Eliopoulos Chapter 30 - Spirituality

1. An older female patient tells the nurse that even though she believes in a higher power she is not interested in information on the hospital's chaplaincy services since she has never been religious. What does the nurse recognize as the relationship between religion and spirituality?

A) Some people are religious, while others are spiritual.

B) Religion is a particular, structured way of expressing spirituality.

C) Religion is the essence of our being that connects us with the Divine.

D) All human beings have an innate desire for religious structure and spiritual fulfillment.

B) Religion is a particular, structured way of expressing spirituality.

2. The nurse manager of a geriatric medicine unit learns that spiritual care services are underutilized by patients and their families. Which phenomenon explains this finding?

A) While spiritual needs are a universal part of the human condition, many people do not acknowledge these needs.

B) The high-stress environment of a hospital is incompatible with the solace and quiet necessary for addressing spiritual needs.

C) Spiritual needs are less apparent during times of immediate and tangible need, such as acute illness requiring hospital treatment.

D) Many older adults who have experienced a lifetime of self-sufficiency and practical resourcefulness do not have spiritual needs.

A) While spiritual needs are a universal part of the human condition, many people do not acknowledge these needs.

3. The nurse is aware of the spiritual dimension in Erikson's conceptualization of the older adult's growth and development. When applying Erikson's theory to the care of older patients, what does the nurse realize as being a spiritual component of Erikson's final development task?

A) Awareness that one is loved by others and has provided unconditional love.

B) A confidently held hope that a transcendent and positive afterlife awaits one following death.

C) A sense of contribution that one's relationships and endeavors have benefited society and one's family.

D) A sense of wholeness rooted in the knowledge that life experiences make sense and have served a purpose.

D) A sense of wholeness rooted in the knowledge that life experiences make sense and have served a purpose.

4. The nurse is caring for older patients in a long-term care facility. When ensuring for these patients' dignity, which statement reflects the role of dignity as it relates to the spiritual needs of the older adult?

A) Older adults who have lived a life of integrity and service have earned dignity.

B) An acknowledgment of spiritual needs is necessary for the presence of dignity.

C) Older adults may lack many of the attributes that are valued in society, but they can derive a sense of dignity from spirituality.

D) Older adults who have moved successfully through Erikson's stages of development can experience dignity in spite of disability.

C) Older adults may lack many of the attributes that are valued in society, but they can derive a sense of dignity from spirituality.

5. The spouse of a patient with dementia remains upbeat and is appreciative of having good health and a loving family. The nurse realizes that the spouse is demonstrating which component of spirituality?

A) Hope

B) Fatalism

C) Gratitude

D) Transcendence

C) Gratitude

6. An older patient just learning of having a terminal illness begins to cry. Which statement or question should the nurse make to facilitate the patient's spiritual health?

A) "Remember that everything in life, even the bad things, happens for a reason."

B) "Is there anything in your spiritual beliefs or practices that might bring you comfort at this time?"

C) "It's not appropriate for me to pray with you, but would you like me to arrange a visit from the chaplain?"

D) "It's likely best for you to try to focus on what is going right in your life, even though that's likely hard right now."

B) "Is there anything in your spiritual beliefs or practices that might bring you comfort at this time?"

7. What should the nurse use to help guide interventions to meet the spiritual needs of a patient?

A) The client's prognosis for recovery

B) The nurse's own religious tradition

C) The denominational affiliation of the chaplain

D) The presence of icons and religious books at the bedside

D) The presence of icons and religious books at the bedside

8. An older male patient with end-stage renal disease is sad and believes that he will die within a few days. Which interventions should the nurse use to promote hope in the patient? (Select all that apply.)

A) Using humor at the bedside

B) Facilitating a life review for the client

C) Helping the client to find pleasure during current life activities

D) Encouraging the client to focus on a time of life that was more pleasant

E) Introducing the client to an individual who has a much poorer prognosis and/or health status

A) Using humor at the bedside

B) Facilitating a life review for the client

C) Helping the client to find pleasure during current life activities

9. An older female patient, experiencing cancer pain and nausea and vomiting from chemotherapy, asks the nurse to pray for her during this difficult time. How should the nurse respond to the patient's request?

A) Facilitate a visit from a chaplain to the client at the bedside.

B) First determine whether the client shares a similar religious tradition as the nurse.

C) Pray for the client, asking a higher power to intervene and provide peace and relief.

D) Explain that praying is beyond the nurse's scope of practice and explore alternative interventions.

C) Pray for the client, asking a higher power to intervene and provide peace and relief.

10. An older male patient admits to doing many things in life that he is not proud of and is having a difficult time getting them out of his mind. How should the nurse respond to the patient's statement?

A) "Remember that no one has lived a perfect life."

B) "Is there anyone that you might want to ask forgiveness from?"

C) "Is there anything I can do to help you focus on more positive things?"

D) "Do you think that you were really any worse than most other people?"

B) "Is there anyone that you might want to ask forgiveness from?"

11. Two nurses are discussing the relationship between spirituality and religion. Which statement explains this relationship?

A) They are the same. Both connect individuals to the Divine and to other living things.

B) They are directly related. The more spiritual the individual, the greater his or her commitment to religion.

C) They interact inversely. Heavy involvement in organized religion diminishes spirituality and vice versa.

D) They are different. Spirituality is a sense of connection to the Divine; religion is a structure of beliefs, rituals, and rules.

D) They are different. Spirituality is a sense of connection to the Divine; religion is a structure of beliefs, rituals, and rules.

12. At the conclusion of a health history the nurse conducts a spiritual assessment with the patient. Why is this assessment important?

