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.
That's just stupid. I believe at my school that question would be thrown out. You definitely have to "read into it" to try to get any correlation at all between the possible answers and the question. I would have gone with D because of the possibility of the patient eating saltier foods than she might have otherwise, but that is a stretch because a noncompliant patient would certainly have no trouble with eating salty food without a family gathering to attend. Same with the other possibilities too, really. Just not seeing how "B" is the right answer because martial status would really be very loosely associated with a CHF exacerbation in my mind. Maybe the patient would be more likely to eat poorly without a partner to cook with/for, but that is as much of a stretch, if not more, than answer D. IMO.
It sounds like a classic case of exaserbation of CHF. I don't know anyone who would think about PE given the clinical picture. Even if I was thinking about a PE you don't have to be out of the country to sit for a long period of time. Sounds like a classic case of instructor can't focus. Want to ride bikes.
I mean the ONLY thing that I can think of that even comes close to that answer would be a takotsubo cardiomyopathy, but even then the symptoms arent the same as what is listed.
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
Play the game while in school. But I can tell you that when taking the NCLEX psychosocial answers usually are the wrong ones.
Besides that the questions were supposed to be asked to "best help with determining why the client is currently having health problems", so I'm not sure how B really helps that. Yikes and I though my last semester tests sucked.
The answer is A. Babysitting grandchildren has caused an increase in physical activity. Increased stress > increased BP. Previously asymptomatic heart failure has now become symtomatic.
Saysfaa
905 Posts
hypocaffeinemia, I follow you. but which of those four answers addresses B or C?