Chapter 46

Question 1

Which of the following group of terms best defines spiritual distress?
A) Spirituality, religion
B) Alienation, despair
C) Faith, prayer
D) Forgiveness, purpose

Answer 1

B) Alienation, despair

Terms that define spiritual distress include spiritual pain, alienation, anxiety, guilt, anger, loss, and despair

Question 2

What spiritual need is believed to underlie all religious traditions and is common to all people?
A) Love and relatedness
B) Physical hygiene
C) Religious education
D) Church services

Answer 2

A) Love and relatedness

According to Shelly and Fish (1988), there are three spiritual needs underlying all religious traditions and common t people: (1) the needs for meaning and purpose, (2) love and relatedness, and (3) forgiveness

Question 3

Nurses provide care to meet needs in all the human dimensions. What is one intervention nurses can implement to m
spiritual needs?
A) Refer all questions to a spiritual advisor.
B) Remind clients that nurses are not ministers.
C) Avoid any discussion of religion or spirituality.
D) Offer a compassionate presence.

Answer 3

D) Offer a compassionate presence.

Although nurses may differ in their beliefs about how involved they should become in meeting spiritual needs, it is impossible to ignore the spiritual dimensions of health. Nurses can assist clients to meet spiritual needs through a variety
of interventions, including offering a compassionate presence.

Question 4

A client expresses confidence in his traditional healer to relieve symptoms of an illness. What is the client
demonstrating?
A) Hope
B) Spirituality
C) Faith
D) Charity

Answer 4

C) Faith

Faith generally refers to a confident belief in something for which there is no proof or material evidence. It can involve a
person, idea, or thing and is usually followed by action related to the ideals and values of the belief. A client who has faith in a health care provider is more likely to follow the plan of care, and experience benefits.

Question 5

A client tells the nurse, “I am an atheist. I do not believe in God.” What would be an appropriate response by the nurse?
A) “Well, I believe in God and you should, too.”
B) “I respect what you choose to believe in.”
C) “How can you deny the existence of God?”
D) “What makes you think you are an atheist?

Answer 5

B) “I respect what you choose to believe in.”

An atheist is a person who denies the existence of God, guided by philosophies of living that do not include a religious faith. The atheist deserves respect for what he or she chooses to believe.

Question 6

A client states that his life has meaning and purpose, he feels loved, and has experienced forgiveness in his life. What is
the term that describes this state of spirituality?
A) Spiritual belief
B) Spiritual alienation
C) Spiritual health
D) Spiritual bliss

Answer 6

C) Spiritual health

Defined most simply, spiritual health or well-being is the condition that exists when the universal spiritual needs for meaning and purpose, love and belonging, and forgiveness are met.

Question 7

What factor is necessary to express and experience spirituality?
A) Quiet time in isolation from others
B) Membership in an organized religion
C) Long-term suffering and pain
D) Connectedness with other people

Answer 7

D) Connectedness with other people

People express and experience spirituality through love and connectedness with other people. Love develops from the basic human need to love and be loved and is necessary to spiritual wholeness.

Question 8

While reviewing the chart for an assigned client before beginning care, a student notes that the client does not belong to a specific religion. Based on this information, what should the student interpret about the client?
A) A person may be deeply spiritual but not profess a religion.
B) Belonging to an organized religion is essential to spirituality.
C) The student will not have to consider the spiritual dimension.
D) The client should be referred for spiritual counseling

Answer 8

A) A person may be deeply spiritual but not profess a religion.

Religion refers to an organized system of beliefs about a higher power. A nurse should not interpret the fact that a client
does not belong to an organized religion to mean the client has no spiritual needs; a person may be deeply spiritual yet
not profess a religion.

Question 9

Which of the following health care practices may be influenced by a young woman’s religion?
A) Yearly mammograms
B) Annual physicals
C) Birth-control measures
D) Health assessments

Answer 9

C) Birth-control measures

Certain practices associated with health care may have religious significance for a client. For example, acceptable birthcontrol measures are determined by some religious faiths

Question 10

How can religious, life-affirming influences be compared with basic human needs?
A) Life-affirming influences encourage self-actualization.
B) Life-affirming influences enhance life.
C) Life-affirming influences meet basic physiologic needs.
D) Life-affirming influences cultivate wisdom

Answer 10

A) Life-affirming influences encourage self-actualization.

