Chapter 17: Spiritual Needs, Spiritual Caring, and Religious Differences My Nursing Test Banks

Chapter 17: Spiritual Needs, Spiritual Caring, and Religious Differences

Test Bank

MULTIPLE CHOICE

1. A nurse is preparing a presentation about spirituality and religion. To adequately prepare for peer questions, the nurse should know that the three major religious groups in the United States are the

a.

Lutherans, Catholics, and Presbyterians.

b.

Baptists, Assembly of God, and Lutherans.

c.

Roman Catholics, Protestants, and Jews.

d.

Protestants, Unitarians, and Catholics.

ANS: C

Roman Catholics number more than 67 million members. All Protestant denominations combined have 66 million members. Jews are estimated at 5.6 million members. The other options do not reflect current data.

DIF: Cognitive Level: Knowledge REF: p. 215 OBJ: 3

TOP: Religions in the U.S. KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

2. Select the patient who would benefit least from the nurse reading from the New Testament.

a.

Mrs. A of the Assembly of God

b.

Mr. B, who is Roman Catholic

c.

Miss C, who is a Jehovahs Witness

d.

Mr. D, who is an Orthodox Jew

ANS: D

Mr. D, an Orthodox Jew, does not believe in Jesus as the Messiah. New Testament readings are based on Christianity. The other options identify patients who are Christians.

DIF: Cognitive Level: Comprehension REF: pp. 216-217 OBJ: 7

TOP: Christian sects KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

3. To provide effective spiritual care for a Muslim patient, the nurse recognizes that those who believe in Islam refer to God as

a.

Brahma.

b.

Moroni.

c.

Redeemer.

d.

Allah.

ANS: D

Muslims believe in one god, Allah. Brahma is the Hindu creator god. Moroni is the angel sent to reveal the Book of Mormon (Church of Jesus Christ of Latter Day Saints). Redeemer is used by Christians to refer to Jesus.

DIF: Cognitive Level: Comprehension REF: p. 220 OBJ: 7

TOP: Islam KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

4. The nurse working in the neonatal intensive care unit would implement baptism for a baby not expected to live if the infants religion is listed as

a.

Assembly of God.

b.

Roman Catholic.

c.

Mormon.

d.

Baptist.

ANS: B

Roman Catholic infants who are critically ill may be baptized by a nurse without a witness. Baptism is considered necessary for salvation and cleansing of all sin. The other Christian denominations do not practice infant baptism.

DIF: Cognitive Level: Application REF: p. 217 OBJ: 8

TOP: Baptism KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

5. The nurse is caring for an Orthodox Jewish patient who is close to death. An important intervention would be to find out whether the patient

a.

wishes to have the Sacrament of the Sick.

b.

has been baptized.

c.

wishes to have his Koran nearby.

d.

can be touched by the nurse after death.

ANS: D

Some Jews may not want the nurse to touch the body of a deceased Jew. The nurse should respect this consideration. The other options refer to preferences of other religions.

DIF: Cognitive Level: Application REF: p. 216, Box 17-3

OBJ: 8 TOP: Care of the dying patient

KEY: Nursing Process Step: Assessment (Data Collection)

MSC: NCLEX: Physiological Integrity

6. The Jewish patient tells the nurse that he does not observe the Sabbath on Sundays. What other time interval would the nurse need to provide for patient Sabbath observances?

a.

Monday noon to Tuesday noon

b.

Friday sundown to after sunset Saturday

c.

Thursday midnight to Friday midnight

d.

Alternate Saturdays

ANS: B

Jews celebrate the Sabbath from sunset Friday to sunset Saturday. The other options are not times religious groups celebrate the Sabbath.

DIF: Cognitive Level: Application REF: p. 216, Box 17-3

OBJ: 8 TOP: Religious practices

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

7. The nurse who is preparing a Muslim female for a physical examination is told by the patient, I cannot undress completely. The nurse will appropriately choose interventions based on the knowledge that Muslim women

a.

observe standards of modesty requiring coverage from head to ankle.

b.

speak openly to women but are silent in the presence of men.

c.

wear writings from the Koran on the neck, arm, or waist.

d.

are given alcoholic beverages with each meal.

ANS: A

Modesty standards in Islam may require the women to have her body covered from head to ankle. If this is the case, the nurse should arrange for the individual to be draped and able to expose one body part at a time for examination.

DIF: Cognitive Level: Application REF: p. 221, Box 17-7

OBJ: 8 TOP: Modesty standards

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

8. A patient who is a member of the Church of Latter Day Saints (Mormon) must increase fluid intake. Which beverages should the nurse offer?

a.

