Values and Beliefs

1. It is believed that a person’s value system is well established by age:

a.
5.
b.
8.
c.
10.
d.
12.

ANS: C

The value system, developed in early childhood, is well established by the age of 10 years.

DIF: Cognitive Level: Knowledge REF: 234 OBJ: 1

TOP: Value System KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

2. The culturally sensitive nurse is aware that in caring for a patient with a different value system, the nurse should:

a.
be open and nonjudgmental.
b.
treat all patients the same without concern for their value system.
c.
explain the differences between the two value systems.
d.
abandon their own value system.

ANS: A

Persons are prone to view those with a different value system from their own in a negative and prejudicial manner.

DIF: Cognitive Level: Comprehension REF: 236 OBJ: 1

TOP: Value Systems Differences KEY: Nursing Process Step: Planning

MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation

3. When the 80-year-old Orthodox Jewish man dies in the hospital, the nurse should:

a.
notify the rabbi to send a member of the synagogue to stay with the body.
b.
inform the mortuary about the desire of the patient to be cremated.
c.
prepare the body for the ritual bath by temple members before embalming.
d.
facilitate removal of the body because the burial must take place 48 hours after death.

ANS: A

A synagogue member will come to pray and read scripture from the time of death to the time of burial, which must take place 24 hours after death. The reader will accompany the body to the morgue, mortuary, and burial site. Jewish persons are forbidden to be cremated or embalmed.

DIF: Cognitive Level: Analysis REF: 235, Cultural Considerations

OBJ: 5 TOP: Jewish Culture

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation

4. The nurse is careful not to remove the yarmulke from the head of the Jewish man during care because it is a symbol of:

a.
having been circumcised.
b.
the belief that God is higher than man.
c.
God’s endless love and protection.
d.
the justice of Talmudic law.

ANS: B

The yarmulke is worn by Jewish men to remind them that God is higher than man.

DIF: Cognitive Level: Application REF: 235, Cultural Considerations

OBJ: 4 TOP: Jewish Culture

KEY: Nursing Process Step: Planning

MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation

5. When checking the diet trays, the nurse identifies a menu choice that would be culturally inappropriate for the Muslim patient as:

a.
fish and tomatoes.
b.
liver and onions.
c.
chicken and broccoli.
d.
pork chops and sweet potatoes.

ANS: D

Muslims are forbidden to eat pork or pork products.

DIF: Cognitive Level: Application REF: 235, Cultural Considerations

OBJ: 4 TOP: Muslim Beliefs

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation

6. The home health nurse caring for an 85-year-old Hispanic woman anticipates that the patient will want to seek health advice from the:

a.
local pharmacist for prescription drugs.
b.
folk healer (curandero).
c.
priest of her church.
d.
close family members.

ANS: B

The curandero is a significant person to the older Hispanic adult for health matters. The use of folk remedies and nonprescription OTC drugs is common.

DIF: Cognitive Level: Comprehension REF: 235, Cultural Considerations

OBJ: 4 TOP: Hispanic Beliefs

KEY: Nursing Process Step: Planning

MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation

7. Included in the Native American’s spiritual beliefs is that:

a.
there is no life after death.
b.
all things in the world have a spirit.
c.
after death, the spirit stays as part of the tribe.
d.
the spirit world is the protector of health.

ANS: B

Native Americans believe that all things have a spirit.

DIF: Cognitive Level: Comprehension REF: 235, Cultural Considerations

OBJ: 4 TOP: Native American Beliefs KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

8. The nurse anticipates that the 80-year-old African American woman believes that her health will be improved by:

a.
eating fresh fruits and vegetables.
b.
daily Bible reading.
c.
a visit from her pastor to pray for her recovery.
d.
the close attendance of her family.

ANS: C

A visit from the pastor and his prayers will improve her health perception. Illness is viewed as being caused by a lack of faith or the devil.

DIF: Cognitive Level: Application REF: 235, Cultural Considerations

OBJ: 4 TOP: African American Beliefs

KEY: Nursing Process Step: Planning

MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation

9. The basic and most important way for the nurse to become culturally sensitive is:

a.
interaction with persons of another culture.
b.
increasing personal knowledge of another culture.
c.
remaining open-minded.
d.
reading materials about other cultures.

ANS: B

Open-mindedness and understanding of other cultures assist the nurse to work effectively with persons from a variety of cultures.

