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1. A co-worker asks the nurse to explain spirituality. What is the nurse’s best response?
a. It has a minor effect on health.
b. It is awareness of one’s inner self.
c. It is not as essential as physical needs.
d. It refers to fire or giving of life to a person.
Answer: B
Spirituality is often defined as an awareness of one’s inner self and a sense of connection to
a higher being, to nature, or to some purpose greater than oneself. Spirituality is an
important factor that helps individuals achieve the balance needed to maintain health and
well-being and to cope with illness. Florence Nightingale believed that spirituality was a
force that provided energy needed to promote a healthy hospital environment and that
caring for a person’s spiritual needs was just as essential as caring for his or her physical
needs. The word spirituality comes from the Latin word spiritus, which refers to breath or
wind. The spirit gives life to a person.
2. The nurse is caring for a patient who is an agnostic. Which information should the nurse
consider when planning care for this patient?
a. The patient is devoid of spirituality.
b. The patient does not believe in God.
c. The patient believes there is no known ultimate reality.
d. The patient finds no meaning through relationship with others.
Answer: C
Some people do not believe in the existence of God (atheist), or they believe that there is no
known ultimate reality (agnostic). Nonetheless, spirituality is important regardless of a
person’s religious beliefs. Agnostics discover meaning in what they do or how they live

because they find no ultimate meaning for the way things are. They believe that people
bring meaning to what they do.
3. The nurse is caring for an Islam patient who wants a snack. Which action by the nurse is
most appropriate?
a. Offers a ham sandwich
b. Offers a beef sandwich
c. Offers a kosher sandwich
d. Offers a bacon sandwich
Answer: B
Islam religion does allow beef. Islam does not allow pork or alcohol. Ham and bacon are
pork. Kosher is allowed for Judaism.
4. A nurse is teaching a patient how to meditate. Which information from the patient
indicates effective learning?
a. I will lie on the floor.
b. I will breathe quickly.
c. I will focus on an image.
d. I will do this for 10 minutes every day.
Answer: C
The steps of meditation include sitting in a comfortable position with the back straight;
breathe slowly; and focus on a sound, prayer, or image. Meditation should occur for 10 to
20 minutes twice a day.
5. The nurse is admitting a patient to the hospital. The patient is a very spiritual person but
does not practice any specific religion. How will the nurse interpret this finding?
a. This indicates a strong religious affiliation.
b. This statement is contradictory.
c. This statement is reasonable.

d. This indicates a lack of hope.
Answer: C
The patient’s statement is reasonable and is not contradictory. Many people tend to use the
terms spirituality and religion interchangeably. Although closely associated, these terms are
not synonymous. Religious practices encompass spirituality, but spirituality does not need
to include religious practice. When a person has the attitude of something to live for and
look forward to, hope is present.
6. A nurse hears the following comments from different patients. Which patient comment
does the nurse identify as faith?
a. I go to church every Sunday.
b. I believe there is life after death.
c. I have something to look forward to each day.
d. I get a feeling of awe when looking at the sunset.
Answer: B
Faith allows people to have firm beliefs despite lack of physical evidence (life after death).
Religion refers to the system of organized beliefs and worship that a person practices to
outwardly express spirituality (go to church). When a person has the attitude of something
to live for and look forward to, hope is present (look forward to each day). Selftranscendence is the belief that there is a force outside of and greater than the person (awe
when looking at a sunset).
7. A nurse is caring for a Hindu patient. Which action will the nurse take?
a. Allow time to practice the Five Pillars.
b. Allow time to practice Blessing way.
c. Allow time for Holy Communion.
d. Allow time for purity rituals.
Answer: D

Hindus practice prayer and purity rituals. Blessing way is a practice of the Navajos that
attempts to remove ill health by means of stories, songs, rituals, prayers, symbols, and sand
paintings. Islams must be able to practice the Five Pillars of Islam. Holy Communion is
practiced in the Christian religion.
8. The nurse is caring for a patient with a chronic illness who is having conflicts with
beliefs. Which health care team member will the nurse ask to see this patient?
a. The clergy
b. A psychiatrist
c. A social worker
d. An occupational therapist
Answer: A
Other important resources to patients are spiritual advisors and members of the clergy.
Spiritual care helps people identify meaning and purpose in life, look beyond the present,
and maintain personal relationships, as well as a relationship with a higher being or life
force. A psychiatrist is for emotional health. A social worker focuses on social, financial,
and community resources. An occupational therapist provides care with vocational issues
and functioning within physical limitations.
9. The nurse is caring for a patient with a terminal disease. The nurse sits down and lightly
touches the patient’s hand. Which technique is the nurse using?
a. “Doing for”
b. Establishing presence
c. Offering transcendence
d. Providing health promotion
Answer: B
Establishing presence by sitting with a patient to attentively listen to his or her feelings and
situation, talking with the patient, crying with the patient, and simply offering time are
powerful spiritual care approaches.

Benner explains that presence involves “being with” a patient versus “doing for” a patient.
Transcendence is the belief that a force outside of and greater than the person exists beyond
the material world. In settings where health promotion activities occur, patients often need
information, counseling, and guidance to make the necessary choices to remain healthy.
10. The nurse and the patient have the same religious affiliation. Which action will the
nurse take?
a. Must use a formal assessment tool to determine patient’s beliefs.
b. Assume that both have the same spiritual beliefs.
c. Do not impose personal values on the patient.
d. Skip the spiritual belief assessment.
Answer: C
It is important not to impose personal value systems on the patient. This is particularly true
when the patient’s values and beliefs are similar to those of the nurse because it then
becomes very easy to make false assumptions. It is not a must to use a formal assessment
tool when assessing a patient’s beliefs. It is important to conduct the spiritual belief
assessment; conducting an assessment is therapeutic because it expresses a level of caring
and support.
11. A nurse makes a connection with the patient when providing spiritual care. Which type
of connectedness did the nurse experience?
a. Intrapersonal
b. Interpersonal
c. Transpersonal
d. Multipersonal
Answer: B
Interpersonal means connected with others and the environment. Intrapersonal means
connected within oneself. Transpersonal means connected with God or an unseen higher
power. There is no such term as multipersonal for connectedness.

12. The patient is admitted with chronic anxiety. Which action is most appropriate for the
nurse to take?
a. Focus on finding quick remedies for the anxiety.
b. Realize that the patient’s only goal is relief of the anxiety.
c. Look at how anxiety influences the patient’s ability to function.
d. Help the patient realize that there is little hope of relief from anxiety.
Answer: C
Do not just look at the patient’s anxiety as a problem to solve with quick remedies, but
rather look at how the anxiety influences the patient’s ability to function and achieve goals
established in life (not just anxiety relief). Mobilizing the patient’s hope is central to a
healing relationship.
13. In caring for the patient’s spiritual needs, the nurse asks 20 questions to assess the
patient’s relationship with God and a sense of life purpose and satisfaction. Which method
is the nurse using?
a. The spiritual well-being scale
b. The FICA assessment tool
c. Belief tool
d. Hope scale
Answer: A
The spiritual well-being scale (SWB) has 20 questions that assess a patient’s relationship
with God and his or her sense of life purpose and life satisfaction. The FICA assessment
tool evaluates spirituality and is closely correlated to quality of life. This does not describe
belief or hope.

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