Chapter 16. Spirituality My Nursing Test Banks

Chapter 16. Spirituality

True/False

Indicate whether the statement is true or false.

____ 1. Religion provides people with instruction and guidance about what to believe and what values are essential.

ANS: T

Religion provides instruction and guidance on beliefs, values, and codes of conduct. In contrast, spirituality is a journey that integrates life experiences and understanding.

PTS:1DIF:EasyREF:p. 339

KEY:Nursing process: N/A | Client need: PSI | Cognitive level: Recall

____ 2. Spirituality occurs over time and involves the accumulation of life experiences and understanding.

ANS: T

Spirituality is like a journey; it occurs over time and involves the accumulation of experiences and understanding, whereas religion provides general instruction and guidance on beliefs, values, and codes of conduct.

PTS:1DIF:EasyREF:pp. 339-340

KEY: Nursing process: N/A | Client need: PSI | Cognitive level: Recall

Multiple Choice

Identify the choice that best completes the statement or answers the question.

____ 1. Which statement best describes theology?

1)

Discussions and theories related to God and His relation to the world

2)

Doctrines about the human soul and its relation to eternal life

3)

A life-long journey involving accumulation of experience and understanding

4)

Codes of conduct that integrate beliefs and values

ANS: 1

Theology is best described as discussions and theories related to God and His relation to the world. Eschatology includes doctrines about the human soul and its relation to death, judgment, and eternal life. Spirituality is considered a lifelong journey. Religion provides codes of conduct that integrate beliefs and values.

PTS:1DIF:ModerateREF:p. 339

KEY: Nursing process: N/A | Client need: PSI | Cognitive level: Recall

____ 2. Which of the following is considered a religious denomination within the tradition of Christianity?

1)

Buddhism

2)

Jehovahs Witnesses

3)

Sikhism

4)

Islam

ANS: 2

Jehovahs Witnesses is a religious denomination within Christianity. Buddhism, Sikhism, and Islam are all religious traditions outside of Christianity.

PTS:1DIF:EasyREF:pp. 342-343; ESG, Chapter 16, Supplemental Materials, Major Religions: What Should I Know?

KEY: Nursing process: N/A | Client need: PSI | Cognitive level: Recall

____ 3. Which factor is held in common by many of the world religions?

1)

Strict health code, including dietary laws

2)

Belief that one must submit to a god or gods

3)

Rules prohibiting alcohol consumption

4)

Sacred writings that reveal the nature of the Supreme Being

ANS: 4

Many of the world religions have sacred writings that are authoritative and reveal the nature of the Supreme Being. Mormons follow a strict health code, which advises healthful living. Islam means submission; therefore people of Islamic faith submit to Allah. Some religions, such as Mormon, Christian Science, Bahai, and Sikhism, prohibit alcohol consumption, but many other religions permit it.

PTS:1DIF:EasyREF:p. 339

KEY: Nursing process: N/A | Client need: HPM | Cognitive level: Recall

____ 4. A female patient tells the charge nurse that she does not want a male nurse caring for her. Which intervention by the charge nurse is best?

1)

Explain that hospital policy does not allow nursing assignments based on the gender of the nurse.

2)

Explore with the patient her beliefs and determine which might have caused her to make this statement.

3)

Assure the patient that each nurse is capable of providing professional nursing care, regardless of their gender.

4)

Comply with the patients request and assign a female nurse to care for the patient.

ANS: 2

The charge nurse can best serve the patient and her staff by exploring the patients beliefs that might prevent her from being cared for by a male. There are many reasons the woman may prefer a female nurse: she may be very modest, or she may be prejudiced against male nurses, for example. Hospital policy might state that, to prevent discrimination issues, nursing assignments should not be made based on the gender of the patient or nurse. However, even if this is so, before explaining this to the patient, the charge nurse should explore the patients beliefs and make special arrangements with hospital administration to uphold the patients beliefs, if possible. Telling the patient that each nurse is capable of providing care is not sensitive to the patient and her beliefs. Simply complying with the patients wishes without further investigation may alienate the nursing staff.

PTS: 1 DIF: Moderate REF: pp. 341-343, pp. 351-352

KEY: Nursing process: Interventions | Client need: PSI | Cognitive level: Application

____ 5. A patient of Orthodox Jewish faith is admitted to the hospital with heart failure on Yom Kippur. The physician prescribes digoxin 0.25 mg to be given orally for this patient. Based on the patients religious affiliation, which of the following actions should the nurse take?

1)

Administer the medication as prescribed.

2)

Hold the medication until after Yom Kippur.

3)

Explain the importance of taking the medication despite the holiday.

4)

Ask the physician to change the route of administration.

ANS: 4

Orthodox Jews require an alternative to the oral route of drug administration on Yom Kippur to comply with their religious beliefs. Therefore, the nurse should ask the physician to change the route of administration. Administering the medication as prescribed breaks the patients religious tradition on the holiest day of the Jewish calendar. Holding the medication until after Yom Kippur delays treatment and may cause harm to the patient; furthermore, it is not within the scope of nursing practice to hold medications that have been prescribed by a physician. The nurse should explain the importance of the medication in any case; but the nurse should not try to convince the patient to break away from his religious tradition when an alternative route of administration is available.