Religious influences may be life affirming or life denying. Life-affirming influences encourage self-actualization, the highest level of basic human needs.

Question 11

Some religious beliefs may conflict with prevalent health care practices. For example, what type of treatment is
prohibited by the doctrine of Jehovah’s Witnesses?
A) Using narcotics to treat pain
B) Administering blood transfusions
C) Minor surgical procedures
D) Diagnostic x-ray examinations

Answer 11

B) Administering blood transfusions

Sometimes religious beliefs conflict with prevalent health care practices. For example, the doctrine of Jehovah’s
Witnesses prohibits blood transfusions

Question 12

Each of the major religions has several characteristics in common. What is one of those characteristics?
A) Ministers are addressed as “Reverend.”
B) An ethical code defines right and wrong.
C) Communion is delivered the same way.
D) Men and women are viewed as equals

Answer 12

B) An ethical code defines right and wrong

Each of the major religious groups has several characteristics in common. One of those characteristics is an ethical code
that defines right and wrong.

Question 13

A nurse fills the following roles in the community: health educator, personal health counselor, referral agent, trainer of
volunteers, developer of support groups, integrator of faith and health, and health advocate. What is the term for this
type of nurse?
A) Parish nurse
B) Religious nurse
C) Visiting nurse
D) Home health nurse

Answer 13

A) Parish nurse’

Parish nurses are not “visiting nurses” or “home health nurses” who provide direct bedside care. The key roles of the parish nurse are health educator, personal health counselor, referral agent, trainer of volunteers, developer of support
groups, integrator of faith and health, and health advocate

Question 14

A nurse is caring for a hospitalized child. What would the nurse consider to meet the spiritual needs of the child?
A) Nothing; children do not have a spiritual self.
B) Complete information from the child’s parents.
C) Only terminally ill children believe in God.
D) Children have definite perceptions of God

Answer 14

D) Children have definite perceptions of God

Heller studied spirituality in children. In his study of 40 children between the ages of 4 and 12 years, he found that the children had definite perceptions of God

Question 15

The parents of an infant are members of a faith-healing group. They refuse to give the baby antibiotics for meningitis. What does the American Academy of Pediatrics recommend for cases such as this?
A) Respect for the parents’ wishes, even if the baby dies
B) Exemption from child abuse charges
C) Application of child abuse and neglect statutes
D) Refusal to treat the child no matter how ill

Answer 15

C) Application of child abuse and neglect statutes

Various faith-healing groups are asking for protection (under the veil of religious freedom) of their right to make decisions about medical care, even if those decisions result in the death of a family member, including a child. The American Academy of Pediatrics is urging that all child abuse, neglect, and medical neglect statutes be applied without
potential or actual exemption for religious beliefs

Question 16

A nurse is using Anandarajah and Hight’s (2001) HOPE acronym to assess a client’s spirituality and religious beliefs.
Which of the following is a component of this acronym?
A) H = heaven
B) O = openness
C) P = personal spirituality
D) E = eternity

Answer 16

C) P = personal spirituality

One simple guide is Anandarajah and Hight’s (2001) HOPE acronym:
H—Sources of hope, meaning, comfort, strength, peace, love, and connection; O—Organized religion; P—Personal
spirituality and practice; E—Effects on medical care and end-of-life issue.

Question 17

A client scheduled for complex heart surgery has been reading the Bible for hours each day, cries often, and is not
sleeping well. What might these observations cue the nurse about the client?
A) These behaviors are expected before major surgery.
B) These behaviors are signs of spiritual distress.
C) Family members live far away and the client is lonely.
D) The client is naturally emotional and reactive

Answer 17

B) These behaviors are signs of spiritual distress.

