Can someone please help me answer this question?

[DayDreamin ER CRNP]

See if you can make heads or tails of this one.....

An elderly client arrives in the clinical complaining of dyspnea, weigh gain, chest pain, and increasing edema of the lower extremities. The client's BP is elevated. The nurse discovers the client has a history of heart failure. The nurse questions the client regarding which of the following that may best help with determining why the client is currently having health problems?

A. "Do you have grandchildren that you babysit?"

B. Are you married?

C. Have you been out of the country lately?

D. Have you attended any recent family or social gathering?

Now, I've read that when you have 3 similar answer choices and one that seems out in left field, the one in left field is usually the correct answer. I'm still just stumped and was needing some rationale I guess.

thanks!

meredith

[DayDreamin ER CRNP]

ok. Would it be "Have you traveled out of the country?" because that would imply that the client has been on a plane for an extended period of time that might cause a DVT which could cause these symptoms to be more pronounced?

m

[cupcake231]

This sounds like right-sided CHF...the symptoms could have worsened maybe because of long periods of sitting...so I agree with the above poster that it could be "have you been out of the country lately?" Hope this helps! ...and this is just an educated guess so I would double check with a credible source

[hypocaffeinemia, BSN, RN]

I'd go with D for excess sodium / fluid intake. And I'm only partially joking.

The problem is the answer choices all avoid asking directly relevant questions merely to throw students off.

If I ask if someone's been out of the country lately here in Texas, they could have been just as likely to hopped on a cruise or to have driven over the border into Mexico. It would be wrong to assume "international flight = DVT" in this case, especially when the symptoms are not those of pulmonary emboli, per say.

Hx CHF plus the current symptoms scream exacerbation of CHF, so then narrow down to what would possibly exacerbate it. Being married, babysitting, and traveling don't particularly or directly exacerbate CHF. Although I suppose one could make a case for forgetting to timely take medications while traveling.

Another quality question designed to trick students instead of teach them. In reality, people ask "Have you flown more than two hours recently?", "have you taken all of your prescribed medications on schedule?", and "Has your diet changed or been modified in some way recently?"

[BabyLady, BSN, RN]

ok. Would it be "Have you traveled out of the country?" because that would imply that the client has been on a plane for an extended period of time that might cause a DVT which could cause these symptoms to be more pronounced?

m

I agree with that answer, however, I would also say that it was a poorly worded one.

Mainly because, depending on where you live, you don't have to take a long trip to leave the country and even long trips in a car can do the same thing.

I am curious if this is a question that an instructor made up or if it was from a database.

A nurse would ask about sitting for extended periods of time before they asked about travel.

[canoehead, BSN, RN]

D also, but it's a horrible question.

[DayDreamin ER CRNP]

I totally agree that it is a poorly worded question. We have been struggling with this issue for most of the semester. I'm not sure if this is a teacher-made or database question but it is from an online test we are taking this week.

Sadly, these online med-surg tests are so tough that not one of the 140 students have made an A on a single one of them. Ok, one of my study buddies did but it was only a 90. A lot of us are normally A students but are really frustrated with this class.

And yes, going to another country doesn't always mean a plane ride. They tell us not to read too much into questions so I'm having a harder time with this one and NOT reading into it. You almost have to!

[CuriousMe]

I totally agree that it is a poorly worded question. We have been struggling with this issue for most of the semester. I'm not sure if this is a teacher-made or database question but it is from an online test we are taking this week.

Sadly, these online med-surg tests are so tough that not one of the 140 students have made an A on a single one of them. Ok, one of my study buddies did but it was only a 90. A lot of us are normally A students but are really frustrated with this class.

And yes, going to another country doesn't always mean a plane ride. They tell us not to read too much into questions so I'm having a harder time with this one and NOT reading into it. You almost have to!

So, is this question from an exam you've finished? Or from an online exam you're still working on?

[DayDreamin ER CRNP]

the correct answer is......drum roll please.......

B. "Are you married?"

Rationale: While obtaining the health history the nurse should ask because it addresses the patient's psychosocial status.

I keep having to remind myself..."when in doubt, think Maslow." I've heard that so many times and how you should always think about those needs when answering these types of questions.

I think I got the question right at least!

meredith

[hypocaffeinemia, BSN, RN]

the correct answer is......drum roll please.......

B. "Are you married?"

Rationale: While obtaining the health history the nurse should ask because it addresses the patient's psychosocial status.

I keep having to remind myself..."when in doubt, think Maslow." I've heard that so many times and how you should always think about those needs when answering these types of questions.

I think I got the question right at least!

meredith

That's just brilliant.

"Excuse me, sir. May I interrupt your dying to find out your relationship status so that I can properly assess your psychosocial needs? "

On top of that, it doesn't even address the question asked. Key words in bold:

"...Which of the following [may] best help with determining why the client is currently having health problems?"

I don't see why or how the patient's marriage status (which is quite a bit different than psychosocial wellbeing in its own right!) is relevant to current health problems.

You're absolutely right to think Maslow. In this patient's case, stabilizing his physiological status takes the top priority. It's the bottom of the pyramid for a reason.

Heck, if you look at the ABC's his C is in very poor condition and his B is quickly deteriorating.

[DayDreamin ER CRNP]

That's just brilliant.

"Excuse me, sir. May I interrupt your dying to find out your relationship status so that I can properly assess your psychosocial needs? "

On top of that, it doesn't even address the question asked. Key words in bold:

"...Which of the following [may] best help with determining why the client is currently having health problems?"

I don't see why or how the patient's marriage status (which is quite a bit different than psychosocial wellbeing in its own right!) is relevant to current health problems.

You're absolutely right to think Maslow. In this patient's case, stabilizing his physiological status takes the top priority. It's the bottom of the pyramid for a reason.

Heck, if you look at the ABC's his C is in very poor condition and his B is quickly deteriorating.

haaaaahaaahaaahaa!!!! It was a terrible question. Many of this teacher's test questions are like this. There were about 10 that we just did the whole "doggie head tilt" when we read them. They just didn't make sense. There was also a question in which B and C were the exact same so we chose B. Well, it was keyed that C was the correct answer. WTH? How do you win?

m

[DolceVita, ADN, BSN, RN]

OMG that question, with that answer, would have nearly caused a throw-down in my class.

Decent enough question but the options were dreadful.