit. He was recently diagnosed with metastatic pancreatic cancer and was told that any treatment would be palliative. He tells a nurse that there is no God that he knows of who would subject someone to this. The client's statement is most reflective of:

spiritual crisis Rationale: A spiritual crisis can occur with an acute illness, sudden loss, or a new challenging diagnosis. These turning points often result in the questioning of one's beliefs.