prepU Chapter 45: Spirituality

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?"

A recently graduated nurse is talking to the charge nurse about spirituality and tells the charge nurse that it is difficult to understand why people have a hard time giving spiritual care to clients. The charge nurse identifies the new nurse's lack of understanding when the new nurse makes which statement?

"Spirituality and religion are the same thing."

Which nursing title is being recognized by the American Association of Nursing? This nurse aids and assists the clients with spiritual needs in the community setting.

Congregation care nurse

The home care nurse observes several lighted candles by the client's bedside. What should the nurse do next?

Discuss about the risk of fire with candles in the bedroom.

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?

Read a passage from the Bible to the client

While studying religion and spirituality, the nursing student exhibits an understanding of the concepts when making which of the following statements?

Religion is a collection of spiritual beliefs and practices.

The family members of a dying client have asked for the hospital chaplain's help in having a member of the clergy come to the client's bedside to perform the anointing of the sick. The nurse who is providing care for the client should recognize that the family is likely which religion?

Roman Catholic

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 alienation

While interviewing a client, a nurse is told that the client practices Catholicism. This client is identifying:

his faith

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

According to Shelly and Fish, which of the following is a spiritual need underlying all religious traditions?

need for meaning and purpose

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?

sense of security for present and future

When preparing for a spiritual counselor to visit a hospitalized client, the nurse should:

take measures to ensure privacy during the counselor's visit.

Upon assessment, the client reports that he does not belong to an organized religion. The nurse is correct to interpret this statement as:

the client is not affiliated with a specific system of belief regarding a higher power.

Today you are caring for Mr. Glanden, who recently underwent a lung resection. As you go about your physical assessment, he asks to have the elders from his church perform a "laying on of hands". You interpret this as a healing process associated which of the following religions?

Mormon

A nursing student is studying spirituality and is doing a report on the Mormon faith. Which fact about Mormonism should the student include in the report?

Mormons are not allowed to use tobacco or alcohol.

Mrs. Dupree is a 55-year-old patient with end-stage renal failure who has asked to be taken off dialysis. She now shares with the nurse that she has mistreated her only daughter in the past and would like to reconcile this before she dies. The nurse knows that this is related to which of the following spiritual needs believed to be common to all people?

Need for forgiveness

Mrs. Dopson is a 75-year-old widow who lost her last offspring to cancer last month. She shares with the nurse that she fears being alone. 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

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 her comfort.

Which client statement most clearly suggests the potential of a nursing diagnosis of Spiritual Anxiety?

"Now that I'm nearing the end, I'm worried that God won't think I lived a good enough life."

Based on religious customs, for which patient would the nurse administering medicines avoid touching the patient's lips?

A Hindu patient

A nurse is caring for a client who is upset after being told about a diagnosis of cancer. The client asks the nurse to take a minute to pray, but the nurse is not a very religious person. What is the best action for this nurse?

Agree to pray with the client and stand in silence by the bed.

While admitting a male client, the nurse asks if he has a preferred religion or faith. The client indicates that he is not sure there is any proof of a higher power and therefore, has no preferred religion. The nurse knows that which of the following terms describes the client's feelings about religion?

Agnostic

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

The nurse is caring for a critically ill client, who informs the nurse that there is a conflict between her spiritual beliefs and a proposed health option. What is the nurse's role in this situation?

Assist the client in obtaining information to make an informed decision.

A teenage client comes to the clinic and tells the nurse that she has not had a period for the last 2 months. After assessment and lab work, the client is told that she is 3 months' pregnant. She begins to sob and says she is too young to have a baby. When the nurse offers counseling for an abortion, the client gets even more upset and says that she cannot have an abortion as it is not permitted in her church. This client is most likely which of the following?

Catholic

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.

A dying client requests that the nurse pray with him. The nurse is not accustomed to praying aloud but is comfortable praying silently. What is the best approach for this nurse to follow to pray with this client?

The nurse should select a formal prayer or Bible passage to use to pray aloud.

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?

Contact the chaplain to arrange a visit with the client.

A client who is on hospice care and has no immediate family has been given less than 1 week to live. The nurse caring for the client recognizes that providing presence is most important, especially when a client is dying. What would be the best way for this nurse to provide presence to this client?

Hold the client's hand and sit by the bedside as often as possible.

A client who is scheduled to begin chemotherapy for cancer is overheard telling a family member that everything will eventually be okay and the cancer will be in remission. This client is demonstrating which of the following?

Hope

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?

Islam

The nurse caring for a bedridden hospitalized client who states that this will be the first time that he has missed a Methodists church service in 50 years plans care based on which of the following NANDA diagnosis?

Spiritual distress related to inability to attend church services evidenced by verbal states of guilt

Mr. J. is a 78-year-old man, who is actively dying of unknown causes. Mr. J. is a practicing Muslim. His wife, children, and grandchildren are present. The physician in charge of Mr. J.'s care plans to discuss Mr. J.'s impending death with the family. Based on the nurse's knowledge of the Muslim faith, which of the following is not true?

