The nurse is caring for a patient who refuses to bathe in the morning. When asked why, the patient says, "I always bathe in the evening." Which action by the nurse is best?
Explain the importance of maintaining morning hygiene practices.
Tell the patient that daily morning baths are the "normal" routine.
Cancel hygiene for the day and attempt again in the morning.
Defer the bath until evening and pass on the information to the next shift.
The Correct Answer is D
A. Explaining the importance of morning hygiene may overlook the patient's established routine and could create resistance.
B. Stating that morning baths are the "normal" routine does not acknowledge the patient's preferences, potentially causing the patient to feel invalidated.
C. Canceling hygiene for the day disregards the patient's needs and preferred routine.
D. Deferring the bath until evening respects the patient’s routine and preference, promoting patient-centered care and improving comfort and compliance with hygiene practices.
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Correct Answer is B
Explanation
A. The definition of spirituality does not typically include concepts of fire or giving life; this option does not accurately capture the essence of spirituality.
B. Awareness of one's inner self encompasses the essence of spirituality, focusing on personal beliefs, values, and the search for meaning, which is widely recognized in health care.
C. Spirituality is often considered equally essential to physical needs, especially in holistic approaches to health and well-being, making this statement misleading.
D. Spirituality can have a significant impact on health, influencing coping mechanisms and overall well-being; therefore, labeling it as having a minor effect is not accurate.
Correct Answer is C
Explanation
A. Increased cholesterol levels are not directly related to garlic intake or the effects of warfarin.
B. Distended jugular veins may indicate fluid overload or heart failure but are not a direct concern related to warfarin and garlic interaction.
C. Garlic can enhance the anticoagulant effect of warfarin, increasing the risk of bleeding; therefore, monitoring for signs of bleeding is crucial.
D. Angina is not a direct consequence of the interaction between garlic and warfarin and does not specifically relate to the assessment for this patient.