CHAMBERLAIN NR 222 Exam 3 Review Questions and answers

NR 222 EXAM 3 REVIEW QUESTIONS INFANT AN INFANT IS LYING IN A CRIB WATCHING AND LISTENING TO A COLORFUL MOBILE. WHAT IS THE PURPOSE OF HAVING A MOBILE? A. Provides stimulation necessary for continued growth and development for the infant. B. Provides too much stimulation for the infant, making it difficult for the infant to focus. C. Serves as inadequate stimulation for the infant because it is an inanimate object. D. Serves as a distractor for the infant, making it easier to fall asleep. A. The mobile is providing the stimulation necessary for continued growth and development because both auditory and visual stimuli are necessary to promote growth and development. Additionally, soft sounds and voices are soothing to infants. A DELIVERY ROOM NURSE SENSES DISAPPOINTMENT WHEN A MOTHER IS TOLD SHE JUST DELIVERED A BABY GIRL. WHICH OF THE FOLLOWING WOULD BE THE MOST THERAPEUTIC RESPONSE BY THE NURSE? A. “Yes, you just delivered a healthy, beautiful baby girl.” B. “This is your first baby. You can always try again for a boy.” C. “Don’t worry, many parents often feel the same way you do.” D. “You are tired. I think you should get some rest.” A. The nurse should respond by saying, “Yes, you just delivered a healthy, beautiful baby girl.” This response provides information that will help increase the mother’s acceptance of having a girl rather than a boy. Acceptance and bonding are important in preventing child abuse. The fact that the mother appeared disappointed should be acknowledged with a positive comment. DURING A HOME VISIT, THE NURSE FINDS A 9-MONTH-OLD IN A PLAYPEN WITH A COUPLE OF TOYS. WHICH OF THE FOLLOWING INSTRUCTIONS WOULD BE MOST APPROPRIATE FOR THE NURSE TO PROVIDE TO THE PARENT TO ENCOURAGE GROWTH AND DEVELOPMENT OF THE CHILD? A. Encourage the addition of a few more toys to the playpen. B. Suggest keeping the infant in the playpen as much as possible to promote safe play. C. Encourage providing the infant with supervised time outside of the playpen. D. Suggest removing all toys from the playpen. C. The nurse should encourage the mother to provide the infant with sufficient supervised time outside of the playpen to allow the child to crawl and explore. These activities help promote growth and development. Additionally, by 9 months of age, most infants are crawling. A NEW FATHER IS INSTALLING A CAR SEAT FOR AN INFANT. WHICH OF THE FOLLOWING INFORMATION SHOULD BE GIVEN TO THE FATHER BY THE NURSE? A. The infant should be in a rear-facing car seat in the front seat. B. The infant should be in a rear-facing car seat in the back seat. C. The infant should be in a front-facing car seat in the front seat. D. The infant should be in a front-facing car seat in the back seat. B. The AAP recommends rear-facing car safety seats for infants up to 2 years of age. The back seat is recommended because of the danger posed by air bags.A 5-MONTH-OLD INFANT HAS BEEN BROUGHT INTO THE OFFICE BY HIS SPANISH-SPEAKING MOTHER FOR SYMPTOMS OF AN UPPER RESPIRATORY INFECTION. WHICH OF THE FOLLOWING SHOULD BE THE INITIAL ACTION TAKEN BY THE NURSE? A. Ask the mother if she would like an interpreter. B. Ask the mother what home remedies have been used. C. Ask the mother how long the child has had these symptoms. D. Ask the mother about any allergies the child may have. A. The nurse should start by asking the mother if she would like an interpreter. Once the need for an interpreter has been established, the nurse can continue with the other questions.DURING A VISIT TO THE HOME OF A 3-MONTH-OLD INFANT, WHICH ENVIRONMENTAL FINDING REQUIRES IMMEDIATE PARENTAL EDUCATION? A. A pool in the backyard without a gate B. The lack of smoke detectors C. The lack of childproof latches on drawers and cupboards D. Two azalea plants in the living room B. The lack of a smoke detector places the infant at immediate risk if a fire were to occur. The majority of fire deaths occur in the home, and most people die from smoke inhalation, not burns. At 3 months of age, the infant is not yet able to crawl; thus, the other three findings, although risks, are not immediate.TODDLER AT A WELL-CHILD VISIT, THE PARENTS OF A TODDLER ASK THE NURSE HOW THEY SHOULD TEACH THEIR TODDLER THE IMPORTANCE OF DENTAL HYGIENE. WHICH