Test Bank: Spiritual Issues Keltner : Psychiatric Nursing, 8th Edition,100% CORRECT - $13.49   Add to cart

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Test Bank: Spiritual Issues Keltner : Psychiatric Nursing, 8th Edition,100% CORRECT

Test Bank: 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? a. Theism b. Humanism c. Behaviorism d. Existentialism ANS: A Theism is the only model that suggests that people are inextricably tied to a transcendent being. This view provides hope for a better future. None of the other views have this basis. DIF: Cognitive level: Understanding TOP: Nursing process: Assessment MSC: Client Needs: Psychosocial Integrity 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? a. Atheism b. Humanism c. Agnosticism d. Sick religiosity ANS: D NURSINGTB.COM Sick religiosity is marked by a lack of openness to other possibilities, a sense of exclusiveness, and absolutism. The scenario does not give evidence of any of the other options. DIF: Cognitive level: Understanding TOP: Nursing process: Assessment MSC: Client Needs: Psychosocial Integrity 3. A depressed patient expresses feelings of hopelessness, helplessness, and powerlessness. The patient’s spiritual distress is best addressed by which nursing intervention? a. Assisting the patient find meaning and hope through making personal choices b. Encouraging the patient to develop wisdom in the face of adversity c. Assessing the patient in drawing strength from a higher power d. Identifying ways the patient can live by higher principles ANS: A Although individuals cannot always choose their circumstances, they always have a choice of attitudes toward their experiences. Without finding meaning, individuals develop hopelessness. None of the other options relates directly to hopelessness. DIF: Cognitive level: Applying TOP: Nursing process: Assessment MSC: Client Needs: Psychosocial Integrity 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? a. Recurrent losses b. Overindulgence c. Lack of nurturing d. Poor school performance ANS: C Loder has hypothesized that early developmental experiences set the stage for later spiritual dynamics. Inadequate nurturing may result in lack of establishment of trust. Later, spiritual issues of abandonment and shame might surface. None of the other options have been advanced as explanations for feelings of abandonment by God. DIF: Cognitive level: Understanding TOP: Nursing process: Assessment MSC: Client Needs: Psychosocial Integrity 5. Which statement made by a nurse demonstrates an understanding about why completing a spiritual assessment is important? a. “Research clearly demonstrates that spiritual interventions by nurses are a cost-effective practice.” b. “Accrediting organizations regard spiritual care as a patient right.” c. “Spirituality is better addressed by nurses than by clergy.” d. “Prayer consistently improves mental health outcomes.” ANS: B There is a lack of agreement as to whether or not spiritual care should be a legitimate concern of nurses, despite a large bodNy ofRresIearcGh eBCnceMciting its advantages to patients. Among the major deterrents to including spiritual care is the concern that already overburdened nurses will not find time to perform the assessment. It should be noted, however, that when an accrediting body considers a facet of care to be a right of patients, it will look for evidence of attention to that right. A spiritual assessment documented in the medical record provides such evidence. The other options are of lesser importance when weighed against the standards set by an accrediting agency. DIF: Cognitive level: Analyzing TOP: Nursing process: Planning MSC: Client Needs: Psychosocial Integrity 6. Which statement by a mentally ill patient best exemplifies sick religiosity? a. “Suicide will result in eternal damnation for your soul.” b. “Your illness has nothing to do with insufficient faith.” c. “Questioning God is a common reaction to illness.” d. “Your illness is not related to sin.” ANS: A Sick religiosity is marked by a lack of openness to other possibilities, a sense of exclusiveness, and absolutism. The correct option best exemplifies this thinking. The other options are supportive of the patient’s spirituality. DIF: Cognitive level: Understanding TOP: Nursing process: Implementation MSC: Client Needs: Psychosocial Integrity 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? a. Psychiatric nurse clinician b. Professional chaplain c. Clinical psychologist d. Community minister ANS: B A professional chaplain holds a ministerial degree and has had a year of special study in ministering to individuals with spiritual concerns related to health problems. The other professionals have less knowledge and experience in dealing with the dual problems of mental illness and spiritual concerns. DIF: Cognitive level: Understanding TOP: Nursing process: Implementation MSC: Client Needs: Psychosocial Integrity 8. A nurse providing spiritual care for a patient awaiting a liver transplant demonstrates knowledge of anticipated spiritual needs by focusing on what area? a. Issues related to personal mortality b. The need for prayer and organized religion c. Misinterpretation of medical information regarding liver transplantation d. Techniques for minimizing clinical depression ANS: A Although each of the options is possible, the most likely response is thinking about what the illness means in terms of life span, quality of life, and other mortality issues. The other responses are pathologic and are not seen as frequently. N R I G B.C M DIF: Cognitive level: Analyzing TOP: Nursing process: Planning MSC: Client Needs: Psychosocial Integrity 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? a. The parents’ stage of dementia b. The caregiver’s religious ideology c. Whether or not the parents’ medications are helping d. If financial resources are sufficient to provide a health care aide ANS: B Serious illness of loved ones often presents difficult dilemmas and problems in adjustment for caregivers. It is known that religious activities are important coping mechanisms for many African-American caregivers of older adults. The correct answer is the only option directly concerned with caretaker coping. The foci of the other options are on the parents. DIF: Cognitive level: Applying