1.An elderly patient is dying, and begins talking to loved ones who have died before him. The nurse feels a sense of inner peace as his patient quietly dies. What is the best term for this feeling of peace?
a.
Self-transcendence
b.
Intrapersonal connectedness
c.
Interpersonal connectedness
d.
Transpersonal connectedness
ANS: A
Self-transcendence refers to connecting to your inner self, which allows you to go beyond yourself to understand the meanings of experiences, whereas transcendence is the belief that there is a positive force outside of and greater than oneself that allows you to develop new perspectives that are beyond physical boundaries. Examples of transcendent moments include the feelings of awe when holding a new baby or watching the sun rise over the mountains. Spirituality offers a sense of connectedness intrapersonally (connected with oneself), interpersonally (connected with others and the environment), and transpersonally (connected with God, the unseen, or a higher power).
PTS: 1 DIF: Cognitive Level: Remembering (Knowledge)
REF:548
OBJ: Describe the relationship among faith, hope, and spiritual well-being.
TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity
2.The nurse is caring for a patient who states that he does not believe in the existence of God. The nurse realizes that this person:
a.
is not a spiritual person.
b.
is an agnostic.
c.
believes that people bring meaning into the world.
d.
finds meaning in life through work and relationships.
ANS: D
Atheists search for meaning in life through their work and relationships with others. Spirituality exists in all people regardless of their religious beliefs and it gives people the energy needed to maintain health and cope with difficult situations. Spirituality is an important concept for individuals who either do not believe in the existence of God (atheist) or who believe that any ultimate reality is unknown or unknowable (agnostic). It is important for agnostics to discover meaning in what they do or how they live because they find no ultimate meaning for the way things are. They believe that we, as people, bring meaning to what we do.
PTS: 1 DIF: Cognitive Level: Understanding (Comprehension)
REF:549
OBJ: Describe the relationship among faith, hope, and spiritual well-being.
TOP: Nursing Process: Diagnosis MSC: NCLEX: Psychosocial Integrity
3.A nurse is caring for a patient with a debilitating chronic illness. The patient mentions several times that faith would guide her healing. The nurse knows that faith can best be defined as a:
a.
system of organized beliefs and worship.
b.
relationship with a higher power, authority, or spirit.
c.
source of energy needed to cope with difficult situations.
d.
multidimensional concept that gives comfort while a person endures hardship.
ANS: B
Faith is a relationship with a divinity, higher power, authority, or spirit that incorporates a reasoning faith (belief) and a trusting faith (action). Religion refers to the system of organized beliefs and worship that a person practices to outwardly express spirituality. Spirituality exists in all people regardless of their religious beliefs and it gives people the energy needed to maintain health and cope with difficult situations. Hope is multidimensional and gives comfort while a person endures hardship and personal challenges.
PTS: 1 DIF: Cognitive Level: Remembering (Knowledge)
REF:549
OBJ: Describe the relationship among faith, hope, and spiritual well-being.
TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity
4.A patient has been diagnosed with a terminal disease. Hope may be used effectively with this type of patient. Nurses can support a patient’s use of hope because hope provides a:
a.
system of organized beliefs and worship.
b.
belief in a higher power, spirit guide, God, or Allah.
c.
cultural connectedness, structure, and guidance in difficult times.
d.
motivation to achieve and the resources to use toward that achievement.
ANS: D
Hope is energizing, giving individuals a motivation to achieve and the resources to use toward that achievement. Religion refers to the system of organized beliefs and worship that a person practices to outwardly express spirituality. Faith involves a belief in a higher power, spirit guide, God, or Allah. Spirituality offers a sense of connectedness. Spirituality is unique for each person. It is a unifying theme in life and a state of being.
PTS: 1 DIF: Cognitive Level: Remembering (Knowledge)
REF:550
OBJ: Describe the relationship among faith, hope, and spiritual well-being.
TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity
5.When caring for patients, a nurse must understand the difference between religion and spirituality. Religious care helps patients maintain their faithfulness to:
a.
their belief systems and worship practices.
b.
a relationship to a higher being or life force.
c.
a sense of connectedness.
d.
the awareness of one’s inner self.
ANS: A
Religious care helps patients follow their belief systems and worship practices. Spirituality is an awareness of one’s inner self and a sense of connection to a higher being, nature, or some purpose greater than oneself. Spirituality offers a sense of connectedness. Spirituality is unique for each person. It is a unifying theme in life and a state of being.
PTS: 1 DIF: Cognitive Level: Remembering (Knowledge)
REF: 550 OBJ: Compare and contrast the concepts of religion and spirituality.
TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity
6.A patient who has been diagnosed with terminal liver cancer states that he does not believe in God, but he has had a meaningful life by contributing to the lives of those around him. This person is most likely which of the following?
a.
Buddhist
b.
Christian
c.
Agnostic
d.
