Spirituality Flashcards
When planning care for an older client residing in your skilled nursing facility who is searching to make life meaningful, which nursing action would be most beneficial?
1. Assess for depression.
2. Diagnose and document that the client has “spiritual distress.”
3. Keep the client busy with social activities.
4. Explore with the client desired legacy.
- Answer: 4. Rationale: Options 1 and 2 involve assessment and diagnosis, not planning. Option 3, simply keeping the client busy, does not necessarily contribute to feeling fulfilled or purposeful. Cognitive Level: Applying. Client Need: Psychosocial Integrity. Nursing Process: Planning. Learning Outcomes: 41-1; 41-3; 41-6.
A client’s wife asks the nurse to pray for her. What would be the best initial response for a nurse who believes in prayer?
1. “May I call the chaplain to come and pray with you?”
2. “I know your faith is important to you. It is to me, too. Let’s pray.”
3. “I’m happy to do that. For what would you like me to pray?”
4. “Isn’t it wonderful that we have a God with whom we can share our concerns?”
- Answer: 3. Rationale: The best initial response is to assess. Option 1 may be interpreted as distancing by the client. Option 2 inserts the nurse’s experience, which is generally inappropriate. Option 4 is not appropriate for someone in spiritual distress. Cognitive Level: Analyzing. Client Need: Psychosocial Integrity. Nursing Process: Evaluation. Learning Outcomes: 41-5; 41-6.
A client is experiencing severe pain that cannot be controlled by analgesics. An appropriate intervention is full presencing, which involves which of the following?
1. Physical presence
2. Physical presence with mental awareness of the client
3. Physical, mental, and emotional presence
4. Physical, mental, emotional, and spiritual presence
- Answer: 3. Rationale: The key term is full. Option 1 would be inadequate; option 2 is only partial presencing; and option 4 is transcendent presencing. Cognitive Level: Remembering. Client Need: Psychosocial Integrity. Nursing Process: Implementation. Learning Outcome: 41-6.
A client reports, “Cancer was the best thing that happened to me! It is making me appreciate life so much more.” This statement fits best with which NANDA diagnosis?
1. Spiritual Distress
2. Risk for Spiritual Distress
3. Readiness for Enhanced Spiritual Well-Being
4. Cognitive Denial
- Answer: 3. Rationale: This client portrays no distress (option 1) or risk for distress (option 2), but rather the potential for enhanced spiritual health as a result of the transformative illness experience. Option 4 is not a valid diagnosis. Cognitive Level: Applying. Client Need: Psychosocial Integrity. Nursing Process: Diagnosis. Learning Outcomes: 41-1; 41-2.
A dying client states, “Part of what makes dying hard is that I don’t know for sure where I’m going. Nurse, what do you believe happens in the hereafter?” Which ethical guideline should guide your response?
1. Never share personal spiritual beliefs.
2. Share all spiritual beliefs, favoring none.
3. Share only your beliefs.
4. First assess for what prompts the client’s question.
- Answer: 4. Rationale: Assessment is always the first step of the process of spiritual caregiving or any nursing activity. Options 1, 2, and 3 may not respect the spiritual beliefs of either the nurse or the client. While an assessment may lead the nurse to share personal beliefs, these are never urged on the client. Cognitive Level: Applying. Client Need: Psychosocial Integrity. Nursing Process: Implementation. Learning Outcomes: 41-1; 41-4; 41-7.
After the death of several long-term clients, which action indicates the nurse is demonstrating ineffective coping?
1. The nurse talks at length to her partner about the deaths.
2. The nurse keeps busy with other actions and doesn’t think about the deaths for several days.
3. The nurse offers to work extra shifts for several weeks.
4. Several nurses schedule a group session with the agency clergy to discuss the deaths.
- Answer: 3. Rationale: Many older adults are religious and spiritually aware. Options 1, 2, and 4 are disputed by recent research evidence. Cognitive Level: Remembering. Client Need: Psychosocial Integrity. Nursing Process: Implementation. Learning Outcomes: 41-1; 41-3.
- Answer: 3. Rationale: Options 1, 2, and 4 are potentially uncaring or unethical. Jehovah’s Witnesses have a well-developed network of representatives who can be called to explain and explore medical options with their fellow believers and medical staff. Cognitive Level: Analyzing. Client Need: Psychosocial Integrity. Nursing Process: Evaluation. Learning Outcomes: 41-1; 41-4; 41-6.
- Answer: 2. Rationale: Residing in the SNF likely will curb the client’s participation in her church. Options 1, 3, and 4 are incorrect because it is not known if the relocation or an alteration in religious practice will affect her spiritual well-being in either a negative or positive way. Cognitive Level: Applying. Client Need: Psychosocial Integrity. Nursing Process: Diagnosis. Learning Outcomes: 41-1; 41-2; 41-5.
- Answer: 4. Rationale: Recognizing personal emotional responses to events that parallel those experienced by a client, allows a nurse to identify an empathic response to a client’s spiritual or emotional need. Options 1, 2, and 3 fail to show a nurse drawing deep to recognize inner experience that can inform empathy. Cognitive Level: Applying. Client Need: Psychosocial Integrity. Nursing Process: Implementation Learning Outcome: 41-8.
- Answer: 1. Rationale: Although the mother is arguably angry, it is unknown whether this anger is impairing her religiosity or her coping. More data are needed before determining that either option 2 or 3 is the best diagnosis. The mother is experiencing distress versus being at risk for it (option 4). Cognitive Level: Applying. Client Need:Psychosocial Integrity. Nursing Process: Diagnosis. Learning Outcomes: 41-2; 41-5.
