Spiritual Care

Pre-Test

1. Before meeting with a client with a terminal illness, a new

graduate nurse reviews information on spirituality. Which

of the following is the best explanation of spirituality?
A. That which gives people purpose and meaning in their
lives.
B. A formalized religious dogma.
C. A non denominational community service.
D. People being responsible for their life patterns.
Ans: A. Spirituality gives us purpose and meaning in life;
involves a relationship with oneself, others, and a higher
power, and involves finding significant meaning in the
entirety of life. Spirituality is a much broader concept than
religion and religious services. Responsibility to life
patterns is a concept of humanism.

2. A client asks the nurse the differences between

traditional and alternative therapies. Which of the
following is the best response?
A. Alternative therapies cost less than tradtional therapies.
B. Alternative therapies are used if traditional therapies are
ineffective.
C. Alternative therapies can be as effective as traditional
therapies for some conditions.
D. Alternative therapies utilize products from nature but
traditional therapies do not.
Ans: C. Although the effectiveness of alternative therapies
is sometimes not scientifically established, many people
report significant benefit from them for a wide variety of
conditions. Alternative therapies often cost less, but this
is not the primary difference. Both traditional therapies
utilize products from nature.

3. In which of the following ways do nurse create healing

environments?
A. Use technology to prevent hospital-acquired
infections
B. Empower clients to make healthy decision for
themselves
C. Place aquariums in day rooms of nursing homes.
D. Ensure the physicians orders are carried out.
Ans: B. Healing environments help empower clients to
make healthy decisions. They are not dependent on
technology or physicians orders. Aquariums are
environmental interventions, not a general approach
to clients.

4. The shift changed while the nursing staff was waiting for
the adult children of a deceased client to arrive. The
incoming nurse has never met the family. Which of the
following greetings is most appropriate?
A. Im very sorry for your loss.
B. Ill take you in to view the body.
C. I didnt know your husband, but I am sure he was a
wonderful person.
D. How long will you want to stay with your father.
Ans: A. This statement acknowledges the familys grief
simply. Avoid statements that may be interpreted as
overly impersonal(Option B), false support(Option C), or
harsh(Option D).

5. An 82 year-old man has been told by his primary care

provider that it is no longer safe for him to drive a car.
Which statement by the client would indicate beginning
positive adaptation to this loss?
A. I told the doctor I would stop driving, but I am not going
to yet.
B. I always knew this day would come, but I hoped it
wouldnt be now.
C. What does he know? Im a better driver than he will
ever be.
D. Well, at least I have friends and family who can take me
places.
Ans: D. Adaptive responses indicate the client can put the
loss into perspective and begin to develop strategies for
coping with the loss. Although the other options are
responses the client might likely give and feel, and are
not pathologic, they do not demonstrate movement
toward a goal of adaptation nor problem solving.

6. A nursing care plan includes the desired outcome of quality of

life for a client with a chronic degenerative illness who is likely to
live for many more years. Which of the following is one example
that would indicate the outcome has been met?
A. The client demonstrates having adequate financial resources to
pay for health care for many more years.
B. The client spends the majority of his/her time in spiritual
reflection.
C. The client has no signs or symptoms of preventive complications
of the illness.
D. The client verbalizes satisfaction with current relationships with
other persons.
Ans: D. Quality of life is determined by the client and expressed in
terms of his/her satisfaction with a variety of aspects of life.
Although being able to pay for care, apparent spiritual peace, and
absence of physiological complications may appear to contribute
to good quality of life, only the clients expression of satisfaction
can provide the data the nurse requires to evaluate the goal.

7. The nurse is caring for a family in a shelter two days following the
loss of their home due to a fire. The fire caused minor burns to
several members of the family but no life-threatening conditions.
Which of the following is the most important assessment data for the
nurse to gather at this time?
A. Availability of insurance coverage for rebuilding the house
B. Family members understanding of the extent of their physical
injuries
C. Psychological support resources available from friends or other
sources
D. Family members grief responses and coping behaviors
Ans: D. In order for the nurse to plan with and assist the family, the
nurse needs more data regarding the familys reactions to their
loss. Information on issues such as insurance coverage can wait
until later and may be more appropriately the responsibility of
social services rather than the nurse. It is important for the nurse
to determine their understanding of their injuries but they are
stated as minor. Once the nurse has assessed the familys
responses it will be important to determine availability of outside
resources to assist them.

8. After the death of several long-term clients, which of the

following actions indicates the nurse is demonstrating ineffective
coping?
A. The nurse talks at length to her partner about the death.
B. The nurse keeps busy with other actions and doesnt think
about the deaths for several days.
C. The nurse offers to work extra shifts for several weeks.
D. Several nurses schedule a group session with the agency
clergy to discuss the deaths.
Ans: C. Taking an additional work would only serve as an
additional stressor. In addition, a nurse who has nit begun
resolution of feelings is unlikely to be able to meet clients
emotional needs. Effective coping may include verbalizing
feelings or initiating distractions.

9. An 89-year old client states, Im a lost cause. I cant even

stand long enough to cook my own meals anymore. Which
of the following is the most appropriate response?
A. That must be difficult. What things are you still able to
do?
B. Well that is to be expected at your age.
C. Do you have someone else who can cook for you?
D. Are you a good cook?
Ans: A. This response encourages the client to say more and
focuses on the positive. B is condescending and closes the
dicussion. Both C and D ignore the emotional component
of the clients statement and do not address the persons
feeling of worthlessness.

10. A client who is having a mastectomy expresses sadness

about losing her breast. Based on this information, the nurse
would identify that the client is at risk for which nursing
diagnosis?
A. Body Image Disturbance
B. Anticipatory Grieving
C. Fear
D. Ineffective Coping
Ans: B. Anticipatory grieving is the state in which an individual
experiences reactions in response to an expected
significant loss. A is confusion in mental picture of oneself.
C is fear, and D is usually characterized by verbalization of
inability to cope, or inability to meet role expectations.