The Faith Community Nurse

1. Which of the following best describes the primary difference between parish nursing and all other nursing positions?

a.
Affiliation with a church or congregation
b.
Incorporation of spiritual aspects into nursing care
c.
Provision of holistic nursing care
d.
Residence within the community of service

ANS: A

In 1998 the American Nurses Association accepted parish nursing as the most recognized term for the practice of nurses working with congregations or faith communities. All nurses may choose to incorporate spiritual aspects into holistic nursing care.

DIF: Cognitive Level: Understand (Comprehension) REF: p. 536

2. To help congregation members better meet their nutritional needs, the parish nurse organized members to participate in activities that focused on fellowship while providing healthy meals to homebound members and serving “healthy heart” church suppers. Which of the following activities is being completed?

a.
Entitlement programs
b.
Health ministries
c.
Partnerships
d.
Pastoral care practices

ANS: B

Health ministries are those activities and programs in faith communities organized around health and healing to promote wholeness in health across the life span. These services include activities such as visiting the homebound, providing meals for families in crisis or when returning home after hospitalization, organizing prayer circles, serving “healthy heart” church suppers, and holding regular grief support groups.

DIF: Cognitive Level: Apply (Application) REF: p. 536

3. Which of the following best describes why it is helpful to be a member of a faith community?

a.
Belief and traditions help with coping.
b.
Members can ask others in the group for help.
c.
It is a social outlet.
d.
Members are able to get others to contribute to the causes they support.

ANS: A

Although there is some truth in all the options, persons who encounter assaults with physical and emotional illness and brokenness and who are able to call upon their faith beliefs and religious traditions are able to increase coping skills and realize spiritual growth even during adversity.

DIF: Cognitive Level: Understand (Comprehension) REF: p. 538

4. Which of the following principles is central to the role of the parish nurse?

a.
Advanced nursing practice education and skills
b.
Faith consistent with the community and its leadership
c.
Spiritual dimension of care
d.
Willingness to serve anyone in need

ANS: C

Although all options would be helpful, the spiritual dimension of health care is central to the practice of parish nursing.

DIF: Cognitive Level: Understand (Comprehension) REF: pp. 539-540

5. A young woman had been away from home several years before she returned home sick and disheartened. Her mother called a nurse to help. Which of the following behaviors would suggest that the caregiver who arrived was a parish nurse?

a.
Advanced nursing practice education and skills
b.
Compassionate, skilled, dedicated touch
c.
Offered a prayer with the daughter and mother
d.
Willingness to do whatever was needed by mother or daughter

ANS: C

Although all options hopefully would occur, the spiritual dimension of health care is central to the practice of parish nursing. Both nursing functions and pastoral care functions are performed by parish nurses, whose visits often involve prayer and reference to scripture, symbols, sacraments, and liturgy of the faith community.

DIF: Cognitive Level: Apply (Application) REF: pp. 539-540

6. Which of the following statements best describes how clients and parish nurses typically perceive spiritual health?

a.
It exists at the point that cure is attained.
b.
It has a tangential relation to well-being.
c.
It is part of an ongoing dynamic process.
d.
It is usually unchanging across the life span.

ANS: C

Health, spiritual health, and healing are considered parts of an ongoing, dynamic process. Because spiritual health is central to well-being, influences are evident in the total individual and noted in a healthy congregation. Well-being and illness may occur simultaneously; spiritual healing or well-being can exist in the absence of cure.

DIF: Cognitive Level: Understand (Comprehension) REF: p. 540

7. Which of the following statements suggests that faith community nursing is a nationally recognized specialty of nursing?

a.
Academic programs now offer a clinical specialty in parish nursing.
b.
Faith community nurses are increasingly receiving salaries for their efforts.
c.
Faith community nursing is being adapted in other countries and to non-Christian faiths.
d.
Scope and standards of faith community practice have been developed and revised.

ANS: D

The 2005 Faith Community Nursing: Scope and Standards of Practice revised the original 1998 document in describing the who, what, where, when, why, and how of the practice of faith community nursing. The most recent edition, released in 2012, focuses on faith community nurses but is also aimed at other healthcare providers, spiritual leaders, families, and members of faith communities. Specialty areas within professional nursing achieve a major milestone when the standards and scope common to that practice are recognized.

DIF: Cognitive Level: Understand (Comprehension) REF: p. 541

8. A group of parish nurses affiliated with a number of faith-based communities located in different regions across the state are attending a quarterly meeting. Which of the following statements made by one of them indicates a lack of understanding of parish nursing?

a.
“I always make sure to have new clients sign a release of information form to obtain their health record from their previous parish nurse.”
b.
“Because I work for and within the church, I am immune from civil laws.”
c.
“The pastor and I work together for the spiritual health of the community.”
d.
“Yes, I am happy to pray with my clients and help them worship.”