DIF: Cognitive Level: Analysis REF: 236 OBJ: 1

TOP: Cultural Sensitivity KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

10. The home health nurse is aware that the conservative economic values of the 85-year-old will lead the older adult to:

a.
use credit cards rather than cash.
b.
hoard old prescription drugs for later use.
c.
seek the care of a physician frequently.
d.
seek to qualify for food stamps.

ANS: B

Older adults are “savers” and avoid outlay of money until it is absolutely necessary. They are prone to hoard drugs, delay medical care, and avoid debt of any type.

DIF: Cognitive Level: Analysis REF: 237 OBJ: 4

TOP: Economic Values KEY: Nursing Process Step: Planning

MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation

11. The nurse is aware that basic spiritual beliefs, regardless of culture, are based on:

a.
the presence of a supreme being.
b.
faith in an afterlife existence.
c.
a rigid code of behavior.
d.
the need for an organized church.

ANS: A

The awareness of a supreme being is basic to all spiritual beliefs.

DIF: Cognitive Level: Comprehension REF: 237 OBJ: 1

TOP: Spiritual Values KEY: Nursing Process Step: Assessment

MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation

12. The nurse provides space on the bedside table of a terminally ill Roman Catholic Hispanic woman for the religious objects that have spiritual meaning to her, which would be a:

a.
Koran and prayer mat.
b.
rosary and vial of holy water.
c.
Torah and prayer shawl.
d.
Bible and whole kernels of corn.

ANS: B

The rosary and holy water are significant religious items for the Roman Catholic.

DIF: Cognitive Level: Analysis REF: 238 OBJ: 10

TOP: Religious Objects KEY: Nursing Process Step: Implementation

MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation

13. In the spiritual assessment prompt SPIRIT, the R reminds the nurse to assess the patient for the need of:

a.
rituals.
b.
religious objects.
c.
rosary.
d.
religious reading materials.

ANS: A

The “R” is the prompt to inquire about the need for any religious rituals.

DIF: Cognitive Level: Comprehension REF: 239, Box 14-1

OBJ: 7 TOP: Mnemonic for Spiritual Assessment

KEY: Nursing Process Step: Assessment

MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation

14. When the spiritual leader comes to visit the bedfast patient in a long-term care facility, the nurse can enhance the visit best by:

a.
taking the resident’s roommate to the dayroom.
b.
pulling the curtain for privacy.
c.
closing the door to the room.
d.
giving notice to the CNAs of the presence of the spiritual leader.

ANS: A

Although all the options increase privacy, the best intervention is to have the roommate go somewhere else.

DIF: Cognitive Level: Analysis REF: 240 OBJ: 10

TOP: Privacy for Spiritual Counseling KEY: Nursing Process Step: Implementation

MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation

MULTIPLE RESPONSE

1. The nurse is aware that a patient’s values reflect influences from __________. (Select all that apply.)

a.
religion
b.
philosophy
c.
family
d.
financial status
e.
society

ANS: A, B, C, E

Financial status does not play a part in the makeup of a person’s value system.

DIF: Cognitive Level: Knowledge REF: 234 OBJ: 1

TOP: Values KEY: Nursing Process Step: Planning

MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation

2. The nurse takes into consideration that values and beliefs set the framework for daily life for each individual and influence __________. (Select all that apply.)

a.
health practices
b.
perception of illness
c.
social status
d.
spouse selection
e.
morality

ANS: A, B, D, E

Social status is not influenced by values and beliefs.

DIF: Cognitive Level: Comprehension REF: 234 OBJ: 1

TOP: Influence of Values KEY: Nursing Process Step: Planning

MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation

3. The nurse takes into consideration to include the five pillars of the Islamic faith in the care of the Muslim male, which include __________. (Select all that apply.)

a.
to make a confession of faith
b.
perform five daily prayers at the appropriate time
c.
observe Ramadan
d.
make a pilgrimage to Mecca
e.
to care for children

ANS: A, B, C, D

The care of children is not one of the five pillars of the Islamic faith.

DIF: Cognitive Level: Comprehension REF: 235, Cultural Considerations

OBJ: 4 TOP: Muslim Culture

KEY: Nursing Process Step: Planning

MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation

4. In planning the care of a Muslim woman, the nurse will __________. (Select all that apply.)

a.
provide time for five daily prayers
b.
address all health questions to the husband
c.
assign only female caregivers
d.
keep all cut flowers and greenery out of the room
e.
remind caregivers to be especially protective of the patient’s modesty

ANS: A, C, E

Muslims observe five prayers daily. Women are extremely modest and usually request female caregivers.