TOP: Nursing process: Assessment MSC: Client Needs: Psychosocial Integrity 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? a. Hostility b. Distractibility c. Inability to trust d. Inability to find meaning in suffering ANS: C Individuals with paranoid schizophrenia often have an inability to trust. Inability to trust may be related to inadequate nurturing in infancy and to later difficulty recognizing a connection with God. The other options are less clearly related to issues of paranoia and trust. DIF: Cognitive level: Understanding TOP: Nursing process: Evaluation MSC: Client Needs: Psychosocial Integrity 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? a. Making meaning through choices b. A presence that orders the world c. Higher purpose and principles d. Higher power and achievement ANS: A Frankl advocated that humans find meaning when they commit themselves to something beyond themselves. Making meaningful choices improves an individual’s mental health. The constructs mentioned in the other options have less to do with the individual’s decision making described in the scenario. DIF: Cognitive level: Understanding TOP: Nursing process: Assessment MSC: Client Needs: PsychosocNiaUl IRntSegIriNtyGTB.COM 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? a. Potential for enhanced spiritual well-being b. Disturbed personal identity c. Spiritual distress d. Powerlessness ANS: C Defining characteristics for the nursing diagnosis of spiritual distress are present. They include concern with the meaning of life, anger toward God, questioning the meaning of suffering, conflict about beliefs, and questions about the morality of the therapeutic regimen. Spiritual distress is more applicable to the patient’s comments than the other diagnoses. DIF: Cognitive level: Analyzing TOP: Nursing process: Assessment MSC: Client Needs: Psychosocial Integrity 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? a. “Rest assured that God will fill your heart with peace.” b. “I am concerned about your spiritual distress.” c. “God will hold you in the palm of His hand.” d. “God knows your every thought.” ANS: B The correct answer shows compassion and caring on the part of the nurse and contributes to trust building. The nurse has offered concerns, which reassures the individual that he or she will not be abandoned. The other options each include abstract concepts that are difficult for someone who thinks concretely to interpret correctly. They might even be frightening to patients who think concretely. DIF: Cognitive level: Analyzing TOP: Nursing process: Implementation MSC: Client Needs: Psychosocial Integrity 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. a. Ask the patient, “What do you think the verse means?” b. Invite professional clergy to join the dialog with the patient. c. Explain to the patient, “I’m not familiar with that passage. It would be better for me not to comment.” d. 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.” ANS: B The correct answer shows that the nurse recognizes personal limits but remains engaged in the interaction with the patient. The distracters reject the patient’s concerns. DIF: Cognitive level: Applying TOP: Nursing process: Implementation MSC: Client Needs: PsychosocNiaUl IRntSegIriNtyGTB.COM 15. On the admission papers, a patient checked the box labeled “No religious affiliation.” What meaning can the nurse draw from this information? a. The patient is not religious. b. The patient is among a growing group. c. The patient has conventional religious values. d. The patient is probably experiencing spiritual distress. ANS: B People hold strong opinions about spirituality and religion, but a significant number—39%—of young Americans aged 18 to 29 are religiously unaffiliated, four times as many as a generation ago. The distracters offer misinformation and misinterpretation about the meaning of “No religious affiliation.” DIF: Cognitive level: Understanding TOP: Nursing process: Assessment MSC: Client Needs: Psychosocial Integrity 16. What is the predominant religious tradition in the United States? a. Christian b. Buddhist c. Muslim d. Jewish ANS: A Christians compose 70% of Americans. DIF: Cognitive level: Understanding TOP: Nursing process: Assessment MSC: Client Needs: Psychosocial Integrity MULTIPLE RESPONSE 1. A patient asks, “What religions are considered monotheistic? “ The nurse understands that religions are included? (Select all that apply.) a. Judaism b. Islam c. Buddhism d. Christianity e. Wicca ANS: A, B, D The world’s three largest monotheistic religions include Christianity, Islam, and Judaism. The remaining options are polytheistic religions. DIF: Cognitive level: Understanding TOP: Nursing process: Assessment MSC: Client Needs: Psychosocial Integrity 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.) a. Being authentic b. Being respectful c. Demonstrating caring NURSINGTB.COM d. Speaking slowly and concretely e. Ability to answers theological questions ANS: A, B, C, D The needs elicited from patients (authenticity, caring, respect) can be seen as caregiver behaviors that enhance trust formation. The need to speak slowly and in concrete terms is important for patients with thought disorders who have cognitive problems that make comprehension slower and abstraction difficult to understand. Answering theological questions is not a focus in this situation. DIF: Cognitive level: Understanding TOP: Nursing process: Implementation MSC: Client Needs: Psychosocial Integrity 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.) a. Healthy spirituality versus sick religiosity b. That which gives the patient hope and meaning in life c. Important personal spiritual practices d. Role of religion in the patient’s life e. Sources of strength and comfort ANS: B, C, D, E The HOPE questions gather information about sources of hope, strength, comfort, meaning, peace, love, and connection; the role of organized religion for the patient; personal spirituality and practices; and effects on medical care and end-of-life decisions. Healthy spirituality versus sick religiosity is not addressed in this tool. DIF: Cognitive level: Understanding TOP: Nursing process: Assessment MSC: Client Needs: Psychosocial Integrity NURSINGTB.COM

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