Health Assessment Spirituality and Religion

A client on hospice care tells his nurse that he is not afraid of death. He explains that this is because he believes he has lived a very good life and therefore his next life should be even better than this one, as all of his life actions will be carried into the next. The nurse recognizes this belief as which of the following?

• Ramadan

• Karma

• Holy Trinity

• Kosher

Answer explanation

Rationale:In Hinduism, death marks a passage because the soul has no beginning or end. At death the soul may be reborn as another person and one's karma, or life actions, is carried forward. It is important for karma to leave this life with as little negativity as possible to ensure a better life next birth. Ramadan is a Muslim holy month that involves fasting from food and drink between sunrise and sunset. The Holy Trinity is the Christian belief that God exists in three persons simultaneously: the Father, the Son, and the Holy Spirit. In Judaism, kosher laws govern methods of slaughter and food handling.

A nurse is caring for a terminally ill client. The client's family has requested that at the time of death, the client's arms not be crossed and any clothing or bandages with the client's blood be prepared for burial with the person. The nurse recognizes that this family follows the rituals of which religion?

• Islam

• Hinduism

• Judaism

• Buddhism

Answer explanation

Rationale:In Judaism, the Psalms and the last prayer of confession are held at bedside. At death, the arms are not crossed; any clothing or bandages with the client's blood should be prepared for burial with the person. It is important that the whole person be buried together. Hinduism, Buddhism, and Islam do not follow this ritual.

A Muslim teenager is in the hospital for surgical repair of a severe fracture in the leg during the month of Ramadan, which the client says he would like to observe during his stay. Which of the following interventions should the nurse be prepared for in caring for this client?

• Serve meals as normal, but do not include pork

• Withhold all food and drink between sunrise and sunset

• Do not mix dairy and meats together on the client's tray

• Do not mix dairy and meats together on the client's tray

Answer explanation

During the holy days of Ramadan (29 days in December and/or January), neither food nor drink is taken between sunrise and sunset, though frail, ill, and young children are exempt. At all times, consumption of pork or alcohol is prohibited. Other meats must meet ritual requirements and many use kosher (Jewish ritual) foods because these meet the requirements of Islamic believers as well. Not mixing dairy and meats is a Jewish dietary practice, not Muslim.

A nurse assesses the spirituality of a client who is terminally ill with pancreatic cancer. Which of the following is the best rationale for this action, from the nurse's perspective?

• Identifying possible coping mechanisms

• Searching for meaning and purpose

• Finding common practices shared with a group

• Defining the meaning of the afterlife

Answer explanation

Rationale:Religion and spirituality have been related to a client's well-being in the face or illness and disease. They can be powerful coping mechanisms when a client is facing end-of-life issues. The definition of spirituality is a search for meaning and purpose in life. Common practice shared by a group of persons defines a religion. Religion also helps to define the meaning of the afterlife

While preparing a Hindu client for surgery, it becomes apparent that the client's view about spirituality is entirely different from the nurse's. What is the most appropriate action by the nurse?

• Suggest the client meet with a chaplain for spiritual support

• Request a nurse to continue care who shares the client's belief

• Tell the client that his illness is due to his spiritual views

• Be respectful, open, and willing to discuss spiritual issues as appropriate

Answer explanation

Rationale:In whatever form spirituality is incorporated into client care, the nurse should be respectful, open, and willing to discuss spiritual issues if seen as appropriate. The nurse should avoid conveying a judgmental attitude toward the client's spiritual beliefs and religious practices. Unless specifically requested by the client, the nurse should be able to care for the client despite their differing spiritual views. The nurse telling the client that his illness is due to his views or suggesting that he meet the chaplain is inappropriate: a chaplain would be of a different faith than the Hindu client.

A client reports to the nurse that reading the holy book of his faith brings him comfort during his prolonged illness. Which of the following should the nurse do in response to this report?

• Encourage the client to continue reading the book, as evidence has shown the positive effects of spirituality on health

• Discourage the behavior, because evidence has shown that such activities actually hinder health

• Neither encourage nor discourage the behavior, because evidence has shown no benefit of such activities to health

• Encourage the client to read the holy books of several faiths, not just his own

Answer explanation

Rationale:A substantial amount of evidence shows the positive effects of spirituality on health. Spiritual practices have the potential to encourage greater mental and physical health. A limited list of spiritual activities may include prayer, participation in church services, meditation, yoga, tai chi, dietary restrictions, pilgrimage, confessions, reflection, forgiveness, and any other activity that includes a search for meaning and purpose in life. If a client reports spiritual activities, the activities should be encouraged if found beneficial to the clients overall health.

A client expresses to the nurse that he is unable to get the support to mentally prepare himself to undergo the treatment for leukemia. Which nursing diagnosis is appropriate for the client?

• Anxiety

• Spiritual distress

• Disturbed body image

• Ineffective coping

Answer explanation

Rationale:The appropriate nursing diagnosis for the client should be spiritual distress. The client expresses his concern that he does not have an inner strength, which indicates that he needs a spiritual support to regain faith and strength. The client does not exhibit any abnormal behavior, and therefore ineffective coping cannot be the diagnosis. Disturbed body image is also not a suitable diagnosis, as there is no mention of concern about the appearance. Anxiety is always related to something unknown.

A nurse cares for a client who states that he believes that God can be seen in everything and every action. The nurse recognizes this as what characteristic of spirituality?

• Self-reflection

• Ritualistic

• Objective

• Organized

Answer explanation

Rationale:The client refers to self-reflection. Spirituality is based on self-reflection and not group-oriented as a religion. It is unorganized and subjective; it differs from person to person. There are no universal beliefs on spirituality. Rather, spirituality is based on experience and not rituals.

A nurse cares for a client who practices Hinduism. The nurse understands that Hindus believe illness is caused by which type of behavior?

• Cured by worshipping God

• Unhygienic habits

• Consumption of dirty food

• Result of past and current life actions

Answer explanation

Rationale:According to Hinduism, illness is the result of past and current life actions. The right hand is seen as holy, and eating and intervention need to be with the right hand to promote clean healing. The spiritual health belief in Hinduism is not that illness is due to consumption of dirty food or to unhygienic habits or that illness can be cured by worshipping God.

A nurse assesses the spirituality of a client who is terminally ill with pancreatic cancer. Which of the following is the best rationale for this action, from the nurse's perspective?

• Finding common practices shared with a group

• Identifying possible coping mechanisms

• Searching for meaning and purpose

• Defining the meaning of the afterlife

Answer explanation

Rationale:Religion and spirituality have been related to a client's well-being in the face or illness and disease. They can be powerful coping mechanisms when a client is facing end-of-life issues. The definition of spirituality is a search for meaning and purpose in life. Common practice shared by a group of persons defines a religion. Religion also helps to define the meaning of the afterlife.