University of San Francisco - NURS 320

Chapter 06: Spiritual Issues

Keltner: Psychiatric Nursing, 8th Edition

MULTIPLE CHOICE

1)The patient says, “I know I’m very sick right now, but I trust that God will make me better.” Based on this statement, the nurse can assess the patient’s spirituality as being based on what model?

1. 1. Theism
   2. Humanism
   3. Behaviorism
   4. Existentialism

2. The partner of a psychiatric patient says, “This mental illness should not have happened. I tried to teach the importance of professing faith in God and getting converts, but my partner rejected them. Those practices keep me well. It’s the only way to live.” The nurse can assess that the spouse is demonstrating what form of religiosity?
   1. Atheism

1. 2. Humanism
   3. Agnosticism
   4. Sick religiosity

3. A depressed patient expresses feelings of hopelessness, helplessness, and powerlessness. The patient’s spiritual distress is best addressed by which nursing intervention?
   1. Assisting the patient find meaning and hope through making personal choices
   2. Encouraging the patient to develop wisdom in the face of adversity
   3. Assessing the patient in drawing strength from a higher power
   4. Identifying ways the patient can live by higher principles

4. A patient says, “I know I need religion in my life, but I don’t know how to find God. I feel I have been abandoned.” The nurse should assess for a childhood history of what experience?
   1. Recurrent losses
   2. Overindulgence
   3. Lack of nurturing
   4. Poor school performance

5. Which statement made by a nurse demonstrates an understanding about why completing a spiritual assessment is important?
   1. “Research clearly demonstrates that spiritual interventions by nurses are a cost-effective practice.”
   2. “Accrediting organizations regard spiritual care as a patient right.”
   3. “Spirituality is better addressed by nurses than by clergy.”
   4. “Prayer consistently improves mental health outcomes.”

6. Which statement by a mentally ill patient best exemplifies sick religiosity?
   1. “Suicide will result in eternal damnation for your soul.”
   2. “Your illness has nothing to do with insufficient faith.”
   3. “Questioning God is a common reaction to illness.”
   4. “Your illness is not related to sin.”

7. A patient diagnosed with schizophrenia says, “I am a reincarnation of Jesus. I can raise the dead.” Who is the most qualified person for the nurse to refer the patient to?
   1. Psychiatric nurse clinician
   2. Professional chaplain
   3. Clinical psychologist
   4. Community minister

8. A nurse providing spiritual care for a patient awaiting a liver transplant demonstrates knowledge of anticipated spiritual needs by focusing on what area?
   1. Issues related to personal mortality
   2. The need for prayer and organized religion
   3. Misinterpretation of medical information regarding liver transplantation
   4. Techniques for minimizing clinical depression

9. A caregiver says, “Both of my parents have dementia. I find it so difficult to care for them because of their disabilities. I get depressed and hopeless thinking about it. Can you give me any suggestions for coping?” Before making any suggestions, the nurse should implement what assessment?
   1. The parents’ stage of dementia
   2. The caregiver’s religious ideology
   3. Whether or not the parents’ medications are helping
   4. If financial resources are sufficient to provide a health care aide

10. A patient diagnosed with schizophrenia, paranoid type, has been suspicious of staff since admission. The patient visits with a chaplain but then tells the nurse, “Don’t send any more preachers.” What is the most likely reason for the patient’s reaction?

1. 1. Hostility
   2. Distractibility
   3. Inability to trust
   4. Inability to find meaning in suffering

11. A patient tells the nurse, “I make decisions each day that have a positive effect on my life.” This statement is most closely related to what spiritual construct?
    1. Making meaning through choices
    2. A presence that orders the world
    3. Higher purpose and principles
    4. Higher power and achievement

12. A patient moans, “God wants me to suffer, but I don’t know why. I feel like an outcast. I should have never been born.” Which nursing diagnosis should the nurse include in patient’s plan of care?
    1. Potential for enhanced spiritual well-being
    2. Disturbed personal identity
    3. Spiritual distress
    4. Powerlessness

13. A patient diagnosed with schizophrenia reports hearing demon voices coming through the television. Which statement by the nurse providing spiritual care would be most comforting to the patient?
    1. “Rest assured that God will fill your heart with peace.”
    2. “I am concerned about your spiritual distress.”
    3. “God will hold you in the palm of His hand.”

1. 4. “God knows your every thought.”

14. A patient diagnosed with major depression shows the nurse a passage in the Bible and says, “How do you think this verse relates to me?” The nurse is unfamiliar with the verse and unsure how to respond. Select the nurse’s best action.
    1. Ask the patient, “What do you think the verse means?”
    2. Invite professional clergy to join the dialog with the patient.
    3. Explain to the patient, “I’m not familiar with that passage. It would be better for me not to comment.”
    4. Say to the patient, “Would you bring that up in the group session? You can get input from several people about what the verse means.”

15. On the admission papers, a patient checked the box labeled “No religious affiliation.” What meaning can the nurse draw from this information?
    1. The patient is not religious.
    2. The patient is among a growing group.
    3. The patient has conventional religious values.
    4. The patient is probably experiencing spiritual distress.

16. What is the predominant religious tradition in the United States?
    1. Christian
    2. Buddhist
    3. Muslim
    4. Jewish

MULTIPLE RESPONSE

1. A patient asks, “What religions are considered monotheistic? “ The nurse understands that religions are included? (Select all that apply.)
   1. Judaism
   2. Islam
   3. Buddhism
   4. Christianity
   5. Wicca

2. A new nurse asks the mentor, “How can I help meet patients’ spiritual needs?” What personal characteristics should the mentor focus upon? (Select all that apply.)
   1. Being authentic
   2. Being respectful

1. 3. Demonstrating caring

1. 4. Speaking slowly and concretely
   5. Ability to answers theological questions

3. What information about a patient’s perceptions and values would the nurse obtain by using questions from the HOPE tool? (Select all that apply.)
   1. Healthy spirituality versus sick religiosity
   2. That which gives the patient hope and meaning in life
   3. Important personal spiritual practices
   4. Role of religion in the patient’s life
   5. Sources of strength and comfort