The family will likely want an autopsy

Mr. V. is recovering from pneumonia. You know that a well-balanced diet will help him to recover. However, Mr. V. informs you that it is Ramadan and he must fast from sunrise to sunset. What is your most appropriate nursing action?

Work with the nutrition staff to provide nutritious meals at off hours.

A client recently diagnosed with cancer informs the nurse that she values faith and finds comfort in her faith. The nurse is aware that faith is best defined as:

a belief in something for which there is no proof or material evidence

Which food group would be appropriate to suggest to a client who practices tenets of the Islamic faith?

broiled chicken sandwich with skimmed milk

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.

The best definition of a spiritual need is:

expression of a person's inner being and meaning.

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

A nursing instructor, while teaching a class on spiritual health, identifies which of the following to be spiritual needs common to all people? Select all that apply.

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

A nurse is conducting a spiritual assessment on a client recently admitted to the hospital unit. Which questions would be appropriate to ask the client about his religious and spiritual practices? Select all that apply.

• "Does the present situation interfere with any spiritual or religious practice?" • "Is religion a significant part of your life?" • "Are there any spiritual practices that you would like to continue while hospitalized?"

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.

• "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?

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 nurse clients well even though you ignore the spiritual dimension of health."

The nurse is caring for Mr. Z., a 55-year-old man admitted to the hospital for liver failure. He is an active member in the Latter-Day Saints (Mormon) church. Mr. Z. tells the nurse that he strictly adheres to the religious practices that are condoned by the church. However, the nurse overhears two of his physicians discussing that Mr. Z.'s liver failure is likely due to chronic alcohol use. The nurse suspects that they are wrong. Which of the following is an appropriate nursing activity?

Engage Mr. Z. in a discussion about past and present religious practices.

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

When a nurse supports the client's spiritual needs, the nurse supports which level of the Maslow's hierarchy of needs?

Self-actualization needs

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

A recently graduated nurse is caring for a client who was just given the diagnosis of pancreatic cancer. The client asks the nurse to help her understand this death sentence and tell her why God did this to her, as she has lived a good life all along. The nurse, not being comfortable as a spiritual counselor, should do which of the following?

Suggest to the client that she can call her spiritual advisor to help give her counsel

After being informed that his wife only has a few hours to live, the nurse hears the husband say; "If you take my wife now. I will never pray to you!" What should be the nurse's reply?

Use silence and allow the husband to express his emotions.

Individuals who are Christian Scientists may not approve of:

immunizations.

A client who is admitted for a debilitating disease is talking to the nurse. She relates that family is the only thing that matters, stating that family helps fulfill all the spiritual needs by first fulfilling the most basic of all needs. What is this basic need?

love

Which set of terms best reflects nursing's view of clients as holistic beings?

mind, body, spirit

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.

A client strongly refuses to be admitted to a long-term facility despite having no family to assist him with his needs at home. The client states, "If I go, I won't be able to go to church every Sunday!" The nurse understands that this statement is reflective of which issue?

separation from Spiritual ties

An older adult who identifies herself 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. She is quite upset by this restriction and states, "Going to daily mass was my life." The nurse recognizes that this client is suffering:

spiritual distress.

The nursing diagnosis Spiritual Distress related to crisis of illness as evidenced by loss of meaning in life and overuse of pain medication is created for a client who attempted to take his life. Which intervention is appropriate for these problems?

Plan and coordinate a multidisciplinary team conference including the chaplain.

A terminally ill patient tells the nurse that he does not belong to an organized religion. It is safe for the nurse to assume what?

The patient may still be deeply spiritual.

The mother of a child diagnosed with leukemia starts crying and states "We are being cursed because my husband changed his religion." The nurse identifies this as:

impaired religiosity.

A nurse assessing children for spirituality keeps in mind which central themes in children's descriptions of God, based on David Heller's study? Select all that apply.

• Children have a notion of a God who works through human intimacy. • Children believe in the interconnectedness of human lives. • Children show considerable anxiety in the face of God's power.

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. Choose all that apply.

• Clear the bedside table; cover with clean towel • Have a chair available near the bed • Clear the room of unnecessary items

A clinical instructor has asked that the nurse pay particular attention to the spiritual needs of a client today. The nurse knows that spiritual beliefs can have a positive effect on general health in which of the following ways? Select all that apply.

• Diet • Support system • Endurance of extreme stress • Positive emotions

A nurse working in a facility that treats clients with Alzheimer's understands the importance of spirituality in client care. However, when a family caregiver tells the nurse that her faith has been broken and asks about help in getting through the day, the nurse does not know how to respond. What are some approaches that the nurse could use to help the family member? Select all that apply.

• Help the family member get relief so she can attend church services • Contact the family church group members for assistance • Give the family member some spiritual reading materials

A nurse is caring for a client who is spiritually distressed. Which of the following are the factors that affect the spiritual distress of a client? Select all that apply.

• Inability to reconcile a current life situation with spiritual beliefs • Separation from the religious community or supports

The nurse planning spiritual care for a client understands which of the following to be true about spirituality according to Burghardt and Nagai-Jacobson (1997)?

• Spirituality permeates life, providing purpose, meaning, strength, and guidance and shaping the journey.