Question 1

The nurse is caring for a patient of the Muslim faith who prays ritually several times daily. The patient tells the nurse, "I don't know how I can possibly pray using my prayer rugs here in the hospital." What is the nurse's best response?

Accepted Answer

3. Nurses can promote an individual's religious rituals by making sure that the patient has the items necessary for the ritual. While prayer is important to this individual, prayer is not a part of healing for all patients. Prayer using a prayer rug is not discouraged in the hospital; rather, nurses must encourage patients to continue in their spiritual rituals in order to continue in the healing process.

Question 2

A nurse is performing a spiritual assessment on a patient with depression. What does the nurse recognize as the key concept to a spiritual assessment?

Accepted Answer

2. A spiritual assessment assesses how the patient answers questions about the meaning of life and how satisfied he or she is with those answers. Spirituality is broad term that describes how individuals answer questions about the meaning of life, while religion is a term used to describe formal faith-based practices and beliefs. While spirituality and religion may be similar to some individuals, these terms are different and the spirituality assessment focuses primarily on the patient's spirituality as a whole, not simply his or her religion. Spirituality is broad and informal, not formal. Also, this assessment does not necessarily relate the patient's symptoms to his or her own spirituality. This assessment is not performed by a series of standardized questions but, rather, by the nurse using both closed and open-ended questions, as well as therapeutic communication.

Question 3

The nurse is caring for a patient who is Muslim. What does the nurse recognize as typical core beliefs of the Islamic faith? Select all that apply.

Accepted Answer

2. Muslims are followers of Islam, the fastest growing religion worldwide. Allah is God in Islam. On the last day, Allah will judge people based on what they have done and assign them to either heaven or hell. Hinduism, not Islam, believes that the universe has no beginning and no end, and that there are three paths to spiritual fulfillment: knowledge, insight, and wisdom; action; and ecstatic devotion. Judaism, not Islam, believes that suffering is a part of human growth and change, but God does not test people beyond what they are able to bear.
5. Muslims are followers of Islam, the fastest growing religion worldwide. Allah is God in Islam. On the last day, Allah will judge people based on what they have done and assign them to either heaven or hell. Hinduism, not Islam, believes that the universe has no beginning and no end, and that there are three paths to spiritual fulfillment: knowledge, insight, and wisdom; action; and ecstatic devotion. Judaism, not Islam, believes that suffering is a part of human growth and change, but God does not test people beyond what they are able to bear.

Question 4

The nurse is caring for a dying patient who tells the nurse that he believes in karma. Which religion does the nurse suspect the patient follows? Select all that apply.

Accepted Answer

3. Both Buddhism and Hinduism emphasize the idea of karma, in which actions of the past have consequences in the present, and actions in the present have consequences for the future. Christianity, Islam, and Judaism do not emphasize the idea of karma.
4. Both Buddhism and Hinduism emphasize the idea of karma, in which actions of the past have consequences in the present, and actions in the present have consequences for the future. Christianity, Islam, and Judaism do not emphasize the idea of karma.

Question 5

The nurse is caring for a terminally ill patient who is Christian. The nurse recognizes that the patient's suffering can be a challenge to which core belief that is central to Christianity.

Accepted Answer

2. Suffering can be a challenge to Christianity because it seems to challenge the idea that God is love. According to Christianity, suffering is an inevitable part of life but will not be present in heaven. Christians believe that Jesus Christ chose to experience suffering and, consequently, can comfort humans in their suffering. Christians do not believe that suffering challenges the ideas of reincarnation, that God is all-powerful, or of repentance.

Question 6

The nurse is caring for a patient who is anticipating the loss of a limb following an accident. The patient states, "I feel like I have no control over this." What nursing diagnosis is most appropriate for this patient?

Accepted Answer

1. Powerlessness is the most appropriate nursing diagnosis for this patient. Powerlessness is defined as the belief that one has no control over circumstances or outcomes. Hopelessness is a state in which an individual feels restrained (without choices or alternatives) and immobilized. While the patient expresses distress over the lack of choice for amputation, the patient states no control over the circumstance, indicating powerlessness, not hopelessness. Spiritual distress is best described by the disruption of an individual's capacity to assimilate or find meaning and purpose in his or her life by connecting with self, others, the arts, nature, and/ or a higher power. Ineffective coping is an impairment of problem solving skills, which the patient is not displaying.