Many clients find it difficult to talk about their spiritual beliefs and problems but may have behavioral indicators of spiritual distress. Significant behavioral observations include sudden changes in spiritual practices, mood changes, sudden interest in spiritual matters, and disturbed sleep

Question 18

A client verbalizes to a mental health counselor that his life is meaningless since his wife divorced him and that he no
longer wants to live. What nursing diagnosis, resulting from his spiritual distress, would be appropriate?
A) Sexual Dysfunction
B) Fear
C) Powerlessness
D) Risk for Self-Directed Violence

Answer 18

D) Risk for Self-Directed Violence

Spiritual distress may affect other areas of human functioning. Spiritual distress may be the etiology of the nursing diagnosis “Risk for Self-Directed Violence” related to feelings that life is meaningless

Question 19

A nurse is caring for a hospitalized client. What intervention can the nurse use to help the client continue normal
spiritual practices?
A) Discuss the nurse’s own religious beliefs with the client.
B) Tell the client that spiritual practices can be resumed later.
C) Request dietary consultation for the client’s dietary restrictions.
D) Request medication from the physician to calm the client.

Answer 19

C) Request dietary consultation for the client’s dietary restrictions

It is a responsibility of the nurse to help the client in an unfamiliar environment continue normal spiritual practices. One intervention that can facilitate the practice of religion is to attempt to meet the client’s dietary restrictions.

Question 20

Which of the following statements by a nurse would nurture spirituality by promoting love and relatedness?
A) “I know you are angry about your diagnosis.”
B) “Tell me about what you do in your job.”
C) “Tell me about how you get along with others.”
D) “How often do you read the Bible each day?”

Answer 20

C) “Tell me about how you get along with others.”

The nurse can help the client nurture his or her own spirituality by promoting meaning and purpose, love and relatedness, and forgiveness. To promote love and relatedness, encourage the client to talk about relationships with
others and to identify the origin of negative beliefs about people.

Question 21

What statement or question is useful for a nurse if a client asks the nurse to pray with him or her?
A) “I’m sorry, I am just too busy.”
B) “How would you like us to pray?”
C) “You will have to talk to your minister.”
D) “Why would you want me to do that?”

Answer 21

B) “How would you like us to pray?”

Clients accustomed to regular periods of prayer but who feel too ill to pray may ask the nurse to pray with them.
Because there are many forms of prayer, the nurse can take the lead by asking “How would you like us to pray?”

Question 22

A nurse is preparing a client’s room to accommodate a visit from a spiritual counselor. Which of the following is a
recommended practice?
A) Dim or turn off the lights.
B) Place a candle on the bedside table.
C) Remove any unnecessary equipment.
D) Place a cross on the bedside table

Answer 22

C) Remove any unnecessary equipment.

Preparations of the client’s room for the visit may vary, but the following are generally recommended practices: the
room should be orderly and free of unnecessary equipment and items; there should be a seat for the religious counselor
at the bedside or near the client so that both can be comfortable; the bedside table should be free of items and covered
with a clean, white cover if a sacrament is to be administered; and the bed curtains should be drawn for privacy if the
client can’t be moved to a more private setting.

Question 23

A client tells a nurse that he does not think he can have the recommended heart surgery because transfusions are against his religion. What is the best response of the nurse in this situation?
A) Tell the client that the surgery is necessary to keep him alive and is the only choice.
B) Obtain all the information needed for the client to make an informed decision.
C) Prepare the client for a visit from his spiritual advisor.
D) Have the client sign a form stating his refusal of the treatment

Answer 23

B) Obtain all the information needed for the client to make an informed decision

The nurse’s role is to assist the client in obtaining the information needed to make an informed decision and to support the client’s decision making. Because what the nurse says, and the way it is said, may powerfully influence the client’s decision, it is important to maintain objectivity. Conflicts that resist resolution may be referred to an ethics committee or
consult team

Question 24

Which of the following religious groups believe in divine healing through the “laying on of hands?”
A) Judaism
B) Mormons
C) Buddhism
D) Christian Scientist

Answer 24

B) Mormons

Devout Mormon adherents believe in divine healing through the “laying on of hands,” though many do not prohibit medical therapy. The Church maintains an extensive and well-funded welfare system, including financial support for the
sick

Question 25

A nurse has developed a plan of care to meet the needs of a client with the nursing diagnosis of Spiritual Distress. What
would be an expected outcome?
A) Identify factors in life that challenge spiritual beliefs.
B) Attend church services on a weekly basis.
C) Share feelings about religion with other health care providers.
D) Commit to reading passages from the Bible daily.

