Which nursing pioneer established the Red Cross in the United States in 1882?

Choice A reason: Effective interventions (e.g., sedatives) improve sleep but are not evaluators. Insomnia, a disruption of sleep-regulating brain regions like the hypothalamus, is best assessed by patient-reported sleep quality. Interventions address neurotransmitter imbalances (e.g., GABA), but outcomes rely on subjective patient experience, not the intervention itself, making this incorrect.

Choice B reason: The patient is the best evaluator of sleep, as insomnia is subjective, involving perceived sleep quality and duration. Patient reports reflect hypothalamic regulation of sleep-wake cycles and neurotransmitter activity (e.g., melatonin). Subjective data, like feeling rested, provide the most accurate outcome evaluation, aligning with patient-centered care principles, making this correct.

Choice C reason: Nurse observations (e.g., restlessness) provide objective data but are less accurate than patient reports for insomnia. Sleep quality depends on subjective experience, influenced by brain regions like the reticular activating system. Observations may miss subtle sleep disturbances, making patient self-assessment the most reliable evaluator of insomnia outcomes, rendering this incorrect.

Choice D reason: The nurse is not the best evaluator of sleep, as insomnia is a subjective condition. Nurses can observe behaviors, but only patients report perceived sleep quality, reflecting circadian rhythm regulation and neurotransmitter balance. Objective assessments may overlook patient-specific experiences, making patient self-evaluation critical for accurate insomnia outcome assessment, so this is incorrect.

Choice A reason: Reporting only the exact intake to the physician’s nurse is incomplete, as fluid status requires balancing intake with output. Intake alone does not indicate hydration or overload, risking misinformed decisions. Comparing intake and output provides a full picture, per fluid balance assessment principles.

Choice B reason: Comparing total intake and output over 24 hours accurately assesses fluid status, as it reveals imbalances like dehydration (output > intake) or retention (intake > output). This guides interventions, ensuring proper fluid management, aligning with physiological monitoring and clinical assessment standards.

Choice C reason: Comparing intake to a normal range is useful but insufficient without output data. Normal intake varies, and fluid status depends on balance. This approach misses output-related issues like oliguria, reducing its accuracy for assessing hydration, per fluid and electrolyte management guidelines.

Choice D reason: Including intake in verbal reports is important but does not directly assess fluid status. Comparison of intake and output is needed to evaluate balance, guiding clinical decisions. Reporting alone risks overlooking imbalances, per nursing documentation and fluid assessment protocols.