Question 7

The nurse is caring for a patient who has dysfunctional grieving after the traumatic loss of a spouse. The patient tells the nurse, "I'm so mad at God." What nursing diagnosis would be most appropriate for this patient?

Accepted Answer

4. The most appropriate nursing diagnosis for the patient is spiritual distress. Spiritual distress is best described by the disruption of an individual's capacity to assimilate or find meaning and purpose in his or her life by connecting with self, others, the arts, nature, and/ or a higher power. Hopelessness is a state in which an individual feels restrained (without choices or alternatives) and immobilized. Powerlessness is defined as the belief that one has no control over circumstances or outcomes. Risk for violence is a diagnosis for individuals who are aggressive and angry and may become violent. Though this patient states he is mad, the patient does not present as violent.

Question 8

The nurse is caring for a patient who is suffering from severe depression. How can the nurse best help the patient find meaning in the experience of suffering from mental illness?

Accepted Answer

2. Helping patients find meaning in the experience of the suffering of mental illness is an important nursing intervention that promotes comfort to patients who are in distress. The nurse simply needs to listen and be present when the patient questions the meaning of life. The nurse does not, however, need to suggest answers when the patient questions the meaning of life. Also, the nurse should not expect or encourage the patient to provide well-formulated answers to the meaning of life.

Question 9

The nurse is caring for a patient with a major mental illness who is experiencing distress. The nurse suggests that the patient join a support group for patients with the disease. How can the group setting bring comfort to the patient? Select all that apply.

Accepted Answer

2. In some cases, connectedness and being a part of a group can help to increase hope. Often this happens when individuals receive support from others living with mental illness or by confronting unhealthy ideas or ways of living. Hope may also occur in the group setting by addressing issues of stigma and dysfunctional beliefs. Typically the group setting does not focus on individual goals or physical symptoms of the disease.
4. In some cases, connectedness and being a part of a group can help to increase hope. Often this happens when individuals receive support from others living with mental illness or by confronting unhealthy ideas or ways of living. Hope may also occur in the group setting by addressing issues of stigma and dysfunctional beliefs. Typically the group setting does not focus on individual goals or physical symptoms of the disease.
5. In some cases, connectedness and being a part of a group can help to increase hope. Often this happens when individuals receive support from others living with mental illness or by confronting unhealthy ideas or ways of living. Hope may also occur in the group setting by addressing issues of stigma and dysfunctional beliefs. Typically the group setting does not focus on individual goals or physical symptoms of the disease.

Question 10

The nurse is assessing a patient's spirituality. What does the nurse recognize as one of the most important aspects of a belief system, according to Sharon Parks?

Accepted Answer

3. Sharon Parks (1986), who has done significant work with young adult spiritual formation, suggests that one of the most important aspects of a belief system is that it is based on a foundation that is strong enough to handle the changes and challenges of life. According to Parks, spiritual belief systems do not need to be based on truth, evidence, or religion.

Question 11

The nurse is performing a spiritual assessment on a newly admitted patient. In addition to asking a patient how he or she answers life's questions, what is also important for the nurse to ask during the patient's spiritual assessment?

Accepted Answer

1. During the spiritual assessment, in addition to asking a patient how he or she answers life's questions, it is also important for the nurse to ask how well the patient's answers are working for him or her, to provide understanding for the patient's situation in life. How well the patient's answers fit into his or her religion, if these answers are accepted by family members, or if the answers are working for the patient's family are not aspects of the patient's spiritual assessment.

Question 12

The nurse is planning care for a patient who is terminally ill. The nurse chooses spiritual distress as the patient's nursing diagnosis. What clinical observations or manifestations warrant this nursing diagnosis?