Wine or beer

b.

Fruit juice, milk, or water

c.

Coffee, tea, or iced tea

d.

Unfermented or fermented apple juice

ANS: B

Patients who are Mormon do not drink alcoholic beverages and usually avoid beverages that contain caffeine, making fruit juice, milk, or water the only correct answers.

DIF: Cognitive Level: Application REF: p. 222, Box 17-8

OBJ: 7 TOP: Dietary restrictions

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

9. A patient has a small piece of paper on which unfamiliar symbols are written hanging on a black string around the neck. To prepare the patient for the operating room (OR), the nurse should

a.

allow the patient to wear the item, but make note of it for the OR staff to see and reposition if needed.

b.

insist that the patient take off the item and leave it in the bedside stand.

c.

remove the item and tie it to the foot of the patients bed.

d.

place the item in a plastic bag and lock it in the narcotics cabinet.

ANS: A

Muslim patients often wear writings from the scriptures tied to their bodies. They should be allowed to remain on the patient. Making a note of the location of the writing is appropriate, so the OR staff can reposition it, if necessary, for the surgical procedure. The remaining options are incorrect, because the patient should be allowed to wear the writing.

DIF: Cognitive Level: Application REF: p. 221, Box 17-7

OBJ: 8 TOP: Religious practices

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

10. A patient who is terminally ill describes himself as agnostic. The nurse caring for this person can correctly assume that the patient

a.

does not possess spirituality.

b.

will not experience spiritual distress.

c.

will practice the rituals of a particular denomination.

d.

will benefit from general spiritual care interventions.

ANS: D

Spiritual assessment and interventions are appropriate for agnostic patients, because all people have spirituality, even if they do not profess religious beliefs. Agnostic patients possess spirituality. Agnostics may experience spiritual distress. Agnostics do not practice the rituals of any religion.

DIF: Cognitive Level: Analysis REF: p. 214 OBJ: 6

TOP: Agnosticism KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

11. For which patient should the nurse be most alert for emerging spiritual needs?

a.

Miss A, who has been given the diagnosis of gallbladder disease

b.

Mrs. B, who has been told she has metastatic cancer

c.

Mr. C, who has varicose veins

d.

Mr. D, who has herpes zoster

ANS: B

Patients who have been given bad news are at high risk for experiencing spiritual distress. Of the options provided, only metastatic cancer is considered an incurable disease.

DIF: Cognitive Level: Application REF: p. 212 OBJ: 4

TOP: Emerging spiritual needs KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

12. A patient whose religion is listed as Seventh-Day Adventist is admitted to the unit just before lunch. The patient is being examined, and the nurse does not want to interrupt to ask about lunch preferences. A good choice would be to order a

a.

regular diet.

b.

Kosher meal.

c.

vegetarian meal.

d.

meal with no dairy products.

ANS: C

Many Seventh-Day Adventists are vegetarians. When dietary preferences are unknown, this choice would be safe.

DIF: Cognitive Level: Application REF: p. 219, Box 17-6

OBJ: 8 TOP: Dietary preferences

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

13. A Hindu patient is admitted after a severe head injury and is near death. The organ procurement person tells the nurse, I dont know much about the Hindu religion, and I have to talk to the family about organ donation. Can you give me any hints? The best response for the nurse would be

a.

Organ donation is prohibited by the religion.

b.

The family is very concerned about where the patients soul will go after death.

c.

The religion permits organ donation, but you would have to ask the family their feelings about it.

d.

Its hard to know what people who believe cows are sacred will think about organ donation.

ANS: C

Although the religion permits organ donation, individuals or families may have differing viewpoints. Organ donation is not prohibited by religion, and the family would not be very concerned about where the patients soul will go after death. The statement that its hard to know what people who believe cows are sacred will think about organ donation is not culturally sensitive.

DIF: Cognitive Level: Application REF: p. 224, Table 17-2

OBJ: 8 TOP: Organ donation

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

14. A patient who practices Buddhism tells the nurse, My pain is the result of things I have done in the past. The nurse, who wishes to be supportive, should respond

a.

Are you saying you have been a bad person?

b.

This understanding helps give meaning to your pain.

c.

Perhaps you could ask God to help you bear the pain.

d.

Pain can be an enlightening experience.

ANS: B

Buddhists believe pain and suffering are due to actions in this or a past life. The correct option accepts the patients belief. The statement, Are you saying you have been a bad person? is probing. Encouraging a patient who practices Buddhism to ask God to help them bear the pain is inappropriate, because Buddhists do not believe in God. Enlightenment has a specific meaning to Buddhists; it refers to finding the truth of existence and should not be used as a general term.