Answer 25

A) Identify factors in life that challenge spiritual beliefs.

Goals and expected outcomes for clients in spiritual distress do not need to be individualized. An appropriate expected
outcome would be that the client will identify factors in life that challenge spiritual beliefs

Question 26

The U.S. Religious Landscape Survey of 35,000 Americans by the Pew Research Center’s Forum on Religion &
Public Life (2008) finds that most Americans are religious and they have a nondogmatic approach to faith. Which of the
following statements accurately describes religion in America? Select all that apply.
A) A majority of Americans who are affiliated with a religion believe their religion is the only way to salvation.
B) More than half of Americans rank the importance of religion very highly in their lives, attend religious services
regularly, and pray daily.
C) A plurality of adults who are affiliated with a religion want their religion to adjust to new circumstances or adopt
modern beliefs and practices.
D) Significant minorities across nearly all religious traditions see a conflict between being a devout person and living in a
modern society.
E) While more than 50% of Americans believe in the existence of God or a universal spirit, there is considerable variation
in the nature and certainty of this belief.
F) Sixty percent of adults believe that God is a person with whom people can have a relationship; but one out of four— including about half of Jews and Hindus—see God as an impersonal force.

Answer 26

B) More than half of Americans rank the importance of religion very highly in their lives, attend religious services
regularly, and pray daily.

D) Significant minorities across nearly all religious traditions see a conflict between being a devout person and living in a
modern society.

F) Sixty percent of adults believe that God is a person with whom people can have a relationship; but one out of four—
including about half of Jews and Hindus—see God as an impersonal force.

A majority of Americans who are affiliated with a religion do not believe their religion is the only way to salvation. And
almost the same number believes that there is more than one true way to interpret the teachings of their religion. More
than half of Americans rank the importance of religion very highly in their lives, attend religious services regularly, and
pray daily. A plurality of adults who are affiliated with a religion want their religion to preserve its traditional beliefs
and practices, rather than adjust to new circumstances or adopt modern beliefs and practices. Significant minorities
across nearly all religious traditions see a conflict between being a devout person and living in a modern society. While
92% of Americans believe in the existence of God or a universal spirit, there is considerable variation in the nature and
certainty of this belief. Six out of 10 adults believe that God is a person with whom people can have a relationship; but
one out of four—including about half of Jews and Hindus—see God as an impersonal force.

Question 27

While admitting a clilent who is having elective surgery tomorrow, the nurse asks if he has a preferred religion or faith.
The client indicates that he does not believe in a higher power and therefore has no preferred religion. The nurse knows
that which of the following terms describes the client’s feelings about religion?
A) Atheist
B) Jehovah’s Witness
C) Agnostic
D) Spiritualist

Answer 27

A) Atheist

An atheist is a person who denies the existence of a higher power. An agnostic is one who holds that nothing can be known about the existence of a higher power. Jehovah’s Witnesses are an organized religion. A spiritualist is one who believes in spirituality.

Question 28

This is the nurse’s third day of caring for a client who recently underwent a colectomy that resulted in a colostomy. As the nurse goes about the physical assessment, a discussion about spirituality develops. The client tells the nurse that his religion believes in a basic harmony between religion and science. You interpret this as which of the followinggroups?
A) Buddhism
B) Baha’i International Community
C) Mormon
D) Jehovah’s Witness

Answer 28

B) Baha’i International Community

The Baha’i International Community believe in a basic harmony between religion and science. Jehovah’s Witnesses
oppose the false teachings of other sects; opposition often extends to modern science, including medicine. Buddhists
believe in the Four Noble Truths and the Noble Eightfold Path. Mormons believe in divine healing through the laying on
of hands.”

