A client has sought care because of a sudden increase in the size of his scrotum after a cough. The nurse's assessment reveals the presence of a large scrotal mass. How can the nurse best assess for a scrotal hernia?

Auscultate the scrotum for bowel sounds

Inspect the femoral hernia while the patient coughs

Ask the client to stand up to see if the mass disappears

Palpate the abdomen for pain

Answer and Explanation

The Correct Answer is A

Choice A reason: Auscultating for bowel sounds in the scrotum detects an inguinal hernia, where intestines protrude after coughing. This confirms the mass’s nature, making it the best method to assess this sudden scrotal enlargement accurately and directly here.
Choice B reason: Inspecting femoral hernia focuses on the thigh, not scrotum. Scrotal masses from coughing suggest inguinal hernia, misaligning this with the primary site, rendering it less effective for this specific assessment entirely and fully here.
Choice C reason: Standing may reduce some hernias, but disappearance isn’t diagnostic. Cough-induced scrotal mass needs auscultation for bowel sounds to confirm hernia, making this less precise than listening for intestinal presence comprehensively here fully.
Choice D reason: Abdominal palpation for pain assesses tenderness, not hernia type. Scrotal mass from coughing points to inguinal hernia, where auscultation directly identifies bowel, making this less specific for the scrotal finding entirely here fully.

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Correct Answer is B

Explanation

Choice A reason: Rapid ankle oscillations might suggest tremor, possibly basal ganglia issues, not cerebellar dysfunction. The heel-shin test assesses coordination, where cerebellar damage causes drift, not rhythmic shaking, making this less indicative of the target pathology here.
Choice B reason: Heel deviation to one side in the heel-shin test signals cerebellar dysfunction, impairing coordination. The cerebellum fine-tunes movement; damage causes ataxia, leading to inaccurate sliding, making this the key sign of cerebellar issues accurately.
Choice C reason: Pain and knee flexion suggest joint or nerve issues, not cerebellar dysfunction. This test evaluates smooth motion, not pain response; cerebellar problems show ataxia, not discomfort, disconnecting this from the intended motor assessment fully.
Choice D reason: Paresthesia (tingling) indicates sensory nerve issues, not cerebellar motor control. The cerebellum coordinates movement, not sensation; this response misses the coordination focus of the heel-shin test, excluding it as a cerebellar sign here entirely.

A. Review the client's medication regimen B. Have the client provide a 24-hr diet recall C. Prepare the client for a thyroid screening D. Assess the client's cranial nerve function

Correct Answer is D

Explanation

Choice A reason: Medications like antipsychotics can cause tremors, but tongue fasciculations often signal neurological issues, not just drug effects. Reviewing regimen is secondary to assessing cranial nerve XII (hypoglossal), which controls tongue movement, for a more immediate etiology here.

Choice B reason: Diet recall might explore nutritional deficits, but tongue fasciculations tie to nerve or muscle pathology, not food intake. This lacks a direct link to neurological signs, making it less relevant than assessing nerve function for this specific finding fully.

Choice C reason: Thyroid issues cause coarse tremors, not fine fasciculations, which are more neuromuscular. Preparing for screening diverts from the priority of cranial nerve XII assessment, misaligning with the neurological basis of tongue movement observed in this examination entirely.

Choice D reason: Fasciculations suggest cranial nerve XII dysfunction, like in ALS or stroke, affecting tongue motor control. Assessing cranial nerves, especially hypoglossal, directly targets the finding’s neurological root, making it the best response to evaluate this abnormality accurately and promptly.

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A client has sought care because of a sudden increase in the size of his scrotum after a cough. The nurse's assessment reveals the presence of a large scrotal mass. How can the nurse best assess for a scrotal hernia?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is testing for motor functioning by having the client lie down and slide the heel of the right foot down the left shin and then slide the heel of the left foot down the right shin. Which response by the patient would indicate that there may be cerebellar dysfunction?

Correct Answer is B

Explanation

While examining a client's mouth the nurse notes the presence of fasciculations, fine tremors of the client's tongue. How should the nurse best respond to the assessment finding?

Correct Answer is D

Explanation

A client has sought care because of a sudden increase in the size of his scrotum after a cough. The nurse's assessment reveals the presence of a large scrotal mass. How can the nurse best assess for a scrotal hernia?

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