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 C

Explanation

A. Hyperactive bowel sounds are not typically associated with gastroesophageal reflux disease (GERD). They are more indicative of gastrointestinal disturbances such as increased bowel activity or a bowel obstruction. Since the client's symptoms are related to heartburn, assessing bowel sounds is less relevant to GERD. This choice does not provide useful information for diagnosing or managing GERD.
B. This option is not commonly associated with GERD. In fact, small frequent meals are often recommended as a management strategy for GERD to reduce the occurrence of heartburn, as large meals can exacerbate symptoms by increasing stomach pressure. This choice does not align with typical GERD management strategies and may not be a useful symptom to assess in this context.
C. This finding is highly relevant for GERD. Heartburn that occurs or worsens when lying down, especially at night, is a classic symptom of gastroesophageal reflux disease. When a person lies flat, stomach acid can more easily flow back into the esophagus due to decreased gravitational pressure, leading to heartburn. Identifying this symptom helps confirm GERD and guides management strategies, such as elevating the head while sleeping or avoiding late meals.
D. Light grey and chalky stools are indicative of issues related to bile production and could suggest a problem with the liver or biliary system rather than GERD. This symptom is not associated with GERD and would be more relevant in assessing conditions such as biliary obstruction or liver disease.

A. Intermittent pain on deep inspiration. B. An audible abdominal bruit. C. A bulge over umbilicus when coughing. D. Hypoactive bowel sounds in all quadrants.

Correct Answer is B

Explanation

A. Intermittent pain on deep inspiration could suggest pleuritic pain, which is related to the lungs or pleura rather than the abdomen. While this might be significant, it is less directly related to the client’s deep abdominal pain radiating to the back. This finding may be less urgent compared to other potential signs of serious abdominal pathology.

B. An abdominal bruit is a sound heard over the abdomen due to turbulent blood flow, often associated with vascular abnormalities like aneurysms or significant arterial stenosis. An audible abdominal bruit, especially if associated with deep abdominal pain, could indicate a serious vascular condition such as an abdominal aortic aneurysm (AAA).
C. A bulge over the umbilicus when coughing could indicate an umbilical hernia. While a hernia can be problematic and may require treatment, it is generally less urgent compared to findings that might suggest more acute or severe conditions like vascular issues.
D. Hypoactive bowel sounds can indicate decreased gastrointestinal activity, which might be related to various conditions such as ileus or bowel obstruction. While this finding is significant and warrants attention, it is often less immediately critical compared to signs of serious vascular issues or acute abdominal pathology.

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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

Correct Answer is C

Explanation

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Correct Answer is B

Explanation

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