OF THE FOLLOWING ACTIONS SHOULD THE NURSE RECOMMEND TO THE PARENTS?A. Remind the toddler to brush his teeth every day. B. Have the dentist tell the toddler about the importance of dental hygiene. C. Schedule a time to brush their own teeth with their toddler. D. Have the toddler watch an educational cartoon video on the teeth brushing. C. Toddlers identify with parents, caregivers, and other important role models, internalizing a wider range of lifestyle attributes. Parents’ and caregivers’ health perceptions and health behaviors should model the perceptions and behaviors desired for health promotion. Thus, scheduling a time to brush their teeth with their toddler is the best way for parents to teach their toddler the importance of dental hygiene.A MOTHER IS CONCERNED BECAUSE HER 22-MONTH-OLD HAS BEEN SKIPPING MEALS LATELY. WHICH OF THE FOLLOWING ACTIONS SHOULD THE NURSE RECOMMEND TO THE MOTHER? A. Put the child in time out whenever he skips a meal. B. Offer him foods he likes such as cookies and chips. C. Limit the child’s consumption of juices and cookies. D. Talk to the child about how important it is to eat three meals a day. C. Toddlers often use mealtime to assert their individuality. They sometimes do this by refusing to eat. Additionally they are often not hungry because they have been given empty calories by their parents, because the parents want to make sure the toddler eats something. However empty calories should be avoided. Parents should take control and offer the toddler healthy, age-appropriate foods. Punishment and focusing on food should be avoided. WHICH OF THE FOLLOWING TODDLERS WOULD REQUIRE FURTHER INVESTIGATION FROM THE NURSE? A. Sitting quietly on a couch B. Experiencing a temper tantrum C. Playing with a toy next to another child also playing with a toy D. Exploring his environment and playing with new toys A.Toddlers are always busy. They spend most of their day playing and exploring their environment. Thus, a toddler sitting quietly is not an anticipated behavior and should be evaluated further.THE INABILITY OF A TODDLER TO VIEW SITUATIONS FROM ANOTHER PERSON’S PERSPECTIVE IS KNOWN AS: A. autonomy. B. egocentrism. C. self-perception. D. integrity. B. The inability of a toddler to put him- or herself in another’s shoes is known as egocentrism.A NURSE IS PROVIDING ANTICIPATORY GUIDANCE TO PARENTS OF A TODDLER. WHICH OF THE FOLLOWING STATEMENTS WOULD THE NURSE MOST LIKELY MAKE? A. “Temper tantrums are expected, so always give in to them.” B. “Put your toddler in time out if he has a temper tantrum.” C. “Childproof your home.” D. “Always provide your toddler with challenging toys.” C. The developmental task of toddler is to acquire a sense of autonomy. During this stage toddlers do a lot of exploring, and this includes climbing, crawling, and tasting. As a result, they are at increased risk for injury and should be provided with a childproof environment. AN 18-MONTH-OLD TODDLER IS BEING SEEN FOR A WELLCHILD VISIT. WHICH OF THE FOLLOWING STRATEGIES WOULD THE NURSE USE TO PROMOTE THE TODDLER’S COOPERATION? A. Ask the toddler if he wants to be examined today. B. Ask his mother leave the room while the nurse examines him. C. Have him hold the stethoscope diaphragm on his chest while the nurse listens to his chest. D. Have his mother hold him down while the nurse examines him. C.Toddlers need to explore their environment to master it. This includes health care visits. They need to observe and listen to their parents interact with the health care provider, be allowed to manipulate the equipment, and be given simple instructions and choices so they can maintain some control. Therefore having the child hold the stethoscope on his chest while being examined will help make the visit more productive.PRESCHOOLER A MOTHER COMMENTS TO THE SCHOOL NURSE THAT HER CHILD HAS POOR HYGIENE HABITS AND ASKS THE NURSE FOR SUGGESTIONS ABOUT HOW TO TEACH HER CHILD TO IMPROVE ON HIS HYGIENE. WHICH OF THE FOLLOWING RECOMMENDATIONS WOULD THE NURSE GIVE THE MOTHER? A. Have him learn it at school. B. Model the behavior at home. C. Lecture him about hygiene. D. Punish him when he forgets to brush his teeth. B. The best way for a parent to teach a child good hygiene is to model the behavior at home. Reinforcement of