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. Auscultation of the abdomen involves listening to bowel sounds and can provide information about the gastrointestinal system's activity, such as whether there is increased or decreased motility. While important for assessing general bowel function, auscultation is not specific for confirming steatorrhea. It does not provide direct information about the presence of fat in the stool.
B. Inspecting the area around the umbilicus may help in identifying other abdominal conditions, such as hernias or signs of ascites. However, it does not provide information about stool characteristics or fat content, so it is not the most appropriate action for confirming steatorrhea.
C. Light palpation of areas of abdominal protuberance can help assess for abdominal masses or tenderness. While palpation can provide useful information about the abdominal organs and possible fluid accumulation, it does not give information about stool fat content.

D. Observing the appearance of the client’s stool is the most direct method to confirm steatorrhea. Stool that is greasy, foul-smelling, and floats is characteristic of steatorrhea, indicating the presence of undigested fat. This observation directly assesses the presence of fat in the stool, making it the best action to confirm steatorrhea.

A. A painful ulcerated mucosal area inside the cheek for 1 day. B. Stippled gingival margins that adhere firmly to the teeth. C. A number of small yellowish-white and raised lesions on the buccal mucosa. D. An ulceration under the tongue that has been present for the last three

Correct Answer is D

Explanation

A. A painful ulcerated mucosal area inside the cheek that has been present for only 1 day is concerning but less alarming in the short term compared to chronic lesions. Acute ulcers can be caused by minor trauma, infections, or canker sores. While it is important to monitor and evaluate these lesions, especially if they persist or worsen, a duration of only 1 day typically suggests it might be related to a transient condition.
B. Stippled gingival margins that adhere firmly to the teeth can indicate gingival hyperplasia or certain systemic conditions like vitamin deficiencies. While this finding can be concerning and warrants further investigation into oral health or potential systemic issues, it is generally less urgent compared to other findings that may indicate malignancy or severe chronic conditions.

C. Small yellowish-white lesions on the buccal mucosa could be oral leukoplakia or aphthous ulcers, which can be benign or related to underlying conditions. While these lesions need to be assessed to determine their cause, they are usually less immediately concerning than persistent ulcers that could indicate more serious issues.
D. An ulceration under the tongue that has been present for three weeks is the most concerning finding. Chronic oral ulcers, especially those persisting for more than two weeks, can be indicative of serious conditions such as oral cancer or other malignancies. Persistent lesions warrant thorough investigation to rule out or address potential malignancy or other significant pathologies.

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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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