DIF: Cognitive Level: Application REF: 235, Cultural Considerations

OBJ: 10 TOP: Muslim Beliefs

KEY: Nursing Process Step: Planning

MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation

5. The nurse is sensitive to the cultural beliefs of Native Americans; they practice rituals for the improvement of their health by creating harmony among __________. (Select all that apply)

a.
mind
b.
faith
c.
wellness
d.
spirit
e.
body

ANS: A, D, E

Faith and wellness are not part of the health ritual.

DIF: Cognitive Level: Comprehension REF: 235, Cultural Considerations

OBJ: 4 TOP: Native American Culture

KEY: Nursing Process Step: Planning

MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation

6. The home health nurse listens to the 94-year-old Italian man who lives with his daughter and her family when he verbalizes his frustrations about the conflict of his grandchildren’s values with his own, such as __________.(Select all that apply.)

a.
hairstyle and clothing
b.
lack of reverence for age and wisdom
c.
rejection of traditional ethnic foods
d.
process of selecting a spouse
e.
desire for education

ANS: A, B, C, D

The value for education would not be in conflict with Old World values.

DIF: Cognitive Level: Application REF: 236 OBJ: 8

TOP: Intrafamily Cultural Conflict KEY: Nursing Process Step: Implementation

MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation

7. The culturally sensitive nurse is alert for indications of spiritual distress in the older adult, which may be evidenced by __________. (Select all that apply.)

a.
expressions of the meaningless of life
b.
verbalizations of guilt about past behavior
c.
an expressed need to mend a broken relationship
d.
daily prayer to a supreme being
e.
diminished hope

ANS: A, B, C, E

The feeling that life has no meaning and is hopeless, preoccupation with perceived guilt, and a need to mend relationships are indicators of spiritual distress.

DIF: Cognitive Level: Application REF: 239 OBJ: 8

TOP: Spiritual Distress KEY: Nursing Process Step: Assessment

MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation

8. When the patient asks the nurse to pray for him because he does not know how to pray, the nurse assures him that a supreme being can hear a prayer of any type, such as prayer that is __________. (Select all that apply.)

a.
ritualized
b.
read from a holy book
c.
structured
d.
informal and conversational
e.
recited from childhood memory

ANS: A, B, C, D, E

Prayer is anything that the person makes it, from formal ritualistic prayer to an informal conversation with the supreme being. All are prayers, and all are heard.

DIF: Cognitive Level: Comprehension REF: 239, Complementary and Alternative Therapies

OBJ: 10 TOP: Prayer KEY: Nursing Process Step: Implementation

MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation

9. While working with an older adult at a clinic, the nurse is aware that health practices include __________. (Select all that apply.)

a.
health promotion
b.
coping with illness
c.
health maintenance patterns
d.
spiritual support
e.
religious practices

ANS: A, B, C

Health practices are those behaviors that show health promotion and maintenance and coping with illness. Spiritual and religious matters are not necessarily health practices but may influence them.

DIF: Cognitive Level: Comprehension REF: 234 OBJ: 3

TOP: Health Practices KEY: Nursing Process Step: Planning

MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation

10. During the admission process, the registered nurse makes a nursing diagnosis of spiritual distress. Which question(s) may help clarify the situation? (Select all that apply.)

a.
“What gives you meaning to life?”
b.
“Are there any spiritual objects that you want in your room?”
c.
“Do you want a particular spiritual counselor notified?”
d.
“Is there any special religious practice that you would want us to be aware of?”
e.
“What is your cultural background?”

ANS: A, B, C, D

Asking about the cultural background can lead to stereotyping. Questions regarding the meaning of life, symbolic objects, counselors, and practices will help identify sources of conflict and desired spiritual assistance.

DIF: Cognitive Level: Application REF: 239, Critical Thinking

OBJ: 9 TOP: Spiritual Assessment

KEY: Nursing Process Step: Assessment

MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation

COMPLETION

1. After the burial of a Jewish man who was a resident in a long-term care facility, along with his wife, the nurse is aware that his wife and family will observe __________, a 7-day period of mourning.

ANS: shivah

DIF: Cognitive Level: Comprehension REF: 235, Cultural Considerations

OBJ: 10 TOP: Shivah KEY: Nursing Process Step: Planning

MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation

2. The nurse explains that Muslims have a great reverence for their holy book, called the __________.

ANS: Koran; Qur’an

DIF: Cognitive Level: Knowledge REF: 235, Cultural Considerations

OBJ: 4 TOP: Muslim Beliefs

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation