Question 1

A nurse works in a pediatric oncology unit and is feeling depressed and discouraged. What initial action by the nurse is best?

Accepted Answer

Hospital chaplains are great resources for nurses experiencing burnout, moral distress, or spiritual distress. The nurse can take all options, but a consultation with the chaplain is the best place to start to see if the issue can be resolved. The chaplain has a wider range of perceptions and tools than do the other staff nurses.

Question 2

The nurse who is aware of spirituality practices of major religions knows that which religions view health and illness as a process of balance or imbalance? (Select all that apply.)

Accepted Answer

Native American, Hindu, and Buddhist practitioners believe that health and illness are a matter of balance or imbalance in the body.

Question 3

A patient is considering a life-saving procedure that is not accepted by his faith community. What nursing diagnosis is a priority as the nurse plans care?

Accepted Answer

Moral distress can occur when there is a conflict between medical care and religious beliefs. This is the diagnosis the nurse should consider when planning care. The other diagnoses may exist as well, but they are not manifested by this conflict.

Question 4

A patient is concerned that she will not be able to maintain her dietary restrictions while in the hospital. What nursing diagnosis is most appropriate for this patient?

Accepted Answer

Impaired religiosity occurs when a patient is unable to maintain religious rituals and practices. The other diagnoses are not related.

Question 5

A patient has the nursing diagnosis Spiritual Distress. What assessment by the patient best indicates that an important goal has been met?

Accepted Answer

Patients may have spiritual distress when facing situations that threaten their meaning and purpose in life, such as in the face of a terminal diagnosis. Patients often express anger, frustration, neediness, or crying. The patient who has worked through this situation and is able to pray has best shown goal attainment. Indecision and questioning do not indicate the resolution of this diagnosis. Executing a living will may be an indication of pragmatism.

Question 6

The nursing student learns which facts about religion and spirituality? (Select all that apply.)

Accepted Answer

Spirituality focuses on the meanings of life, death, and existence. Religion is an organized and structured method of practicing or expressing one's spirituality, so they are interconnected and not mutually exclusive. Religion provides the structure for expressing spirituality. Spirituality can be expressed through relationships with others.

Question 7

A patient is scheduled to have an MRI and has a metal religious icon pinned to his gown, which can't go in the scanner. What action by the nurse is best?

Accepted Answer

The religious icon has profound significance for the patient and should not be removed by the nurse. Since the icon cannot go into the MRI scanner itself, the nurse should explain the situation to the patient and get the patient's opinion of various options. All other options are possibilities, but it should be the patient's determination.

Question 8

A patient in the hospital is an adherent Muslim. Which of the five pillars of Islam can the nurse assist the patient in meeting?

Accepted Answer

The five pillars of Islam are: believe in one God, pray five times a day facing Mecca, giving alms to the less fortunate, fasting during Ramadan, and making a pilgrimage to Mecca. The nurse is best able to help the patient maintain the practice of praying five times a day while hospitalized.

Question 9

A patient who claims to be very involved in church is near death. What action by the nurse is best?

Accepted Answer

Organized religions use rituals to mark important life events such as birth, marriage, and death. This patient would most likely want end-of-life rituals as practiced in his/her church. The nurse's best action is to contact the religious leader (with permission) of that church or institution. Allowing the family to remain at the bedside is important but not the best option to care for the patient's spirituality needs. The hospital chaplain is a valuable resource, but the patient's own religious leader would be better. Praying with the family is always acceptable, but it is best to let the family take the lead in prayer.

Question 10

A nurse is concerned about not consistently meeting the spiritual needs of patients. What action by the nurse is best?

Accepted Answer

To avoid burnout and a decreased ability to attend to the spiritual needs of patients, nurses must take care of their own spiritual needs first. This may include meditation, consultations, and reading, but other activities can guide the nurse into a reflective practice that will allow better spiritual care.

Question 11

The student nurse asks why spirituality is important in health care. What response by the registered nurse is best?

Accepted Answer

Spirituality affects behavior, which has a direct impact on health. Spirituality is a universal concept, but all people may not recognize it in themselves. Holistic knowledge is indeed based in part on spirituality, but that does not give the student information on a concrete link. Less spiritual people may or may not have worse outcomes.

Question 12

The student nurse asks why he needs to assess a patient's spirituality when he can call the chaplain. What response by the nurse is best?

Accepted Answer

Although there is some truth to all options, several regulatory groups list conducting a spiritual assessment as a vital skill for nurses, including the American Association of Colleges of Nursing, the Joint Commission, and the American Nurses Association.

Question 13

A patient asks the nurse to pray with him. The nurse is an atheist and uncomfortable with this request. What action by the nurse is best?

Accepted Answer

Although the nurse is uncomfortable with the request, the patient's needs (not the nurse's) come first. The nurse should attempt to honor the request while not imposing his/her ideas of religion and spirituality on the patient. The best option is to agree to sit with the patient while he prays himself. This is consistent with caring behaviors and fulfilling the patient's needs. Denying the request does nothing to address the patient's needs. The nurse can offer to call the chaplain in addition to sitting with the patient. Asking the patient to change his practices is unethical.

Question 14

The nurse concerned about a patient's spiritual needs can best address this by which action?

Accepted Answer

Spiritual care must be multidisciplinary in order to be most effective. The nurse best addresses patients' spiritual needs by discussing them during interdisciplinary rounds.

Question 15

The charge nurse overhears a new nurse telling a patient that he should no longer follow his vegetarian diet because his protein needs are so high and because "God made animals for us to eat." What action by the charge nurse is best?

Accepted Answer

The nurse should not share opinions or religious edicts with patients when those beliefs contradict the patient's. The charge nurse should counsel the new nurse about this practice. The patient may hold deep convictions about being a vegetarian and may feel disapproval from the nurse, which will impact the nurse-patient relationship. The other options are not appropriate, although the charge nurse could suggest the new nurse collaborate with the dietitian and patient to determine high-protein foods the patient finds acceptable.

Question 16

A home health care nurse has been working with a patient who has the nursing diagnosis Spiritual Distress. After a few weeks of implementing the care plan, what method is best for the nurse to determine if goals have been met?

Accepted Answer

For a diagnosis with a large subjective component, getting the patient's feedback on goal attainment is best. There may be no objective data the nurse can use to rate goal attainment. Using a scale can be a part of the evaluation, but the patient's determination is best.

Question 17

A patient died suddenly in the emergency department. Which action by the nurse best provides the family connection with others?

Accepted Answer

Promoting connectedness means recognizing that family and friends are providing at least some of the patient's spiritual care. The nurse best assists when offering to call someone for the patient or family. The other options may be appropriate but are not directly related to connectedness.

Question 18

A patient, who is an adherent Muslim, is in a burn unit with severe burns. The patient has high caloric requirements but is refusing to eat during Ramadan. What action by the nurse is best?

Accepted Answer

With permission, the nurse should consult with the patient's religious leader on this situation. There may be exceptions to the rule to fast during Ramadan for medical conditions. The other options ignore the patient's religious preferences, and both the tube feeding and parenteral nutrition have potential serious side effects.

Question 19

The student nurse learns that spirituality consists of practices that lead to connection to which items? (Select all that apply.)

Accepted Answer

Spiritual practices generally promote three categories of activity: connection with oneself, with others, and with a higher power.

Question 20

The nurse is caring for four patients. Which one should the nurse assess for spirituality needs as a priority?

Accepted Answer

There are many cues to alert the nurse that a patient might have unmet spiritual needs, including facing a terminal illness. The nurse should conduct spiritual assessments on all patients, but this one is the priority.

Quiz 22: Spiritual Health