A) Strong spiritual beliefs facilitate health and healing

B) A spiritual crisis can trigger a psychosomatic disease

C) It is the nurse's job to facilitate communication between the patient and the clergy

D) The nurse needs to be careful that therapeutic regimens do not violate a patient's religious beliefs

A) Strong spiritual beliefs facilitate health and healing

13. A patient with cancer asks the nurse to pray with him but the nurse does not feel comfortable with prayer. What should the nurse do?

A) Decline politely and ask a coworker to pray with the patient

B) Arrange transportation so that the patient can attend prayer meetings at his church

C) Pray with the patient after making sure he understands that the nurse would prefer not to

D) Pray with the patient realizing that the patient's needs are more important than the nurse's beliefs

A) Decline politely and ask a coworker to pray with the patient

14. During an interview process as a staff nurse for a geriatric patient care area, the nurse is asked about her philosophy of spirituality. Why is this important when caring for older patients?

A) Spirituality becomes more unconditional as people age

B) Spirituality often becomes more important to people as they age

C) An individual's spirituality remains stable from youth through old age

D) As people age, their spirituality becomes more quantitative than qualitative

B) Spirituality often becomes more important to people as they age

15. Which statement should the nurse use to plan interventions to address the behavior of an older patient sitting quietly alone in a room?

A) Spending a lot of time alone is a sign that an elder is lonely or grieving.

B) Uninterrupted periods of solitude and inactivity are therapeutic for the elderly.

C) Solitude should be discouraged among elders because it leads to social isolation.

D) Occupational therapy should be arranged for an elder often observed doing nothing.

B) Uninterrupted periods of solitude and inactivity are therapeutic for the elderly.

16. The nurse is preparing a list of patients who will need the annual influenza inoculation. Which older adult will most likely refuse this vaccination?

A) A 71-year-old Christian Scientist

B) A 68-year-old man who attends a Unitarian church

C) A 68-year-old female patient who identifies herself on admission as a Jehovah's Witness

D) A 78-year-old who says that she is a member of the Church of Jesus Christ of Latter Day Saints

A) A 71-year-old Christian Scientist

17. For patients from which of the religious groups would an opportunity to fast in the weeks before Easter be most important?

A) Jewish

B) Eastern Orthodox

C) Seventh-Day Adventist

D) Episcopalian (Anglican)

B) Eastern Orthodox

18. The nurse is caring for an older patient who is nearing death and realizes that no professional clergy needs to be contacted. This patient is most likely a member of which faith?

A) Pentecostal

B) Unitarianism

C) Seventh-Day Adventists

D) Church of Jesus Christ of Latter Day Saints

D) Church of Jesus Christ of Latter Day Saints

19. An older female patient in the resident care facility insists that her hair be kept covered at all times. Of which branch of the Jewish faith is she most likely a member?

A) Reform

B) Orthodox

C) Rabbinical

D) Conservative

B) Orthodox

20. An older patient tells the nurse that he meditates to seek enlightenment. Because of this, the nurse might inquire if he wishes to have which item eliminated from his daily dietary intake?

A) Beef

B) Cereal

C) Refined sugar

D) Leavened bread

A) Beef

21. An older female patient tells the nurse that through periods of trial and tribulation, the Bible has been the source of ongoing strength and support. Which statement supports this patient's beliefs by researched evidence?

A) Patients from low socioeconomic levels tend to be more religious.

B) Religious commitment has a positive effect on health care outcomes.

C) Patients holding strong religious convictions experience great emotional stress during illness.

D) Among the elderly, high levels of religiosity correlate with greater levels of physical disability.

B) Religious commitment has a positive effect on health care outcomes.

22. A patient is demonstrating signs of spiritual distress but refuses to be visited by clergy or to participate in religious services. What should the nurse do to help the patient?

A) Arrange for a volunteer to read inspirational essays to the patient

B) Do not challenge the patient's decision or attempt to change his mind

C) Pray that the patient will come to recognize his need for spiritual support

D) Talk with the hospital chaplain about looking in on the patient without talking about religion

B) Do not challenge the patient's decision or attempt to change his mind

23. During an assessment an older male patient states that he has not been happy in life because he does not deserve to be loved. The nurse realizes that this patient believes love has been withheld because of which criteria? (Select all that apply.)

A) Productivity

B) Social position

C) Education level

D) Physical condition

E) Material possessions

A) Productivity

B) Social position

D) Physical condition

E) Material possessions

24. The nurse determines that a patient is experiencing spiritual distress. What did the nurse assess in this patient? (Select all that apply.)

A) Anger

B) Smiling

C) Complaining

D) Poor appetite

E) Refusing to make plans

A) Anger

C) Complaining

D) Poor appetite

E) Refusing to make plans

25. A patient tells the nurse that she has practiced meditation for years since it has helped her with mental clarity. Which type of meditation should the nurse document that the patient practices?

A) Mindfulness

B) Concentrative

C) Transcendental

D) Trans-mutational

B) Concentrative

26. The nurse is planning care to address a patient's spiritual distress. Which interventions would be appropriate to include in this plan of care? (Select all that apply.)

A) Pray with the patient upon request as needed and desired

B) Find a volunteer to read the Bible to the patient upon request

C) Remind the patient that spiritual needs are often addressed last

D) Contact the patient's church to have the clergy visit the patient

E) Help the patient identify factors contributing to spiritual distress

A) Pray with the patient upon request as needed and desired

B) Find a volunteer to read the Bible to the patient upon request

D) Contact the patient's church to have the clergy visit the patient

E) Help the patient identify factors contributing to spiritual distress

27. A patient is observed sitting on the side of the bed crying. When approached the patient does not say anything but continues to cry and hold the nurse's hand. What should the nurse do to communicate being present with the patient?

A) Sit down next to the patient

B) Leave the patient alone to cry

C) Encourage the patient to stop crying

D) Ask the patient to use the call bell if he or she wants to talk

A) Sit down next to the patient