Question 1

A patient moans, &#34;God wants me to suffer, but I don't know why. I feel like an outcast. I should have never been born.&#34; Which nursing diagnosis applies?&#10;A) Potential for enhanced spiritual well-being&#10;B) Disturbed personal identity&#10;C) Spiritual distress&#10;D) Powerlessness

Accepted Answer

Defining characteristics for the nursing diagnosis of spiritual distress are present. They include concern with the meaning of life, anger toward God, questioning the meaning of suffering, conflict about beliefs, and questions about the morality of the therapeutic regimen. Spiritual distress is more applicable to the patient's comments than the other diagnoses.

Question 2

A nurse provides spiritual care for a patient awaiting a liver transplant. The nurse should anticipate that the patient's most likely response will be:&#10;A) consideration of issues related to own mortality.&#10;B) devaluation of prayer and organized religion.&#10;C) misinterpretation of medical information.&#10;D) clinical depression.

Accepted Answer

Although each of the options is possible, the most likely response is thinking about what the illness means in terms of lifespan, quality of life, and other mortality issues. The other responses are pathologic and are not seen as frequently.

Question 3

A group of nurses disagrees about whether or not to make spirituality a part of the assessment. Which statement provides a compelling argument in favor of including spiritual assessment?&#10;A) Research clearly demonstrates that spiritual interventions by nurses are a cost-effective practice.&#10;B) Accrediting organizations regard spiritual care as a patient right.&#10;C) Spirituality is better addressed by nurses than by clergy.&#10;D) Prayer consistently improves mental health outcomes.

Accepted Answer

There is a lack of agreement as to whether or not spiritual care should be a legitimate concern of nurses, despite a large body of research evidence citing its advantages to patients. Among the major deterrents to including spiritual care is the concern that already overburdened nurses will not find time to perform the assessment. It should be noted, however, that when an accrediting body considers a facet of care to be a right of patients, it will look for evidence of attention to that right. A spiritual assessment documented in the medical record provides such evidence. The other options are of lesser importance when weighed against the standards set by an accrediting agency.

Question 4

A patient diagnosed with schizophrenia says, &#34;I am a reincarnation of Jesus. I can raise the dead.&#34; The most qualified person for the nurse to refer the patient would be a:&#10;A) psychiatric nurse clinician.&#10;B) professional chaplain.&#10;C) clinical psychologist.&#10;D) community minister.

Accepted Answer

A professional chaplain holds a ministerial degree and has had a year of special study in ministering to individuals with spiritual concerns related to health problems. The other professionals have less knowledge and experience in dealing with the dual problems of mental illness and spiritual concerns.

Question 5

A patient with major depression shows the nurse a passage in the Bible and says, "How do you think this verse relates to me?" The nurse is unfamiliar with the verse and unsure how to respond. Select the nurse's best action.

A) Ask the patient, "What do you think the verse means?"
B) Invite professional clergy to join the dialogue with the patient.
C) Explain to the patient, "I'm not familiar with that passage. It would be better for me not to comment."
D) Say to the patient, "Would you bring that up in the group session? You can get input from several people about what the verse means."

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Accepted Answer

The correct answer shows that the nurse recognizes personal limits but remains engaged in the interaction with the patient. The distracters reject the patient's concerns.

Question 6

A new nurse asks the mentor, &#34;How can I help meet patients' spiritual needs?&#34; Select the mentor's best responses. &#34;Patients have reported that what they want most is for a spiritual care provider to (select all that apply):&#10;A) be authentic.&#34;&#10;B) be respectful.&#34;&#10;C) demonstrate caring.&#34;&#10;D) speak slowly and concretely.&#34;&#10;E) provide solves to theological questions.&#34;

Accepted Answer

The needs elicited from patients (authenticity, caring, respect) can be seen as caregiver behaviors that enhance trust formation. The need to speak slowly and in concrete terms is important for patients with thought disorders who have cognitive problems that make comprehension slower and abstraction difficult to understand.

Question 7

What information about a patient's perceptions and values would the nurse obtain by using questions from the HOPE tool? Select all that apply.&#10;A) Healthy spirituality versus sick religiosity&#10;B) That which gives the patient hope and meaning in life&#10;C) Important personal spiritual practices&#10;D) Role of religion in the patient's life&#10;E) Sources of strength and comfort

Accepted Answer

The HOPE questions gather information about sources of hope, strength, comfort, meaning, peace, love, and connection; the role of organized religion for the patient; personal spirituality and practices; and effects on medical care and end-of-life decisions.

Question 8

The patient says, &#34;I know I'm very sick right now, but I trust that God will make me better.&#34; Based on this statement, the nurse can assess the patient's spirituality as being based in:&#10;A) theism.&#10;B) humanism.&#10;C) behaviorism.&#10;D) existentialism.