Atheist
ANS: D
Atheists search for meaning in life through their work and relationships with others. It is important for agnostics to discover meaning in what they do or how they live because they find no ultimate meaning for the way things are. They believe that we, as people, bring meaning to what we do. A Buddhist turns inward, valuing self-control, whereas a Christian looks to the love of God to provide enlightenment and direction in life.
PTS: 1 DIF: Cognitive Level: Remembering (Knowledge)
REF: 549 OBJ: Compare and contrast the concepts of religion and spirituality.
TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity
7.A nurse is caring for a 64-year-old patient who has survived cardiopulmonary resuscitation after a triple coronary artery bypass graft surgery. To help this patient cope with this experience, what is the best thing for the nurse to do?
a.
Recommend that the patient not discuss the experience with family.
b.
Assume that the near death experience was a positive experience.
c.
Explain that people who have not had that experience will not understand.
d.
Explore what happened with the patient.
ANS: D
After patients have survived a near death experience (NDE), promote spiritual well-being by remaining open, giving patients a chance to explore what happened, and supporting patients as they share the experience with significant others. Patients who have an NDE are often reluctant to discuss it, thinking family or caregivers will not understand. Isolation and depression often occur. Furthermore, not all NDEs are positive experiences. However, individuals experiencing an NDE who discuss it openly with family or caregivers find acceptance and meaning from this powerful experience.
PTS:1DIF:Cognitive Level: Applying (Application)
REF:552
OBJ: Discuss the relationship of spirituality to an individual’s total being.
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity
8.A nurse who works in a neonatal intensive care unit is caring for a critically ill infant with a poor prognosis. She is Christian and feels responsible to care for both the physical and spiritual needs of the infant and his parents. What is the best statement for the nurse to make to the parents of the infant?
a.
“You should have the child baptized so that its soul will be saved.”
b.
“Would you like me to call the chaplain to christen your child at the bedside?”
c.
“What can I do to support your spiritual needs?”
d.
“I have asked my pastor to stop by and talk to you.”
ANS: C
Differentiate your personal spirituality from that of the patient. Your role is not to solve the spiritual problems of patients, but to provide an environment for your patients to express their spirituality. Having the child baptized or asking your pastor to come talk to the patient is applying your spiritual values on the patient. Asking permission to call the chaplain is assuming that the patient has value regarding that religious denomination.
PTS:1DIF:Cognitive Level: Applying (Application)
REF:552
OBJ: Discuss the relationship of spirituality to an individual’s total being.
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity
9.A patient refuses to remove a specific spiritual garment for daily bathing. The most appropriate action for the nurse would be to:
a.
remove the article anyway because the garment hinders daily care delivery.
b.
respect the patient’s wishes and work around it.
c.
explain to the patient that the garment has no real spiritual value.
d.
identify the refusal as a sign of spiritual distress.
ANS: B
To care for and meet the spiritual needs of your patients, it is essential to respect each patient’s personal beliefs. People experience the world and find meaning in life in different ways and the spiritual garment has meaning for the patient. Caring for your patients’ spiritual needs requires you to be compassionate and remove any personal biases or misconceptions. You need to recognize that not all patients have spiritual problems. Patients bring certain spiritual resources that help them assume healthier lives, recover from illness, or face impending death.
PTS:1DIF:Cognitive Level: Applying (Application)
REF:554
OBJ: Discuss the relationship of spirituality to an individual’s total being.
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity
10.To assess, evaluate, and support a patient’s spirituality the best action a nurse should take includes:
a.
recognizing that spirituality does not enhance therapeutic relationships.
b.
performing a definitive spiritual assessment once because spirituality does not vary.
c.
focusing the assessment on religious doctrine and faith.
d.
remembering that spirituality is very subjective.
ANS: D
Remember that spirituality is very subjective and has different meanings for different people. You are able to gather an accurate assessment of your patients’ spirituality when you take time to build therapeutic relationships with them. Conduct an ongoing spiritual assessment the entire time you care for a patient. Focus your assessment on aspects of spirituality most likely to be influenced by life experiences, events, and questions in the case of illness and hospitalization.
PTS:1DIF:Cognitive Level: Applying (Application)
REF: 554 OBJ: Compare and contrast the concepts of religion and spirituality.
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity
MULTIPLE RESPONSE
1.Interventions a nurse can use to establish presence with a patient include which of the following? (Select all that apply.)
a.
Giving attention
b.
Answering questions
c.
Listening
d.
Administering medication
e.
Speaking with the family
ANS: A, B, C
Behaviors that establish your presence include giving attention, answering questions, listening, and having a positive and encouraging (but realistic) attitude. Presence is part of the art of nursing that involves “being with” a patient versus “doing for” a patient, as in administering medication and speaking with the family. Presence is being able to offer closeness with the patient, which helps to prevent emotional and environmental isolation.
PTS: 1 DIF: Cognitive Level: Understanding (Comprehension)
REF:561OBJ:Establish presence with patients.
TOP: Nursing Process: Diagnosis MSC: NCLEX: Psychosocial Integrity
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