health-promotion activities helps to instill behaviors. Additionally, preschoolers like to imitate adults.A 4-YEAR-OLD GIRL ASKS HER MOTHER FOR A SECOND CUP OF YOGURT BEFORE STARTING TO EAT THE FIRST CUP SHE WAS GIVEN. WHAT WILL THE CHILD MOST LIKELY DO WITH THE EXTRA HELPING? A. Eat it herself. B. Ask her brother if he wants it. C. Feed it to her dog. D. Give it to her imaginary friend. D. The extra helping is likely for the child’s imaginary friend. Preschoolers may have one or more imaginary companions. They are usually another child. Preschoolers eat, play, and sleep with their imaginary companions.A 4-YEAR-OLD CHILD TELLS THE SCHOOL NURSE THAT HE INVENTED A NEW SONG. WHICH OF THE FOLLOWING WOULD BE THE BEST RESPONSE BY THE NURSE? A. Congratulate the child on a job well done. B. Tell the child that he is too young to invent anything. C. Nicely tell the child that it does not sound like a song. D. Ask the child to come back later when there is more time to listen to the song. A. The nurse’s best response is to congratulate the child on a job well done. When children perceive their value, they experience good feelings about themselves. They develop initiative through active imagination. According to Erikson, this is the most important developmental task in the development of self-concept. Reinforcement of behaviors and praising are methods that help develop self-concept. A NURSE IS USING PRIMARY PREVENTION STRATEGIES TO PREVENT CHILD ABUSE IN THE COMMUNITY. WHICH OF THE FOLLOWING INTERVENTIONS WOULD THE NURSE IMPLEMENT? A. Educate the public about violence and the potential for abuse. B. Remove a child who has been abused from the home. C. Report a case of child abuse. D. Refer a parent who abused their child to counseling. A.Educating the public about violence and the potential for abuse is a form of primary prevention. Nurses provide primary prevention for violence by promoting awareness and providing anticipatory guidance. Primary prevention is used before violence actually occurs. DURING A WELL-CHILD VISIT, A FATHER TELLS THE NURSE THAT HIS PRESCHOOLAGED CHILD HAS BEEN ENJOYING THEIR “ROAD TRIPS” THAT THEY TAKE TOGETHER WHEN THE CHILD GETS TO SIT IN THE FRONT SEAT OF THE CAR WITH HIM. WHICH OF THE FOLLOWING ACTIONS SHOULD THE NURSE TAKE NEXT? A. Report the father to the Department of Human Services. B. praise the father for promoting conversation with the child during car rides. C. Educate the father about the dangers of having small children in the front seat. D. Provide the parent with educational materials about car seat safety. C.Federal investigations concluded that children under age 13 should ride in the back seat of a motor vehicle, particularly because of potential injury or death from a passenger seat air bag that could inflate in a severe car accident. Although parents may know that infants should be placed in the back seat, they do not always know that children in the front seat of a motor vehicle face danger, even if they are using a restraint system. A MOTHER THINKS HER 3-YEAR-OLD CHILD INGESTED A POISONOUS SUBSTANCE. WHAT SHOULD THE NURSE TELL THE MOTHER TO DO NEXT? A. Call the pediatrician on call. B. Give ipecac syrup. C. Call the Poison Control Center. D. Wait to see if the child will vomit. C. The first thing the mother should do is call the Poison Control Center. Parents should have the number for the poison control center handy. Ipecac syrup should also be in the home; however, The Poison Control Center should be contacted before administration of ipecac syrup in order to determine if this would be appropriate following ingestion of this substance.SCHOOL AGE CHILD A PARENT ASKS THE NURSE WORKING IN A PEDIATRIC CLINIC HOW SHE CAN HELP HER 6-YEAROLD CHILD FEEL GOOD ABOUT HIMSELF. WHICH OF THE FOLLOWING STATEMENTS SHOULD BE MADE BY THE NURSE?A. “Doing most things for your child will give them a sense of security, and they will have a positive self-image.” B. “Having your child help around the house with tasks such as setting the table will increase self-esteem.” C. “Make sure to highly praise even the smallest effort your child makes at completing a task.” D. “There is little you can do to increase your child’s self-esteem. Their peers have much more of an influence than parents at this age.” B. When