Accepted Answer

Theism is the only model that suggests that people are inextricably tied to a transcendent being. This view provides hope for a better future. None of the other views have this basis.

Question 9

A depressed patient expresses feelings of hopelessness, helplessness, and powerlessness. The patient's spiritual distress is related to an inability to:&#10;A) find meaning and hope through choices.&#10;B) develop wisdom in the face of adversity.&#10;C) draw strength from a higher power.&#10;D) live by higher principles.

Accepted Answer

Although individuals cannot always choose their circumstances, they always have a choice of attitudes toward their experiences. Without finding meaning, individuals develop hopelessness. None of the other options relates directly to hopelessness.

Question 10

A patient diagnosed with schizophrenia, paranoid type, has been suspicious of staff since admission. The patient visits with a chaplain but then tells the nurse, "Don't send any more preachers." What is the most likely reason for the patient's reaction?

A) Hostility
B) Distractibility
C) Inability to trust
D) Inability to find meaning in suffering

Accepted Answer

Individuals with paranoid schizophrenia often have an inability to trust. Inability to trust may be related to inadequate nurturing in infancy and to later difficulty recognizing a connection with God. The other options are less clearly related to issues of paranoia and trust.

Question 11

Which statement by a mentally ill patient best exemplifies sick religiosity?&#10;A) &#34;Suicide will result in eternal damnation for your soul.&#34;&#10;B) &#34;Your illness has nothing to do with insufficient faith.&#34;&#10;C) &#34;Questioning God is a common reaction to illness.&#34;&#10;D) &#34;Your illness is not related to sin.&#34;

Accepted Answer

The answer of Which statement by a mentally ill patient...

Question 12

An African-American caregiver says, &#34;Both of my parents have dementia. I find it so difficult to care for them because of their disabilities. I get depressed and hopeless thinking about it. Can you give me any suggestions for coping?&#34; Before making suggestions, the nurse should assess:&#10;A) the parents' stage of dementia.&#10;B) the caregiver's religious ideology.&#10;C) whether or not the parents' medications are helping.&#10;D) if financial resources are sufficient to provide a health care aide.

Accepted Answer

The answer of An African-American caregiver says, &#34;Both of my...

Question 13

A patient says, &#34;I know I need religion in my life, but I don't know how to find God. I feel I have been abandoned.&#34; The nurse should assess for a childhood history of:&#10;A) recurrent losses.&#10;B) overindulgence.&#10;C) lack of nurturing.&#10;D) poor school performance.

Accepted Answer

The answer of A patient says, &#34;I know I need...

Question 14

A patient diagnosed with schizophrenia complains of demon voices coming through the television. Which statement by the nurse providing spiritual care would be most comforting to the patient?&#10;A) &#34;Rest assured that God will fill your heart with peace.&#34;&#10;B) &#34;I am concerned about your spiritual distress.&#34;&#10;C) &#34;God will hold you in the palm of His hand.&#34;&#10;D) &#34;God knows your every thought.&#34;

Accepted Answer

The answer of A patient diagnosed with schizophrenia complains of...

Question 15

The spouse of a psychiatric patient says, "This mental illness should not have happened. I tried to teach the importance of professing faith in God and getting converts, but my partner rejected them. Those practices keep me well. It's the only way to live." The nurse can assess that the spouse is demonstrating:

A) atheism.
B) humanism.
C) agnosticism.
D) sick religiosity.

Accepted Answer

The answer of The spouse of a psychiatric patient says,...

Question 16

A patient tells the nurse, &#34;I make decisions each day that have a positive effect on my life.&#34; This statement is most closely related to the spiritual construct of:&#10;A) making meaning through choices.&#10;B) a presence that orders the world.&#10;C) higher purpose and principles.&#10;D) higher power and achievement.

Accepted Answer

The answer of A patient tells the nurse, &#34;I make...

Question 17

What is the predominant religious tradition in the United States?&#10;A) Christian&#10;B) Buddhist&#10;C) Muslim&#10;D) Jewish

Accepted Answer

The answer of What is the predominant religious tradition in...

Question 18

A patient says, &#34;I am a Christian.&#34; The nurse understands that Christianity includes which groups? Select all that apply.&#10;A) Judaism&#10;B) Mormonism&#10;C) Buddhism&#10;D) Catholicism&#10;E) Greek Orthodox

Accepted Answer

The answer of A patient says, &#34;I am a Christian.&#34;...

Question 19

On the admission papers, a patient checked the box labeled &#34;No religious affiliation.&#34; What meaning can the nurse draw from this information? The patient:&#10;A) is not religious.&#10;B) is probably monotheistic.&#10;C) has conventional religious values.&#10;D) is probably experiencing spiritual distress.

Accepted Answer

The answer of On the admission papers, a patient checked...

Deck 6: Spiritual Issues