ANS: B

The nurse must personally and professionally abide by the parameters of the nurse practice act of the jurisdiction and maintain an active license of that state.

DIF: Cognitive Level: Apply (Application) REF: p. 541

9. A nurse is considering accepting the parish nursing position within his congregation. Which of the following educational preparation is crucial for the nurse to have received?

a.
Baccalaureate education including community health nursing experience
b.
Graduate education in community health nursing
c.
Passing the national certifying exam for parish health nursing
d.
Worship experiences for the process of ministry

ANS: A

Current educational preparation for the parish nurse includes the successful completion of extensive continuing education contact hours or designated coursework in parish nurse preparation at the baccalaureate or graduate level, as well as a thorough grasp of the scope and standards of the practice. These basic programs provide an orientation to the role and functions of the parish nurse, as well as worship experiences for the process of ministry. The parish nurse must be a member of the faith community and be comfortable with worship practices and traditions to function.

DIF: Cognitive Level: Apply (Application) REF: p. 542

10. A family shared their concerns, including sexual issues, in strictest confidence with a faith community nurse. When the nurse returned to the church office, the pastor asked why the family wanted to see her. Which of the following statements would be the best response by the nurse?

a.
“Because you are my supervisor, I will summarize what was said for you.”
b.
“I will include that information in my report to our church’s wellness committee.”
c.
“They just wanted me to assess their health needs and make some suggestions.”
d.
“The family had some issues they wanted to discuss in confidence, which I will keep in confidence.”

ANS: D

Issues of privacy and confidentiality as well as record management should be discussed upon accepting a position. Regardless, if the nurse agreed to keep the information confidential, the nurse is morally obligated to do so. If the practice is to share all information with the pastor, then the family must be told this before they choose to share any information with the nurse.

DIF: Cognitive Level: Apply (Application) REF: p. 543

11. A father confides to the parish nurse that his wife has been hurting their 3-year-old daughter. The nurse examines the daughter and finds evidence of physical abuse. In the parish nurse role, which of the following actions should the nurse take first?

a.
Contact the pastor for guidance in handling this situation.
b.
Recommend that the family be removed from the faith community.
c.
Refer the family to pastoral services for counseling.
d.
Report the findings to child protective services.

ANS: D

As an advocate of client and group rights, the nurse identifies and reports neglect, abuse, and illegal behaviors to the appropriate legal sources. This is necessary regardless of the feelings of the pastor or the father because the nurse is bound legally to report abuse to a child, confirmed or suspected. Referral for counseling is appropriate; however, the child’s present state of well-being is paramount. Parish nurses must obey the nurse practice act and laws of the state.

DIF: Cognitive Level: Apply (Application) REF: p. 543

12. A faith community nurse is partnering with a local public health department to develop programs for primary, secondary, and tertiary prevention activities. Which of the following should be used as the primary guide for development?

a.
Contemporary articles in nursing journals
b.
Evidence-based practice guidelines for treatment of disease
c.
Healthy People 2020 goals and objectives
d.
Preferences of partners who are funding the programs

ANS: C

Healthy People 2020 guidelines are basic to the planning of health care. Evidence-based practice is for treatment, not for program development.

DIF: Cognitive Level: Apply (Application) REF: p. 544

13. A parish nurse is evaluating health programs that provide holistic care across the life span. Which of the following methods would be the most appropriate approach?

a.
Bringing families together to plan programs to meet the needs of individuals
b.
Establishing a wellness committee to assist in the evaluation process
c.
Matching financial resources with program objectives and goals
d.
Revisiting assessment data to be certain that planning reflects actual problems observed

ANS: B

The nurse and members of the congregation assess, plan, implement, and evaluate programs. The process of providing holistic care is enhanced by an active wellness committee or health cabinet. The other options deal with factors other than program evaluation.

DIF: Cognitive Level: Apply (Application) REF: p. 544

14. Which of the following statements by a parish nurse exhibits a lack of understanding of the concept of pastoral care?

a.
“By working with my clients to help them identify their spiritual strengths, I am drawing on pastoral care aspects of practice.”
b.
“To incorporate pastoral care, I should involve the pastor in ministering to the members of the congregation.”
c.
“I use pastoral care when I emphasize the spiritual dimension of nursing when providing care.”
d.
“When I lend support to my clients during times of joy, as well as during their times of sorrow, this illustrates an important aspect of pastoral care.”