DIF: Cognitive Level: Application REF: p. 223, Table 17-1

OBJ: 8 TOP: Buddhist philosophy

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

15. A patient tells the nurse, I know my minister will visit me when he checks at the admissions desk and learns Im a patient. The most facilitative response the nurse can make would be

a.

Im sure you can count on seeing your pastor within a day or two.

b.

Because of a federal law, the hospital cannot make your name available to clergy.

c.

Clergy rarely make calls to this hospital, so your pastor may not know youre here.

d.

I can arrange for a phone so that you may call your minister and ask him to visit.

ANS: D

The correct option provides an acceptable way of notifying the minister of the patients desire for a visit without violating HIPAA privacy standards. Telling the patient that he can count on seeing his pastor within a day or two is false reassurance. It is true that due to federal law, the hospital cannot make the patients name available to clergy, but that statement does nothing to help the patient make contact with the minister. Telling the patient that clergy rarely make calls to the hospital offers an explanation that is probably untrue.

DIF: Cognitive Level: Application REF: p. 213 OBJ: 7|8

TOP: Privacy KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

16. When a patient is asked about religious preference, she states, I am agnostic. The nurses best interpretation of this is the patient

a.

does not believe in God.

b.

believes in God and supernatural powers.

c.

does not believe that the supernatural exists.

d.

believes that the existence of God can be neither proved nor disproved.

ANS: D

Agnostics hold the belief that the existence of God can be neither proved nor disproved. Atheists do not believe that the supernatural exists, so they do not believe in God.

DIF: Cognitive Level: Comprehension REF: p. 214 OBJ: 6

TOP: Religion KEY: Nursing Process Step: Assessment

MSC: NCLEX: Physiological Integrity

17. A nurse is caring for an Orthodox Jewish patient who has terminal cancer. The nurse demonstrates cultural sensitivity toward the patient by stating

a.

Would you like me to assist you in praying to Jesus?

b.

Im sure you will go to heaven. Youre a good person.

c.

Would you like me to ask your rabbi to come to visit you?

d.

Would you like me to bring you a copy of the New Testament?

ANS: C

Orthodox Jews follow the traditional faith and strictly adhere to rituals. Jews believe in God but do not have a belief in Christ. A nurse should avoid making references to heaven or Jesus. Jewish clergy are called rabbis. The holy books of the Jews are the Torah and the Talmud.

DIF: Cognitive Level: Analysis REF: p. 216, Box 17-3

OBJ: 8 TOP: Religion KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

18. A nurse is caring for a Sunni Muslim patient. The nurse demonstrates cultural sensitivity by

a.

allowing the patient to pray three times daily.

b.

placing the patients dinner tray on top of the Koran.

c.

offering the patient food and fluids during Ramadan.

d.

positioning the patients bed in a southeast direction from the United States.

ANS: D

Muslims are called to prayer five times a day. If a Muslim brings the Koran, the holy book of Islam, to the health care facility, the nurse should not touch it or place anything on top of it. During Ramadan, the ninth month of the Islamic calendar, adult Muslims abstain from dawn to sunset from food, drink, and sexual activity. If a patient requests to face Mecca, the holy city of Islam, a bed or chair may be positioned in a southeast direction from the United States.

DIF: Cognitive Level: Analysis REF: p. 221, Box 17-7

OBJ: 8 TOP: Religion KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

19. A nurse is caring for a Sunni Muslim patient. The nurse demonstrates cultural sensitivity by understanding that the patient would likely pray to

a.

Allah.

b.

Islam.

c.

Buddha.

d.

Jesus Christ.

ANS: A

Muslims believe in one God, Allah. The word Islam implies peace. In the sixth century AD, the prophet Muhammad founded Islam in Arabia. Followers of Islam are called Muslims. Siddhartha Gautama (Buddha) founded Buddhism in the sixth century BC in India. Christianity is based on a belief in Jesus Christ as the Son of God.

DIF: Cognitive Level: Comprehension REF: pp. 220-221, Box 17-7

OBJ: 7 TOP: Religion KEY: Nursing Process Step: Assessment

MSC: NCLEX: Physiological Integrity

20. In what religion do adults abstain from food, drink, and sexual activity from dawn to sunset during the ninth month of their religious calendar?

a.

Buddhism

b.

Jehovahs witness

c.

Mormon

d.

