Nokea
A nurse who is caring for patients on a pediatric unit is assessing children's spiritual needs. Which is the most important source of learning for a child's own spirituality?
- A. Child's church or religious organization
- B. What their parents say about God and religion
- C. Their parents' behavior in relationship to the family, others, and to God
- D. Family's spiritual advisor
Correct Answer: C
Rationale: Children learn most about their own spirituality from how their parents behave in relationship to one another, their children, others, and God (or a higher being). What parents say about God and religion, the family's spiritual advisor, and the child's church or religious organization are less important sources of learning.
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A patient states they feel very isolated from their family and church, and even from God, "in this huge medical center so far from home." When preparing expected outcomes for this patient, which most appropriately measures relief of the patient's spiritual distress?
- A. The patient will express satisfaction with the compatibility of their spiritual beliefs and everyday living.
- B. The patient will identify spiritual beliefs that meet their need for meaning and purpose.
- C. The patient will express peaceful acceptance of limitations and failings.
- D. The patient will identify spiritual supports available to them in this medical center.
Correct Answer: D
Rationale: Each of the four options represents appropriate spiritual goals, but identifying spiritual supports available to this patient in this medical center at this point in time, is the most appropriate and realistic.
A patient who stated their religion as Jewish at the intake interview was served a kosher meal ordered from a restaurant on a paper plate because the hospital had no provision for kosher food or dishes. The patient became angry and accused the nurse of insulting him, emphatically stating, "I want to eat what everyone else does-and give me decent dishes." After analyzing the data, the nurse returns to the patient and makes which of these statements?
- A. "I'm terribly sorry, I should have ordered kosher food and dishes as well."
- B. "Did someone on the staff behave condescendingly or critically?"
- C. "It seems difficult to please you today."
- D. "We did not ask about your dietary preferences; tell me what you usually eat."
Correct Answer: D
Rationale: On the basis of the patient's stated religion, the nurse assumed they would want a kosher diet. This is a form of stereotyping. When evaluating the outcome of the situation, the nurse returns to the first step of the nursing process and assesses the patient's dietary practices and preferences.
A nursing student is caring for a patient admitted with chest pain related to aortic valve stenosis. The student notes the patient, who had been calm and cooperative the day before, has become contemplative and withdrawn, stating, "I've never thought much about dying, but my chances of making it through tomorrow's surgery are 50-50." How does the student best respond when the clinical professor asks the student why this behavior likely surfaced later in the patient's admission?
- A. Patients usually want to maintain privacy about their spiritual needs.
- B. People are better able to focus on spiritual needs after their spiritual advisor visits.
- C. Family members and close friends often initiate spiritual concerns.
- D. Illness increases spiritual concerns, which may initially be difficult to verbalize.
Correct Answer: D
Rationale: Illness may increase spiritual concerns, which many patients find difficult to initially express. The other options presume patients are purposefully secretive or must speak with a spiritual advisor, friends, or family to promote discussion of spiritual concerns.
A parish nurse is speaking to a congregant whose adolescent child was arrested for shoplifting. The congregant is very angry, stating they cannot face the child, let alone discuss the situation: "I just will not tolerate a thief." What nursing action will best assist the congregant at this time?
- A. Assuring the congregant that many parents feel the same way
- B. Reassuring the congregant that many teenagers act rebelliously and that it will pass
- C. Assisting the congregant to identify how withholding forgiveness hurts them
- D. Asking the congregant if they have spent sufficient time with their child
Correct Answer: C
Rationale: Helping the congregant identify how their unforgiving feelings may be harmful to themselves is the only intervention that directly addresses forgiveness, a universal spiritual need.
A hospice nurse who provides pastoral care is teaching nursing students about the three spiritual needs believed to be common to all people. Which of these will the nurse include in the discussion? Select all that apply.
- A. Food, clothing, and shelter
- B. Meaning and purpose
- C. Family
- D. Love and relatedness
- E. Forgiveness
- F. Rules to live by
Correct Answer: B,D,E
Rationale: Meaning and purpose, love and relatedness, and forgiveness are the three spiritual needs believed to be common to all people. Option a is a human need as described by Maslow, as is family (love and belonging). Many people live by a set of rules, but this is not a common spiritual need.