children succeed at age-specific tasks, they increase their sense of self-worth. Doing everything for a child prevents him or her from becoming proficient at a task. Too much praise makes positive feedback lose its value and gives the child a false sense of mastery. Although peers are important, at age 6, parents influence their children more than do peers. WHICH OF THE FOLLOWING STATEMENTS MADE BY A PARENT IS MOST HELPFUL WHEN DISCUSSING RULES OF THE HOUSEHOLD? A. “You did not feed the dog like you promised, so you cannot have ice cream for dessert.” B. “I was upset when you did not feed the dog like you promised. We all need to help take care of him because he depends on us. Let’s talk about what happened.” C. “Why did you forget to feed the dog? Would you like me to forget to feed you?” D. “What you did was bad. We all need to care for the dog.” B.When correcting a child, explaining how one feels, the consequence of the action and then listening to the child discuss the situation is more beneficial than punishment and labeling the child as “bad.”THE SCHOOL NURSE IS EVALUATING CHILDREN FOR SIGNS AND SYMPTOMS OF DEPRESSION. WHICH OF THE FOLLOWING CHILDREN MAY BE AT RISK FOR DEPRESSION? (SELECT ALL THAT APPLY) A. 11-year-old girl who has been involved in fighting during the past month B. 10-year-old boy who no longer wants to play on the school’s soccer team C. 12-year-old boy who has started lifting weights D. 9-year-old girl who visits the nurse on a daily basis for vague complaints A, B, D. Symptoms of depression in school-age children include anorexia, sleeplessness, lethargy, changed affect, aggressive behavior, frequent crying, or withdrawal from previously enjoyed activities.ADOLESCENT PARENTS RECENTLY DISCOVERED THAT THEIR TEENAGE DAUGHTER HAS BEEN CONSUMING ALCOHOL ON A REGULAR BASIS. THEY ASK THE NURSE FOR ADVICE ON HOW TO BEST HELP THEIR DAUGHTER. WHICH OF THE FOLLOWING RECOMMENDATIONS SHOULD THE NURSE GIVE TO THE PARENTS? A. Talk to their daughter at length regarding the dangers associated with drinking. B. Tell their daughter she will not be allowed to use her cell phone if this continues. C. Enroll their daughter in a peer support group focused on teenage drinking. D. Provide their daughter with literature regarding the dangers of drinking. C. Teens do not always consider health risks associated with their risky behaviors. Additionally, peer influence is primary and parental input is often rejected. In this case, the teenager may risk losing her cell phone and privileges by continuing with her risky behavior, but because peer influence is primary, the parents should enroll her in a peer support group focused on teenage drinking. WHICH OF THE FOLLOWING BEHAVIORS IS MOST REFLECTIVE OF A TEENAGER? A. Riding an ATV without a helmet B. Not skiing for fear of falling and getting hurt C. Obeying a new parental rule without a challenge D. Walking away from a group of friends who are smoking cigarettes A. Teenagers are known for their risk-taking behaviors. They do not always consider the health risks associated with their behaviors. In addition, they often do things because their friends do it. Therefore, riding an ATV without a helmet and risking a head injury is most reflective of a teenager’s behavior. DURING A PHYSICAL EXAM, A TEENAGER ASKS THE NURSE IF SHE CAN HAVE A STRONGER MEDICATION FOR HER CONSTIPATION BECAUSE THE LAXATIVES SHE HAS BEEN TAKING ARE NOT HELPING. DURING THE PHYSICAL EXAM, THE NURSE OBSERVES MILD TO MODERATE EROSION OF THE TOOTH ENAMEL. WHICH OF THE FOLLOWING DISORDERS IS THE CLIENT MOST LIKELY EXPERIENCING? a. Bulimia nervosa B. ANOREXIA NERVOSA C. Idiopathic constipation D. Irritable bowel syndrome A. Bulimia nervosa is characterized by binge eating and then purging by self-induced vomiting and/or laxatives. Purging can also lead to erosion of the tooth enamel. Bulimia nervosa occurs more commonly in females. A teenage girl asking for stronger laxatives with tooth enamel erosion should cause any health care provider to consider the possibility of bulimia nervosa. A MOTHER IS CONCERNED BECAUSE HER DAUGHTER HAS BEEN TAKING A NAP EVERY DAY AFTER SCHOOL. WHICH OF THE FOLLOWING STATEMENTS WOULD BE THE BEST RESPONSE BY THE NURSE? A. “Don’t worry; all teenagers do that.” B. “Tell me about your daughter’s schedule.” C. “Let’s bring her in for some blood work.” D. “Have you addressed the topic of drugs with you daughter?’ B. Many teenagers take naps, although this does not address the mother’s concern. Although the nap can be a symptom of a health problem or drug use, additional information is necessary to make that determination. Asking the mother to tell you about her daughter’s schedule provides information to determine whether the behavior is normal or whether it requires further investigation. WHICH OF THE FOLLOWING TEENAGERS IS AT RISK FOR NOT MEETING HIS DEVELOPMENTAL TASKS? A. Arrested for petty theft B. Decided he wants to major in accounting C. Has recently broke up with his girlfriend D. Is a member of the varsity basketball team A. The central task of adolescence according to Erikson is the establishment of identity, with the primary risk being role confusion. As the adolescent searches for direction, he makes choices in social, recreational, volunteer, academic, familial, and occupational activities. When the threat of confusion is exceedingly great, delinquent behavior and alterations in mental health can occur. Thus, a teenager arrested for petty theft is displaying delinquent behavior that may place him at risk for not meeting his developmental task of identity. A MOTHER IS CONCERNED BECAUSE HER 13-YEAR-OLD DAUGHTER COMES HOME HAPPY ONE DAY AND SAD THE NEXT. THE GIRL ALSO ARGUES WITH HER YOUNGER SISTER MORE THAN SHE DID IN THE PAST, AND DOES NOT LIKE PARTICIPATING IN FAMILY ACTIVITIES ANYMORE. WHICH OF THE FOLLOWING IS THE BEST INITIAL RESPONSE FROM THE NURSE? A. “The changes during adolescence can be stressful as they struggle to come to terms with who they are. What other types of behaviors has she been displaying?” B. “Changes in affect can be a warning sign for suicide. Has she had any increase in risktaking behaviors or physical violence?” C. “Is there any history of psychological disorders in your family?” D. “Withdrawal can be a sign of substance abuse. Has she given you any indication she might be using illicit drugs?” A.Although dramatic swings in affect can be a warning sign for suicide, and withdrawal can be a sign of substance abuse, additional information is required before suggesting a diagnosis. Often, mood swings and spending more time with peers and less time with the family is normal adolescent behavior during this period of rapid change in physical, psychosocial, spiritual, moral, and cognitive growth. Parents and teenagers should be aware of and prepared for these changes. A TEENAGER ASKS THE SCHOOL NURSE FOR ADVICE BEFORE GETTING A TATTOO. WHICH OF THE FOLLOWING RESPONSES WOULD BE MOST APPROPRIATE FOR THE NURSE? A. “You should not get a tattoo.” B. “It is okay to get a tattoo if you go to a licensed artist.” C. “Tattoos are popular; however, they can lead to infection and/or bleeding.” D. “A body piercing would be safer and less permanent.” C. Tattoos and piercings carry similar risks, which include localized infection, bleeding, and dermatitis. In addition, tattoos carry a heightened concern for blood-borne disease such as hepatitis and HIV. When providing anticipatory guidance, nurses should treat teenagers as partners and give them the information they need to make an informed decision. Therefore, informing the teenager about the risk of infection is the best response.YOUNG ADULT WHICH OF THE FOLLOWING REFLECTS PIAGET’S THEORY AS APPLIED TO YOUNG ADULTS?A. Voting for a candidate based on popularity B. Voting for a candidate based on media advertisements C. Voting for a candidate based on support of the candidate by peers D. Voting for a candidate based on analysis of views about various issues D. Young adults are in Piaget’s formal operational thinking stage during which they analyze issues objectively and insightfully.A NURSE HAS VOLUNTEERED TO WORK AT A NATURAL DISASTER SITE. WHICH OF THE FOLLOWING QUESTIONS SHOULD THE NURSE ASK TO DETERMINE IF THE 26-YEAROLD INDIVIDUAL BEING SCREENED IS DEPRESSED OR HAS SUICIDE IDEATION? A. “Tell me about your pets.” B. “What do you do for work? How has your work been affected by this disaster?” C. “Have you thought of harming yourself?” D. “Have you seen your friends since the disaster?” C. Direct questioning about the intent to harm