PTS:1DIF:ModerateREF:p. 341

KEY: Nursing process: Interventions | Client need: PSI | Cognitive level: Application

____ 6. The nurse is admitting a Roman Catholic adult patient who is critically ill. Based on her knowledge of the patients religion, for which religious rite should she expect to notify the hospital chaplain?

1)

Anointing of the Sick

2)

Baptism

3)

Eucharist

4)

Sacrament of Reconciliation

ANS: 1

In Catholicism, those who are seriously ill might want to receive the sacrament of Anointing the Sick. The Sacrament of Reconciliation, which is performed by a priest, is used to gain forgiveness for past sins. The Eucharist, or communion, can be prepared and administered to a hospitalized patient, but it is not typically administered to someone who is critically ill. Baptism may be offered when infants or children of Christian parents are critically ill.

PTS:1DIF:EasyREF:p. 342

KEY: Nursing process: Interventions | Client need: PSI | Cognitive level: Comprehension

____ 7. Because of religious beliefs, which of the following patients will most likely refuse a blood transfusion? One who is affiliated with

1)

Islam

2)

Bahai

3)

Hinduism

4)

Jehovahs Witness

ANS: 4

Those of Jehovahs Witness faith believe that taking blood into ones body is morally wrong. Therefore, they will not consent to transfusions of whole blood or its components. Those of Islam, Bahai, and Hindu faith will, as a rule, consent to blood transfusion.

PTS:1DIF:EasyREF:p. 342

KEY: Nursing process: N/A | Client need: PSI | Cognitive level: Recall

____ 8. Which special consideration may the nurse need to make when caring for a female Rastafarian patient?

1)

Allow the patient to wear her own clothing.

2)

Provide a diet that is caffeine-free.

3)

Allow the patient to wear jewelry with religious symbols.

4)

Provide free-flowing water for bathing.

ANS: 1

Wearing secondhand clothes is taboo in the Rastafarian faith; therefore, the nurse should allow the patient to wear her own bedclothes instead of a hospital gown. Rastafarians typically consume tea, but some do not drink milk or coffee. Muslim women may wear a locket containing religious writing around the neck in a small leather bag. These are worn for protection and strength and should not be removed. Hindus prefer washing with free-flowing water for bathing, which should be provided when possible.

PTS: 1 DIF: Moderate REF: ESG, Chapter 16, Supplemental Materials, Major Religions: What Should I Know?

KEY: Nursing process: Interventions | Client need: PSI | Cognitive level: Application

____ 9. What is the most effective action by the nurse when delivering spiritual care to a patient of the same religion as the nurse?

1)

Understanding that the patient shares the same beliefs

2)

Striving to meet the patients spiritual needs independently

3)

Explaining her own religious beliefs to the patient

4)

Developing a greater awareness of her own spirituality

ANS: 4

The nurse can best deliver spiritual care by developing a greater awareness of her own spirituality. This allows the nurse to be a better listener and provide better care for the patient. The nurse should avoid assuming that a patient who shares the same religious affiliation has the same beliefs. Moreover, the nurse should avoid trying to meet the patients spiritual needs independently. A team approach to spirituality provides more comprehensive care. Also, unless asked, the nurse should avoid explaining her own religious beliefs, which might offend the patient.

PTS: 1 DIF: Moderate REF: p. 345

KEY: Nursing process: Interventions | Client need: PSI | Cognitive level: Comprehension

____ 10. A Muslim client has asked the nurse to pray with her. Which item should the nurse anticipate that the patient may request before praying?

1)

Bathing water

2)

Rosary beads

3)

Mala beads

4)

Prayer cloth

ANS: 1

Muslims may want water to wash the mouth, nostrils, and hands before praying. Roman Catholics may want to hold their rosary beads while praying. Some Buddhists and Hindus meditate with a set of beads, called a mala. Others may use a prayer cloth or other religious items.

PTS:1DIF:ModerateREF:pp. 342-343, 350-351; ESG, Chapter 16, Supplemental Materials, Major Religions: What Should I Know?

KEY: Nursing process: Interventions | Client need: PSI | Cognitive level: Comprehension

____ 11. When performing a spiritual assessment, who is the preferred source of information?

1)

Durable power of attorney

2)

Next of kin

3)

Patient

4)

Patients clergyman

ANS: 3

The patient is the preferred source of information. In the event of an emergency admission or when a patient cannot give information, the nurse can consult the next of kin or the durable power of attorney for information about the patients spirituality. Contacting the clergyman without the patients permission is a breach of patient confidentiality.

PTS:1DIF:ModerateREF:pp. 346-347; high-level question, not answered verbatim in text.

KEY: Nursing process: Assessment | Client need: PSI | Cognitive level: Analysis

____ 12. Which type of medicine do those of Hindu faith typically practice?

1)

Ayurvedic medicine

2)

Western medicine

3)

Chiropractic medicine

4)

Qigong

ANS: 1

Those of Hindu faith typically practice Ayurvedic medicine, which encompasses all aspects of life, including diet, sleep, elimination, and hygiene. Some believe in the medicinal properties of hot and cold foods, which have nothing to do with temperature or degree of spiciness. People who practice Hinduism do not typically practice Western medicine, chiropractic medicine, or Qigong. Qigong, a form of Chinese martial arts, is used to achieve healing through focus on the bodys energy centers.

