Psychiatric Nursing, 7th Edition by Norman L. Keltner – Debbie Steele – Test Bank

Psychiatric Nursing, 7th Edition by Norman L. Keltner – Debbie Steele – Test Bank

Chapter 06: Spiritual Issues

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 in:
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 REF: pp. 58-59
TOP: Nursing process: Assessment MSC: NCLEX: Psychosocial Integrity

2. The spouse 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:
a. atheism.
b. humanism.
c. agnosticism.
d. sick religiosity.

ANS: D
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 REF: p. 59
TOP: Nursing process: Assessment MSC: NCLEX: Psychosocial Integrity

3. A depressed patient expresses feelings of hopelessness, helplessness, and powerlessness. The patient’s spiritual distress is related to an inability to:
a. find meaning and hope through choices.
b. develop wisdom in the face of adversity.
c. draw strength from a higher power.
d. 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 REF: p. 59
TOP: Nursing process: Assessment MSC: NCLEX: 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:
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 REF: p. 59
TOP: Nursing process: Assessment MSC: NCLEX: Psychosocial Integrity

5. A group of nurses disagrees about whether or not to make spirituality a part of the assessment. Which statement provides a compelling argument in favor of including spiritual assessment?
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 body of research evidence citing 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 REF: pp. 59-60 TOP: Nursing process: Planning
MSC: NCLEX: Psychosocial Integrity