Accepted Answer

4. A patient who is experiencing spiritual distress may express a lack of purpose in life. A decreased or flat affect and lack of initiative are manifestations of hopelessness, not spiritual distress. Expressed lack of control is evidenced in a patient experiencing powerlessness, not spiritual distress.

Question 13

The nurse is assessing the religious and spiritual beliefs of a patient with mental illness. The nurse understands that which is generally true with regard to spirituality and religion in the care of patients with mental illness? Select all that apply.

Accepted Answer

1. There is a growing body of evidence to support a positive relationship between faith and mental health for many individuals. For example, evidence suggests that aspects of life such as coping, having hope, finding meaning and purpose in life, the ability to forgive, and an overall quality of life are related to having a religious faith. Religious individuals may have some protection against the physiological consequences of stress. Spirituality is a predictor of better outcomes in schizophrenia and schizoaffective disorders. It is still very difficult to find definitive evidence about the relationship between religious beliefs and mental health and illness. Part of the reason for this is that researchers are still trying to define the terms that are important to understanding this relationship and to determine how to measure them.
3. There is a growing body of evidence to support a positive relationship between faith and mental health for many individuals. For example, evidence suggests that aspects of life such as coping, having hope, finding meaning and purpose in life, the ability to forgive, and an overall quality of life are related to having a religious faith. Religious individuals may have some protection against the physiological consequences of stress. Spirituality is a predictor of better outcomes in schizophrenia and schizoaffective disorders. It is still very difficult to find definitive evidence about the relationship between religious beliefs and mental health and illness. Part of the reason for this is that researchers are still trying to define the terms that are important to understanding this relationship and to determine how to measure them.
4. There is a growing body of evidence to support a positive relationship between faith and mental health for many individuals. For example, evidence suggests that aspects of life such as coping, having hope, finding meaning and purpose in life, the ability to forgive, and an overall quality of life are related to having a religious faith. Religious individuals may have some protection against the physiological consequences of stress. Spirituality is a predictor of better outcomes in schizophrenia and schizoaffective disorders. It is still very difficult to find definitive evidence about the relationship between religious beliefs and mental health and illness. Part of the reason for this is that researchers are still trying to define the terms that are important to understanding this relationship and to determine how to measure them.

Question 14

A novice nurse is learning about the importance of patient spiritual care and discussing the differences between religion and spirituality. What statement by the nurse indicates that the nurse understands this concept?

Accepted Answer

2. Spirituality is a broader term, whereas the term religion represents a formalized, and often structured, way of answering questions about the nature of life. Spirituality is not universal among all humans, nor is it structured and organized.

Question 15

The nurse is caring for a patient with depression who expresses hopelessness. How can the nurse use spirituality to comfort the patient? Select all that apply.

Accepted Answer

1. Nursing interventions that can promote spirituality as a comfort to patients with any type of illness include providing a quiet place for prayer or reading religious texts; scheduling activities around designated times for prayer or religious observances; and encouraging patients to use their beliefs to deal with feelings of hopelessness. Although referrals to group therapy or a spiritual advisor may be helpful to patients, these actions do not involve the nurse's use of spirituality in providing comfort to patients.
2. Nursing interventions that can promote spirituality as a comfort to patients with any type of illness include providing a quiet place for prayer or reading religious texts; scheduling activities around designated times for prayer or religious observances; and encouraging patients to use their beliefs to deal with feelings of hopelessness. Although referrals to group therapy or a spiritual advisor may be helpful to patients, these actions do not involve the nurse's use of spirituality in providing comfort to patients.
3. Nursing interventions that can promote spirituality as a comfort to patients with any type of illness include providing a quiet place for prayer or reading religious texts; scheduling activities around designated times for prayer or religious observances; and encouraging patients to use their beliefs to deal with feelings of hopelessness. Although referrals to group therapy or a spiritual advisor may be helpful to patients, these actions do not involve the nurse's use of spirituality in providing comfort to patients.

Question 16

The nurse is caring for a patient who is dying. The patient's family member tells the nurse, "I hope my husband finds Nirvana quickly." Which religion is most commonly associated with belief in Nirvana?