Islam

ANS: D

During Ramadan, the ninth month of the Islamic calendar, adult Muslims abstain from food, drink, and sexual activity from dawn to sunset.

DIF: Cognitive Level: Comprehension REF: p. 220 OBJ: 7

TOP: Religion KEY: Nursing Process Step: Assessment

MSC: NCLEX: Physiological Integrity

21. The LPN/LVN is preparing to educate a healthy patient regarding methods of birth control. The patients history indicates she is a member of the Mormon church. The LPN/LVN is aware that education of this patient should include information related to

a.

oral contraceptives.

b.

natural family planning.

c.

barrier methods.

d.

spermicides.

ANS: B

Mormon beliefs and practices allow natural methods of birth control. Artificial means may be used when the physical or emotional health of the woman is in question. Because the patient is healthy, educational information should relate to natural family planning methods.

DIF: Cognitive Level: Analysis REF: p. 222, Box 17-8

OBJ: 6 TOP: Beliefs, practices and nursing interventions

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

22. A nurse is caring for a patient who follows teachings from a holy book called the Koran. The nurse understands that this patient practices what religion?

a.

Hindu

b.

Islam

c.

Quaker

d.

Buddhism

ANS: B

Muslims, who practice Islam, believe in one God, Allah. Salvation depends on ones commitment to Allah and his teachings in the Koran. This holy book contains the words of Allah as he spoke to Muhammad.

DIF: Cognitive Level: Comprehension REF: p. 220 OBJ: 7

TOP: Religion KEY: Nursing Process Step: Assessment

MSC: NCLEX: Physiological Integrity

23. When Martin Luther separated from the Catholic Church because of scandals in the church, which religion was formed?

a.

Mormonism

b.

Lutheranism

c.

Scientology

d.

Jehovahs Witness

ANS: B

When Martin Luther separated from the Catholic Church because of scandals in the church, this started the Reformation and the beginning of Lutheranism.

DIF: Cognitive Level: Comprehension REF: p. 220 OBJ: 7

TOP: Religion KEY: Nursing Process Step: N/A

MSC: NCLEX: Physiological Integrity

24. A religion that began in Scotland and evolved from John Calvin in the sixteenth century is known as

a.

Presbyterianism.

b.

Episcopalian.

c.

Seventh-Day Adventist.

d.

United Church of Christ.

ANS: A

The Presbyterian religion began in Scotland and evolved from John Calvin in the sixteenth century.

DIF: Cognitive Level: Comprehension REF: p. 218, Box 17-6

OBJ: 7 TOP: Religion KEY: Nursing Process Step: N/A

MSC: NCLEX: Physiological Integrity

25. A religion in which members believe they receive Divine Truth from inner light supplied by the Holy Spirit is

a.

Quaker.

b.

Episcopalian.

c.

Seventh-Day Adventist.

d.

United Church of Christ.

ANS: A

Quakers believe they receive Divine Truth from inner light supplied by the Holy Spirit.

DIF: Cognitive Level: Comprehension REF: p. 219, Box 17-6

OBJ: 7 TOP: Religion KEY: Nursing Process Step: N/A

MSC: NCLEX: Physiological Integrity

26. A religion in which members observe the Sabbath from sunset on Friday to sunset on Saturday is

a.

Mormonism.

b.

Catholicism.

c.

Islam.

d.

Seventh-Day Adventist.

ANS: D

Seventh-Day Adventists observe the Sabbath from sunset on Friday to sunset on Saturday. They do not pursue their jobs or worldly pleasures at this time.

DIF: Cognitive Level: Comprehension REF: p. 219, Box 17-6

OBJ: 7 TOP: Religion KEY: Nursing Process Step: N/A

MSC: NCLEX: Physiological Integrity

27. A religion that was formed in 1957 by merger of Congregational and Evangelical and Reformed Churches is

a.

Mormonism.

b.

Presbyterianism.

c.

Seventh-Day Adventist.

d.

United Church of Christ.

ANS: D

United Church of Christ was formed in 1957 by merger of Congregational and Evangelical and Reformed Churches.

DIF: Cognitive Level: Comprehension REF: p. 219, Box 17-6

OBJ: 7 TOP: Religion KEY: Nursing Process Step: N/A

MSC: NCLEX: Physiological Integrity

28. A nurse is caring for a patient who refuses to consume meat on Ash Wednesday and all Fridays during Lent. The nurse understands that this patient is of what religion?

a.

Islam

b.

Mormonism

c.

Catholicism

d.