Question 29

Then nurse is caring for a female client today. As the nurse is giving the client her morning medications, she begins a conversation about her belief in a higher power. The nurse knows that this can be interpreted as which of the following?
Choose all that apply.
A) Faith
B) Spirituality
C) Religion
D) God
E) Atheism

Answer 29

A) Faith
B) Spirituality
C) Religion
D) God

Spirituality is anything that pertains to a person’s relationship with a nonmaterial life force or higher power. An atheist is
a person who denies the existence of a higher power. Faith generally refers to a confident belief in something for which
there is no proof or material evidence, such as a higher power. God is defined as a higher power. Religion refers to an
organized system of beliefs about a higher power.

Question 30

Then nurse is caring for a hospice client who tells the nurse that she is worried about how she has treated a younger sister. She asks the nurse how to make things right. The nurse recognizes this as which of the following spiritual needs?
A) Meaning
B) Forgiveness
C) Purpose
D) Love

Answer 30

B) Forgiveness

According to Shelly and Fish (1988), there are three spiritual needs underlying all religious traditions and common to all
people: (1) the need for meaning and purpose, (2) the need for love and relatedness, and (3) the need for forgiveness.

Question 31

The nurse’s client today informs her that he receives regular visits from a parish nurse, who helps him with his dietcontrolled diabetes. The nurse is aware that parish nurses do which of the following? Choose all that apply.
A) Provide medicine at no charge
B) Refer clients to appropriate resources
C) Perform physical assessments
D) Promote personal responsibility for health
E) Provide health education

Answer 31

B) Refer clients to appropriate resources
D) Promote personal responsibility for health
E) Provide health education

Parish nurses are not visiting nurses or home health nurses who provide direct bedside care. The key roles of the parish nurse are health educator, personal health counselor, referral agent, trainer of volunteers, developer of support groups,
integrator of faith and health, and health advocate

Question 32

The nurse is caring for a client today who asks to have the coffee removed from his tray. The client informs the nurse
that his religion precludes the intake of caffeine. The nurse is aware that religions often guide daily living habits in
which of the following ways? Choose all that apply.
A) Diet
B) Medical treatments
C) Clothing
D) Education
E) Automobile makes

Answer 32

A) Diet
B) Medical treatments
C) Clothing

Many religions have significance in regard to daily life. For instance, some religions have dietary requirements and
restrictions. The Mormons have special undergarments that are worn by some members. Some religions restrict medical
treatments, such as blood products. Education and automobile makes are not restricted by most religions

Question 33

A client informs the nurse that her physician has planned a procedure that may be in conflict with the client’s personal
spiritual belief. The client asks the nurse for assistance. The nurse is aware that her role should include assisting the client to do which of the following?
A) Confront the physician and refuse to undergo the procedure.
B) Explore and research alternative medicine therapies.
C) Poll other physicians about alternate treatment options.
D) Obtain accurate information in order to make a good decision.

Answer 33

D) Obtain accurate information in order to make a good decision.

The nurse’s role is to assist the client in obtaining the information needed to make an informed decision, and to support the client’s decision making. The nurse should never interfere between a client and the client’s physician.

Question 34

A client requests the nurse not touch his lips when administering his oral medications. Based on the nurse’s understanding of the major religions, the nurse identifies this request as reflecting which of the following?
A) Judaism
B) Christianity
C) Islam
D) Hinduism

Answer 34

D) Hinduism

In the Hindu religion, the nurse administering oral medications should avoid touching the client’s lips. Judaism, Christianity, and Islam do not require this.

Question 35

The nurse caring for a Native American client should inquire if the client utilizes which of the following?
A) Medicine man or woman
B) Priest
C) Rabbi
D) Preacher

Answer 35

A) Medicine man or woman

Many Native Americans utilize a medicine men and women, who have specialized spirits from whom they receive the
mission to cure. Priest is a term used for holy men in the Roman Catholic religion; rabbi in the Jewish religion; preacher in the protestant faiths.