ANS: B

The nurse fulfills the role of pastoral care through stressing the spiritual dimension of nursing, lending support during times of joy and sorrow, guiding the person through health and illness throughout life, and helping identify the spiritual strengths that assist in coping with particular events. Pastoral care is a service ministry formalized by a church or faith community, not necessarily involving the pastor.

DIF: Cognitive Level: Apply (Application) REF: pp. 545-546

15. A parish nurse is using the institution-based model to plan care for a client with a chronic illness. Which of the following activities would the nurse most likely implement?

a.
Bringing in family members to work with the client and nurse in decision making
b.
Partnering with outlying health care centers for coordinating optimal care
c.
Pulling from the collective strengths of faith-based community members for social support for the client
d.
Relying on congregational prayer as a component of healing

ANS: B

The institution-based model includes greater collaboration and partnerships. The nurse may be in a contractual relationship with hospitals, medical centers, long-term care establishments, or educational institutions. Therefore, although the nurse may do all of these things, the item that is related to the institution-based model is partnering with outlying health care centers.

DIF: Cognitive Level: Apply (Application) REF: p. 536

16. A nurse would like to maximize her autonomy in her parish nursing practice. Which of the following models of parish nursing would most likely be preferred by the nurse?

a.
Congregation-based model
b.
Institution-based model
c.
Teamwork model
d.
Partnership model

ANS: A

In the congregation-based model, the nurse is usually autonomous. The development of a parish nurse/health ministry program arises from the individual community of faith. The nurse is accountable to the congregation and its governing body.

DIF: Cognitive Level: Apply (Application) REF: p. 536

17. Research reveals that people who pray more frequently score lower in physical functioning and score higher in their level of pain. Which of the following conclusions has been drawn from these findings?

a.
As persons become more disabled, they pray to retain their mental health and obtain comfort.
b.
Everyone prays more as they get older or become ill.
c.
Praying decreases physical functioning and increases pain.
d.
Research findings are sometimes inaccurate due to extraneous variables.

ANS: A

The “Evidence-Based Practice” box gives the example of a research study that explored the participants’ use of CAM, including reasons and benefits from CAM use. Clients participating in the study most commonly used prayer for health reasons (91%, n = 95), prayed for their own health (88%, n = 92), and had others pray for their health (86%, n = 90). This was followed by participation in group prayer (38%), deep breathing exercises (30%), and meditation (30%). Participants reported that prayer was used to give thanks for support of others and for themselves, whereas others reported that prayer allowed them to share their burden with a higher power. A few participants equated prayer with meditation, which evoked a calming state. Some participants did not equate prayer with being religious or with church attendance. This study affirms the use of prayer for health reasons, to facilitate relaxation, and to enhance emotional and physical well-being. The study affirms the protective results of prayer on the persons’ mental health.

DIF: Cognitive Level: Understand (Comprehension) REF: p. 537

18. Although a particular congregation’s need was obvious, there simply wasn’t enough money to support a parish nurse position. Which of the following community groups would have most likely had a need and funds available to contribute to a shared parish nurse position?

a.
Childcare center
b.
Community elementary school
c.
Community high school
d.
Elderly housing complex

ANS: D

Parish nurses are frequently employed by senior living complexes and nursing homes to offer a spiritual focus to the nursing practice within various levels of living arrangements for elders, in addition to serving one or more congregations in the community.

DIF: Cognitive Level: Apply (Application) REF: p. 538

19. A parish nurse is implementing a primary prevention measure related to obesity among the school-age members of the church. Which of the following activities is most likely being used by the nurse?

a.
Establishing a walking program that is sufficiently challenging yet not too strenuous for those who are obese
b.
Partnering with youth camp cooks to ensure that food is nutritious
c.
Supervising height and weight measurements taken by clinic assistants
d.
Working with parents of obese children to implement family lifestyle changes

ANS: B

An example of primary prevention is encouraging healthy snacks and meals for youth outings and at educational hour and parenting sessions. The other options all deal with secondary prevention activities, which are focused on decreasing obesity.

DIF: Cognitive Level: Apply (Application) REF: p. 540

MULTIPLE RESPONSE

1. A parish nurse has been using pastoral activities when providing care to clients. Which of the following interventions is the nurse most likely using? (Select all that apply.)

a.
Helping families plan healthy nutritious meals and get plenty of rest
b.
Giving health education classes to the congregation
c.
Using hymns and scripture as a source of guidance and comfort
d.
Helping identify spiritual strengths that may assist in coping

ANS: C, D

All the activities listed represent nursing functions. However, when the nurse fulfills pastoral care, the nurse stresses the spiritual dimension, lends support during times of joy and sorrow, guides the person through health and illness, and helps identify the spiritual strengths that assist in coping with particular events.

DIF: Cognitive Level: Apply (Application) REF: pp. 545-546