Accepted Answer

2. Buddhism emphasizes that Nirvana is the end of suffering and rebirth after death. Belief in Nirvana is not associated with Islam, Hinduism, or Christianity.

Question 17

The nurse is assessing an individual's spirituality. Which components would the nurse identify as relating to the patient's overall health? Select all that apply.

Accepted Answer

1. The desire to live in harmony with the transcendent, the need to answer questions about life that go beyond that which we encounter directly, and the need to recognize something that is bigger than ourselves, are all components of an individual's spirituality. The desire to attend religious ceremonies and the need to worship the transcendent are components of formal religion, not individual spirituality.
4. The desire to live in harmony with the transcendent, the need to answer questions about life that go beyond that which we encounter directly, and the need to recognize something that is bigger than ourselves, are all components of an individual's spirituality. The desire to attend religious ceremonies and the need to worship the transcendent are components of formal religion, not individual spirituality.
5. The desire to live in harmony with the transcendent, the need to answer questions about life that go beyond that which we encounter directly, and the need to recognize something that is bigger than ourselves, are all components of an individual's spirituality. The desire to attend religious ceremonies and the need to worship the transcendent are components of formal religion, not individual spirituality.

Question 18

A nurse is performing a spirituality assessment on a patient who is being admitted with acute mania. What question will the nurse ask the patient during the initial assessment of the patient's spirituality? Select all that apply.

Accepted Answer

1. The initial assessment of a patient's spirituality usually begins on admission and involves basic questions about a patient's spiritual or religious practices and what, if any, assistance the patient needs in following them. This primarily involves closed questions, such as: "Do you have a religious preference?"; "Are there any spiritual or religious practices that are important to you?"; "Would you like me to contact your clergy member or religious leader?" The other questions are open-ended questions and would not be asked by the nurse during the initial assessment of the patient's spirituality. The nurse will ask these open-ended questions the nurse-patient therapeutic relationship has been established, after the initial assessment.
3. The initial assessment of a patient's spirituality usually begins on admission and involves basic questions about a patient's spiritual or religious practices and what, if any, assistance the patient needs in following them. This primarily involves closed questions, such as: "Do you have a religious preference?"; "Are there any spiritual or religious practices that are important to you?"; "Would you like me to contact your clergy member or religious leader?" The other questions are open-ended questions and would not be asked by the nurse during the initial assessment of the patient's spirituality. The nurse will ask these open-ended questions the nurse-patient therapeutic relationship has been established, after the initial assessment.
4. The initial assessment of a patient's spirituality usually begins on admission and involves basic questions about a patient's spiritual or religious practices and what, if any, assistance the patient needs in following them. This primarily involves closed questions, such as: "Do you have a religious preference?"; "Are there any spiritual or religious practices that are important to you?"; "Would you like me to contact your clergy member or religious leader?" The other questions are open-ended questions and would not be asked by the nurse during the initial assessment of the patient's spirituality. The nurse will ask these open-ended questions the nurse-patient therapeutic relationship has been established, after the initial assessment.

Question 19

A nurse is caring for a patient of a particular faith who is terminally ill. What is the nurse's best understanding regarding the patient's spirituality?

Accepted Answer

2. It is important for the nurse to understand that the individual who adopts a particular religious belief may not believe or practice every tenet of his or her religion and may, in fact, have his or her own individual answers to questions about life. Therefore, spirituality is defined by the patient, not by the patient's religion, religious structure, or transcendent figure.

Question 20

A patient with chronic pain tells the nurse "I just want to give up all together. I am in so much pain every day, all the time. I don't want to do this anymore." Which is the priority nursing diagnosis for this patient?

Accepted Answer

1. The priority nursing diagnosis for this patient is hopelessness, a state in which an individual feels restrained (without choices or alternatives) and immobilized. The nurse must recognize that the patient may be expressing thoughts of suicide, and the nurse must immediately assess for suicidal ideations. Though the patient is in chronic pain, it is the patient's hopelessness that takes priority. Powerlessness and spiritual distress may be aspects of the patient's current state; however, the patient's expression of hopelessness takes priority.

Quiz 6: Spiritual Awareness