A patient refuses to remove a specific spiritual garment for daily bathing. The most appropriate action for the nurse would be to

Respect the patient's wishes and work around it.

Identify the refusal as a sign of spiritual distress.

Remove the article anyway because the garment hinders daily care delivery.

Explain to the patient that the garment has no real spiritual value.

Answer and Explanation

The Correct Answer is A

A. Respect the patient's wishes and work around it:
Respecting cultural and spiritual beliefs promotes holistic and patient-centered care.

B. Identify the refusal as a sign of spiritual distress:
The refusal alone, especially when grounded in spiritual beliefs, is not automatically a sign of distress.

C. Remove the article anyway because the garment hinders daily care delivery:
Doing so violates the patient’s autonomy and cultural rights.

D. Explain to the patient that the garment has no real spiritual value:
This is dismissive and culturally insensitive.

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Correct Answer is D

Explanation

a. tachycardia:
While tachycardia may occur earlier, as death nears, the heart rate typically slows and becomes weak and irregular.

b. moist mucous membranes:
At the end of life, dehydration is common, often leading to dry mucous membranes.

c. hypertension:
Blood pressure usually drops near death due to reduced cardiac output and circulatory collapse.

d. irregular respirations:
Cheyne-Stokes breathing (irregular breathing with apnea) is a hallmark of impending death.

A. The client has only been sleeping a hours each night B. The client is taking a poetry class C. The client has gained 4.5 kg (10 b) in the past month D. The client takes a 20-minute nap each afternoon. E. The client shows up to work with wrinkled clothes and hair that is not brushed

Correct Answer is ["A","C","E"]

Explanation

A. The client has only been sleeping a few hours each night
Lack of sleep is a sign of stress and ineffective coping.

B. The client is taking a poetry class
Engaging in creative hobbies is a positive coping mechanism.

C. The client has gained 4.5 kg (10 lb) in the past month
Sudden weight gain can indicate stress-related overeating or poor self-care.

D. The client takes a 20-minute nap each afternoon
Short naps can be a healthy coping mechanism for stress.

E. The client shows up to work with wrinkled clothes and hair that is not brushed
Neglect in personal grooming and hygiene may indicate ineffective coping or depression.

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A patient refuses to remove a specific spiritual garment for daily bathing. The most appropriate action for the nurse would be to

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is collecting data from a client who is at the end of life. Which of the following findings should the nurse expect?

Correct Answer is D

Explanation

A nurse is collecting data from a client who is experiencing stress. Which of the following findings should indicate to the nurse ineffective coping? (Select the 3 correct answers)

Correct Answer is ["A","C","E"]

Explanation

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