oneself is appropriate for the nurse to ask during screening/counseling sessions.MIDDLE-AGE ADULT A 45-YEAR-OLD CLIENT WHO HAS EXPERIENCED A TEN POUND WEIGHT GAIN DURING THE PAST YEAR ASKS THE NURSE IF SHE THINKS IRON SUPPLEMENTS WOULD HELP INCREASE HER ENERGY. WHICH OF THE FOLLOWING WOULD BE THE MOST APPROPRIATE ACTION FOR THE NURSE TO TAKE? A. Ask the client to describe her daily activity and diet B. Leave a note requesting an iron supplement on the client’s chart for the doctor C. Provide the client with information related to aerobic exercise classes D. Ask the client if she is still menstruating A. A lack of routine exercise and activity plus a diet high in calories contributes to weight gain and a lack of energy. The priority action by the nurse is assessment, which will reveal the reason for a lack of energy.A NURSE WORKING IN A RURAL LOCATION IS INTERESTED IN STARTING A WEIGHT MANAGEMENT GROUP FOR CLIENTS IN THE AREA. WHICH OF THE FOLLOWING INTERVENTIONS WILL MOST LIKELY ENSURE SUCCESS? A. Using a pre-set list of topics for discussion B. Relying on printed material to relay information to the group C. Asking for a list of topics that interest the group D. Beginning each session with a 2-mile walk C. When participants plan the topics of discussion, interest is maintained. A pre-set list of topics may not meet the learning needs of this particular group. A 2-mile walk may not be realistic for participants.TAKING INTO ACCOUNT ALL OF THE AGENTS THAT AFFECT MIDDLE-AGE ADULTS, THE NURSE PLANS A HEALTH EDUCATION WORKSHOP FOCUSED ON DEVELOPING AN INDIVIDUALIZED LIFESTYLE CHANGE PROGRAM FOR EACH PARTICIPANT. WHICH OF THE FOLLOWING ACTIONS SHOULD THE NURSE STRESS THAT INDIVIDUALS TAKE FIRST? A. Limiting unprotected exposure to sun B. Starting a smoking cessation program C. Exercising at least three times a week D. Scheduling a complete physical and dental exam D. Although limited unprotected exposure to the sun, starting a smoking cessation program, and regular exercise are important to overall health, assessment data must first be collected to create an effective lifestyle change program. Health care needs and issues vary according to race and ethnicity, socioeconomic status, marital status, and so on. Approaches to health care/education must be individualized.OLDER ADULT A NURSE IS PLANNING TO WRITE A GRANT FOR A HEALTH PROMOTION PROJECT IN THE COMMUNITY. WHICH CONSIDERATIONS SHOULD THE NURSE MAKE WHEN DETERMINING THE APPROPRIATE POPULATION FOR THIS PROJECT?A. The fastest growing population is children under the age of 12. B. The fastest growing population is young Black American adults. C. The fastest growing population is White middle-age adults. D. The fastest growing population is adults age 65 and older. D. Adults age 85 and older are the fastest growing population in the United States, and the percentage of White Americans greater than age of 65 is decreasing compared with other ethnic groups.A NURSE IS CONDUCTING A HOME VISIT FOR AN OLDER ADULT IN THE SUMMER. WHICH OF THE FOLLOWING ITEMS SHOULD THE NURSE SHOULD LOCATE IN THE HOME? A. Fan B. Porch chair C. Synthetic blend clothing D. Thermometer A. Older adults are susceptible to heat stroke. The availability of a fan will help cool the ambient air. Light-weight cotton clothing “breathes” and facilitates cooling, whereas synthetic material retains heat. WHICH OF THE FOLLOWING NURSING INTERVENTIONS IMPLIES RESPECT FOR A PERSON’S SPIRITUALITY? (SELECT ALL THAT APPLY) A. Changing the position of the bed in a Muslim client’s room so that it faces east B. Contacting the chaplain to assess the client’s spiritual needs C. Saying a silent prayer with a client at the client’s request D. Praying out loud in the room of a dying client A, C. Because of the highly personal quality of spirituality, an unobtrusive and sensitive presence by the nurse is needed to allow the person in any setting to achieve spiritual health. The nurse can provide an environment that is supportive to the practice of the person’s spirituality. Praying out loud does not demonstrate respect for a person’s spirituality but imposes the nurse’s belief system on the person. Nurses should be able to assess the person’s spirituality initially and determine if it is necessary to further consult the chaplain