A 42-year-old patient presents with lower back pain that radiates down the leg. During your assessment, you perform a straight leg raise (Lasègue's test). As you lift the patient's leg, they report increasing discomfort. What does this finding most likely indicate?
Pain is located only in the knee.
Pain in the lower back only is noted.
No pain is produced during the test.
Pain radiates down the back of the leg and into the foot.
The Correct Answer is D
Lasègue's test, or the straight leg raise, is a provocative maneuver used to identify nerve root irritation, typically at the L4, L5, or S1 levels. Passive elevation of the extended leg stretches the sciatic nerve; a positive result is characterized by reproduction of radicular pain. This finding is highly suggestive of a herniated nucleus pulposus compressing the spinal nerves.
A. Pain is located only in the knee: Discomfort localized to the knee joint during a leg raise usually suggests a primary joint issue, such as a ligamentous tear or meniscus injury. A positive straight leg raise for neurological issues must involve the radiating nerve path. Knee pain alone does not confirm radiculopathy.
B. Pain in the lower back only is noted: While lower back pain can occur during the test, it is not considered a "positive" Lasègue's sign for disc herniation. A positive result specifically requires the reproduction of the patient's radiating leg symptoms. Back pain alone is non-specific and may relate to simple muscle strain.
C. No pain is produced during the test: If the patient can tolerate the leg being raised to 70 degrees without any reproduction of symptoms, the test is documented as negative. This suggests that the sciatic nerve is not being compressed or irritated by a herniated disc. It rules out active nerve root entrapment.
D. Pain radiates down the back of the leg and into the foot: This is the classic positive finding for Lasègue's test. The sharp, shooting pain follows the distribution of the sciatic nerve as it is stretched over a protruding disc. This specific radiating pattern confirms the presence of lumbar nerve root compression.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Borborygmi are exaggerated, audible sounds produced by the rapid movement of gas and chyme through the intestinal lumen. These hyperactive bowel sounds often signify increased peristalsis or the early stages of mechanical obstruction. They are commonly associated with hunger or malabsorption syndromes.
A. Loud continual humming bowel sounds: A continuous humming sound in the abdomen is often a venous hum, which can indicate portal hypertension or collateral circulation. It is a vascular sound rather than a result of gastrointestinal motility. It is not defined as borborygmi.
B. Loud gurgling bowel sounds: This is the correct clinical definition of borborygmi. These are the rumbling sounds heard when the bowel is hyperactive. They are easily audible without a stethoscope and reflect high-velocity movement within the digestive tract.
C. Hypoactive bowel sounds: Hypoactive sounds are infrequent and quiet, indicating slowed motility. Borborygmi are by definition loud and hyperactive. Documenting hypoactivity would be the clinical opposite of noting the presence of borborygmi.
D. A peritoneal friction rub: This is a rough, grating sound heard over the liver or spleen during respiration. It indicates inflammation of the peritoneal surface. It is a sign of friction between organs rather than the sound of gas movement.
Correct Answer is A
Explanation
The Adam's forward bend test is the primary clinical screening tool for identifying adolescent idiopathic scoliosis. As the patient flexes forward, the nurse observes for rib humps or spinal rotation, which indicate a structural rather than functional curve. This maneuver accentuates the asymmetry caused by the vertebral rotation that accompanies the lateral curvature.
A. Ask the client to bend forward at the waist: This position makes any rib asymmetry or unilateral prominence of the back more visible. It is the most sensitive non-radiographic method for screening students for scoliosis. It allows the nurse to see the rotation of the spine that occurs in structural curves.
B. Palpate the spinous processes: While palpation can identify tenderness or significant lateral deviation, it is less effective than the forward bend test for detecting early or mild scoliosis. In many cases, the spinous processes appear aligned even when the vertebral bodies have rotated significantly.
C. Measure the length of the spine from neck to waist: Measuring the absolute length of the spine does not provide information about its lateral curvature or rotation. It is not a diagnostic or screening maneuver for scoliosis. It is a measurement of vertical growth rather than spinal alignment.
D. Palpate for crepitus: Crepitus is a grating sound or sensation produced by friction between bone and cartilage, often associated with osteoarthritis or fractures. It is not a feature of scoliosis, which is a structural deformity of the spinal axis. Palpation for crepitus does not identify lateral curvature.
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