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

[bellerayu]

the answer is B, CHF caused by long time stress..being unmarried you have to do everything by your own and that's very stressful!

[flashback]

Maybe; perhaps; it is possible. Eustress is something to think about during times such as those.

[flashback]

I'll admit that I did consider the possibillity of something that gradually progressed into the sudden discomfort. However, i also considered some contributing factor to be the reason for exacerbation.

[BluegrassRN]

That's the stupidest question ever. How much time in the real world do you have to *****-foot around and ask these indirect questions?

A MUCH better question is "Has anything in your diet changed recently? Have you eaten anything that might have contained a lot of sodium?" Because frankly, attending a social gathering or family event doesn't take into consideration any travel (fast food), trips to the movies (popcorn), having a sick spouse so that you have to do all the cooking yourself and are doing it out of a box, having a catered day at work, the list goes on and on.

God, there would have been a throw-down at my program if that question involved a grade. It seems like a question some educator "RN", who hasn't actually touched or seen a patient in decades, sat in her office, eating ho-hos and ding-dongs, trying to think of questions to bring out her students' critical thinking skills. Complete disconnect from anything that might have some sort of real world application. The real world doesn't count in nursing school.

[gr8rnpjt, RN]

Stop the presses!!!!!

The correct answer IS D. We originally heard from a GTA that the answer was B but after talking to the teacher and another really good clinical teacher the answer is D. The rationale is that a family gathering usually means eating higher fat foods with more sodium.

I still think it was a poorly written question!

m

Thank GOD!!!!

I was reading through this thread getting more and more frustrated and flustered. D is the obvious clear choice in a clinical picture such as this.

[FranEMTnurse, CNA, LPN, EMT-I]

The real world doesn't count in nursing school.

:up:Isn't that the ever living stone cold truth though.

[Do-over, ASN, RN]

It seems like a question some educator "RN", who hasn't actually touched or seen a patient in decades, sat in her office, eating ho-hos and ding-dongs...

Off-topic, but I sense a great story here, especially with ho-hos AND ding-dongs!

[~Mi Vida Loca~RN, ASN, RN]

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.

Have you been married???

Totally kidding, it's late I need to get to bed and I was reading this and busted out laughing when I read the bolded part. Some marriages can be very hazardous to your health. LOL Although I know that isn't what the question or you were getting at. I just needed the laugh, been one of those nights and I am sure I am not making any sense and I will probably be the only one that gets this.

[~Mi Vida Loca~RN, ASN, RN]

the answer is B, CHF caused by long time stress..being unmarried you have to do everything by your own and that's very stressful!

Some people work better being independent and find it far less stressful

[Kringe38]

IMO B should not be the answer because "are you married" is apropos of nothing. They might be happily or unhappily single, happily or unhappily married. So the answer "yes" or "no" is still not going to tell you if the marital status is contributing to the CHF. You would have to dig deeper to see if being single or married is especially adverse for them.

[Lilith]

The only justification for B I could think of would be that the other three options were designed to tempt you out of your scope of practice: i.e. don't diagnose and practice medicine. This is the type of crap they used to do when I was in school. It does not serve you well in the real world, when you need to be able to anticipate urgent interventions. Ofcourse, if that were the correct answer I would have failed - despite my MSN and NP license!

[Bellatrix31]

I had a question once that was: a homecare nurse goes to a patient's home and see vials of insulin laying around. What does the nurse do? a. throw them away b. put them in the refrig. The other two answers did not make sense.

The correct answer was B- which I fought with the teacher over and I did not win. To me the correct answer would be to ask the pt how long have they had the insulin but this answer was not listed. I chose A because my thoughts were I didn't know how long the pt had the insulin and had it been sitting out for over a month. The teacher could not really give me a rationale except to say "because I said B is the answer."