Presbyterianism

ANS: C

Roman Catholics 14 years of age and older are to abstain from meat on Ash Wednesday and all Fridays during Lent. Catholics ages 14 to 59 are to fast (eat one full meal and two lighter meals) on Ash Wednesday and Good Friday. Fasting and abstaining are excused during hospitalization.

DIF: Cognitive Level: Comprehension REF: p. 217, Box 17-5

OBJ: 7 TOP: Religion KEY: Nursing Process Step: N/A

MSC: NCLEX: Physiological Integrity

29. A religion that was founded in the nineteenth century by Mary Baker Eddy is

a.

Mormonism.

b.

Christian Scientist.

c.

Jehovahs Witness.

d.

Seventh-Day Adventist.

ANS: B

Christian Scientist (Church of Christ, Scientist) was founded in the nineteenth century by Mary Baker Eddy, who wrote Science and Health with Key to the Scriptures.

DIF: Cognitive Level: Comprehension REF: p. 222, Box 17-8

OBJ: 7 TOP: Religion KEY: Nursing Process Step: N/A

MSC: NCLEX: Physiological Integrity

30. A patient following a kosher diet consumes a breakfast of toast, eggs, and turkey bacon. The LPN/LVN is aware that 6 hours must pass before the patient is offered

a.

water.

b.

juice.

c.

milk.

d.

coffee.

ANS: C

With a kosher diet, meat may be consumed a few minutes after drinking milk, but 6 hours must pass after eating meat before drinking milk.

DIF: Cognitive Level: Application REF: p. 216, Box 17-3

OBJ: 7 TOP: Beliefs, practices and nursing interventions

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

31. A religion that was founded by Joseph Smith in the nineteenth century is

a.

Mormonism.

b.

Catholicism.

c.

Lutheranism.

d.

Mennonite.

ANS: A

In the nineteenth century, Joseph Smith founded the Mormon Church.

DIF: Cognitive Level: Comprehension REF: p. 222, Box 17-8

OBJ: 7 TOP: Religion KEY: Nursing Process Step: N/A

MSC: NCLEX: Physiological Integrity

32. A religion that was founded by Siddhartha Gautama in the sixth century BC in India is

a.

Buddhism.

b.

Hinduism.

c.

Mormonism.

d.

Catholicism.

ANS: A

Siddhartha Gautama (Buddha) founded Buddhism in the sixth century BC in India.

DIF: Cognitive Level: Comprehension REF: p. 223, Table 17-|p. 225

OBJ: 7 TOP: Religion KEY: Nursing Process Step: N/A

MSC: NCLEX: Physiological Integrity

COMPLETION

1. A nurse is caring for a patient who practices Mormonism. The nurse should expect the patient to study religion from the Holy Bible and ____________________.

ANS:

the Book of Mormon

Members of the Mormon faith read from the Book of Mormon, which contains accounts of ancient peoples in America. This book is considered complementary scripture to the Bible.

DIF: Cognitive Level: Comprehension REF: p. 222, Box 17-8

OBJ: 8 TOP: Religion KEY: Nursing Process Step: N/A

MSC: NCLEX: Physiological Integrity

MULTIPLE RESPONSE

1. To implement effective patient care, which patients would the nurse identify as non-Christians? (Select all that apply.)

a.

Mr. A, who is Jewish

b.

Miss B, who is Presbyterian

c.

Mrs. C, who is Roman Catholic

d.

Mr. D, who is Eastern Orthodox

e.

Miss E, who is Seventh-Day Adventist

f.

Mr. F, who is Buddhist

ANS: A, F

Jewish patients believe in God but not Christ. Buddhist patients follow the teaching of Siddhartha Gautama rather than the teachings of Jesus. The remaining options are Christian religious groups.

DIF: Cognitive Level: Application REF: pp. 215-216 OBJ: 7

TOP: Religions in the U.S. KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

2. The LPN/LVN is providing care to a patient of the Roman Catholic (Western) faith. Necessary knowledge regarding beliefs, practices, and nursing interventions for care of this patient would include which of the following? (Select all that apply.)

a.

Medicine cannot be taken before communion.

b.

The nurse may baptize a stillborn infant without a witness.

c.

Cremation is prohibited.

d.

Organ donation is allowed.

e.

Water may be taken before communion.

ANS: B, D, E

People of the Roman Catholic faith may take medicine and water before communion. If the patient is a gravely ill infant, a stillbirth, or a fetus, the nurse may baptize without a witness. Cremation and organ donation are allowed.

DIF: Cognitive Level: Comprehension REF: p. 217, Box 17-5

OBJ: 8 TOP: Beliefs, practices and nursing interventions

KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity

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