A client states, "I can hear a crunching or grating sound when I kneel and have difficulty getting out of bed in the morning because of pain and stiffness." Which of the following should the nurse expect as an assessment finding?

Bone spur

Crepitation

Tendonitis

Fluid in the knee joint

Answer and Explanation

The Correct Answer is B

A.   A bone spur is a bony projection often caused by joint damage, but it does not typically produce audible crunching or grating sounds.
B.   Crepitation refers to a crunching, grating, or popping sound or sensation that occurs with movement of a joint. It's often associated with conditions like osteoarthritis.
C.   Tendonitis involves inflammation of a tendon and may cause pain or tenderness, but it does not typically produce audible sounds like crepitation.
D.   Fluid in the knee joint might cause swelling and limited movement, but it does not usually produce audible crunching or grating sounds.

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Correct Answer is A

Explanation

A. Dullness above the right costal margin could indicate an enlarged liver. Referring the client to a healthcare provider is crucial for further evaluation and diagnosis.
B. Documenting hepatomegaly without further investigation or confirmation by a healthcare provider could be premature.
C. While alcohol intake can be a factor in liver conditions, additional history alone may not confirm the cause of the dullness. Direct evaluation by a healthcare provider is necessary.
D. Finding an area of dullness above the right costal margin, particularly of such magnitude, should prompt further investigation rather than being considered normal.

A. Condyle of the mandible B. Zygomatic arch of the temporal bone C. Temporomandibular joint D. Intervertebral foramen

Correct Answer is C

Explanation

A. The condyle of the mandible is the rounded protuberance at the end of the mandible bone but doesn't refer to the joint.
B. The zygomatic arch of the temporal bone is part of the skull structure and not directly associated with the mandibular joint.
C. The temporomandibular joint (TMJ) is the joint where the mandible articulates with the temporal bone of the skull, allowing for jaw movement and chewing.
D. The intervertebral foramen is a space between vertebrae through which spinal nerves exit the spinal cord.

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A client states, "I can hear a crunching or grating sound when I kneel and have difficulty getting out of bed in the morning because of pain and stiffness." Which of the following should the nurse expect as an assessment finding?

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Naxlex Comprehensive Predictor Exams

The nurse is percussing a client's abdomen during a physical assessment. The nurse observes an area of dullness above the right costal margin of approximately 11 cm. Which of the following actions should the nurse take?

Correct Answer is A

Explanation

The nurse is performing a physical assessment of the client's mandible and temporal bone. The nurse recognizes that the articulation of the mandible and the temporal bone is called?

Correct Answer is C

Explanation

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