PTS:1DIF:ModerateREF:p. 343

KEY: Nursing process: Assessment | Client need: PSI | Cognitive level: Comprehension

____ 13. A patient tells the nurse, I feel that God has abandoned me. I am so angry that I cant even pray. The patient refuses to see his clergyman when he calls. Which is the most appropriate nursing diagnosis for this patient?

1)

Spiritual Distress

2)

Risk for Spiritual Distress

3)

Impaired Religiosity

4)

Moral Distress

ANS: 1

This patient exhibits three defining characteristics for Spiritual Distress (feeling abandoned by God, inability to pray, refusing to see a religious leader). Therefore, the actual problem of Spiritual Distress exists, not the potential problem of Risk for Spiritual Distress. Impaired Religiosity is difficulty in exercising or impaired ability to exercise reliance on beliefs or to participate in rituals of a faith tradition (e.g., going to church). This patient is not unable to see the clergyman but chooses not to. Moral Distress occurs when a person makes a moral decision but is prevented from carrying out the chosen action.

PTS:1DIF:ModerateREF:p. 348

KEY: Nursing process: Diagnosis | Client need: PSI | Cognitive level: Analysis

____ 14. The nurse is asking the patient reflective, clarifying questions to help the patient make a list of what is important and not important in life and the time commitment for each. Which standardized (NIC) nursing intervention does this action implement?

1)

Spiritual Support

2)

Self-Esteem Enhancement

3)

Values Clarification

4)

Hope Inspiration

ANS: 3

One of the steps of most values-clarification processes is to list values (what is important and not important in ones life) and the time commitment for each. The nurse facilitates this by asking reflective, clarifying questions of the patient. Values clarification does not necessarily directly enhance self-esteem, inspire hope, or provide spiritual support, although it can indirectly contribute to development of spiritual identity.

PTS: 1 DIF: Moderate REF: ESG, Chapter 16, Standardized Language, Table   Standardized Language: Using Selected NIC Interventions and Activities to Support Spirituality

KEY: Nursing process: Interventions | Client need: PSI | Cognitive level: Application

____ 15. The nurse is a Christian. She is caring for a Jewish patient who has asked her to offer a prayer at the bedside. The nurse feels comfortable doing so. Which of the following actions by the nurse is appropriate?

1)

Offer a prayer for healing using the nurses usual words and format.

2)

Begin the prayer with Jehovah God as she always does while avoiding the name of Jesus.

3)

Avoid saying any name for the Supreme Being while praying and quote an Old Testament Bible scripture as the prayer.

4)

Say, What name would you like for me to use to address the Supreme Being when I am praying for you?

ANS: 4

Ask how the patient prefers to address the Divine. Some people prefer the use of parental language in their prayers; for example, Father God or Divine Mother. Some use the names Jehovah, Yahweh, or Allah. Hindus may address one or more of multiple gods, each of whom has several names. So seek direction from the patient in these matters: Most people are honored to be able to explain their beliefs and practices to someone who is open to the experience. The nurse should not assume that using the names Jesus and Jehovah God would be supportive to the patient, although they might not offend in any way. The nurse does not need to avoid addressing God by a name, but the most supportive way to do so is to find out the name the patient wishes to use. Furthermore, the nurse should not assume that the patient would find a New Testament Bible verse to be helpful spiritually.

PTS:1DIF:ModerateREF:p. 350

KEY: Nursing process: Implementation | Client need: PSI | Cognitive level: Application

Multiple Response

Identify one or more choices that best complete the statement or answer the question.

____ 1. A patient has a nursing diagnosis of Noncompliance with medication regimen related to a belief that God will heal her and that it would show a lack of faith to take the medications. The nurse and a clergyman have spent some time discussing spiritual and treatment issues with the patient. Which of the following would indicate that progress is being made toward achieving compliance with healthcare therapy? (Choose all that apply.) The patient says

1)

I will try to pray more often for stronger faith that God will heal me.

2)

Let me think about it until tomorrow; I may see my way to taking those pills then.

3)

You know, Ive known some very holy people who were not cured by God.

4)

There is no confusion in my mind as to the right thing for me to do.

ANS: 2, 3

Agreeing to consider treatment (think about it) and recognizing that sometimes faithful people are not cured both suggest that the patient is at least considering that it is all right for her to question her beliefs. Praying for stronger faith in Gods healing suggests that she is holding strong in her belief that she will be healed if she only has enough faith. Having no confusion about the right thing to do would be evidence of problem resolution, provided the right thing to do is to take the medication. However, you need more information to know if that is what the patient means. It could just as easily mean that she is more sure than ever that she should not take the medication.

PTS:1DIFifficultREF:pp. 346-349; answer not stated in text; student must infer answer from question content

KEY: Nursing process: Evaluation | Client need: PSI | Cognitive level: Application

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