A client is concerned about developing carpal tunnel syndrome. Which screening technique should the nurse perform to provide the client with useful information?

Ask the client about progressive contractures of the 4th and 5th fingers.

Compress the ulnar and radial arteries, then observe for flushing in the hand when ulnar pressure is released.

Compare the client's hands bilaterally for pain, pallor, pulses, paralysis, and paresthesia.

Instruct the client to place the backs of the hands together and flex both wrists.

Answer and Explanation

The Correct Answer is D

A.   Contractures of the 4th and 5th fingers are more indicative of ulnar nerve involvement, not median nerve compression. Carpal tunnel syndrome primarily affects the thumb, index finger, middle finger, and part of the ring finger. Thus, asking about contractures of the 4th and 5th fingers would not provide useful information about carpal tunnel syndrome.
B.   This technique is used to assess the patency of the radial and ulnar arteries, commonly referred to as the Allen test. It is used to evaluate blood flow in the hand, particularly before performing procedures that may impact arterial circulation. This test is not specific to carpal tunnel syndrome and does not provide useful information about median nerve compression.
C.   While comparing the hands bilaterally for various signs can be useful in assessing general hand function and circulation, this method does not specifically target the symptoms or diagnostic tests associated with carpal tunnel syndrome. It provides a broad overview but is not specific enough to confirm CTS.
D.   This technique is known as the Phalen’s test, which is specifically used to assess for carpal tunnel
syndrome. During the Phalen’s test, the client is asked to flex their wrists and hold the position for about 60 seconds. If the client experiences tingling, numbness, or pain in the median nerve distribution (thumb, index, middle finger, and part of the ring finger), it suggests carpal tunnel syndrome.

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Correct Answer is D

Explanation

A. Cloudy discharge is more commonly associated with infections or discharge from the genital area rather than residual urinary symptoms. While urinary tract infections (UTIs) can cause cloudy urine, this is not typically associated with suprapubic tenderness or the sensation of residual pressure alone.
B. An overactive bladder is characterized by symptoms such as frequent urination, urgency, and sometimes incontinence. However, it does not typically cause suprapubic tenderness or a sensation of residual pressure after urination. The described symptoms are more consistent with bladder outlet obstruction or incomplete bladder emptying rather than an overactive bladder.

C. Black tarry stools indicate upper gastrointestinal bleeding and are unrelated to urinary symptoms. This finding would suggest a different issue entirely, such as gastrointestinal bleeding, rather than a problem with the urinary tract or bladder. This is not consistent with the client's reported symptoms of suprapubic tenderness and sensation of residual pressure after urination.
D. A weak urinary stream is a common symptom associated with bladder outlet obstruction or conditions affecting urinary flow, such as benign prostatic hyperplasia (BPH) in older men. This finding aligns with the client's reported symptoms of suprapubic tenderness and feeling of residual pressure after urination.

A. Continue with the cardiac examination. B. Dim the lights in the examination room. C. Question the client about steroid use. D. Position the client in high Fowler's position.

Correct Answer is D

Explanation

A. This may involve using a stethoscope to auscultate the apical pulse, as it might be more easily heard than felt, especially in individuals with significant muscle mass or other anatomical variations. This approach ensures that a thorough cardiac assessment is conducted.
B. Dimming the lights would not impact the ability to palpate or auscultate the apical pulse. Lighting adjustments are generally more relevant for visual examinations rather than for palpation or auscultation of heart sounds. This action would not address the issue of locating the apical pulse.
C. While steroid use can affect cardiovascular health, such as potentially causing changes in heart size or function, questioning the client about steroid use is not the immediate priority if the apical pulse cannot be palpated. The priority should be to ensure a correct assessment and use proper techniques to locate the pulse.
D. Positioning the client in high Fowler's position (sitting up at a 60-90 degree angle) can help in various cardiac assessments and might make it easier to detect the apical pulse, especially if the client has a high muscle mass. This position can improve access to the chest and potentially facilitate better auscultation of heart sounds.

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A client is concerned about developing carpal tunnel syndrome. Which screening technique should the nurse perform to provide the client with useful information?

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Naxlex Comprehensive Predictor Exams

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Explanation

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Explanation

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