A client tells the nurse about pain and numbness in the thumb, first finger, and second finger of the right hand. The nurse discovers that the client is employed as an auto mechanic, and that the pain is increased while working. This may indicate that the client has what health problem?

Carpel tunnel syndrome

Tendonitis

Impingement syndrome

Dupuytren contracture

Answer and Explanation

The Correct Answer is A

A. Carpal tunnel syndrome: Carpal tunnel syndrome involves compression of the median nerve in the wrist, often causing pain, numbness, and tingling in the thumb, index, and middle fingers. Repetitive wrist movements, like those in mechanical work, commonly contribute to this condition and may worsen symptoms during activity.

B. Tendonitis: Tendonitis is inflammation of a tendon and typically presents with localized joint pain, swelling, and tenderness. It does not usually cause numbness or affect specific fingers in the same distribution seen with median nerve compression.

C. Impingement syndrome: Impingement syndrome generally refers to a condition affecting the shoulder joint, often involving pain with overhead activities. It would not account for numbness and pain specifically limited to the thumb and first two fingers.

D. Dupuytren contracture: Dupuytren contracture results in progressive thickening of the palmar fascia, leading to finger flexion contractures, especially of the ring and little fingers. It does not cause numbness or affect the thumb, index, or middle fingers in early stages.

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Correct Answer is D

Explanation

A. Function of the spinal nerve: Spinal nerves control motor and sensory function throughout the body, but tongue movement is not associated with spinal nerve function. Testing tongue movement specifically assesses cranial nerve activity.

B. Function of the trochlear nerve: The trochlear nerve (cranial nerve IV) controls the superior oblique muscle of the eye, allowing for downward and inward eye movement. It does not influence tongue motion or position.

C. Function of the vagus nerve: The vagus nerve (cranial nerve X) controls parasympathetic functions and plays a role in swallowing, heart rate, and voice quality, but it does not govern voluntary tongue movements.

D. Function of the hypoglossal nerve: The hypoglossal nerve (cranial nerve XII) controls the muscles of the tongue, allowing for movement such as sticking it out and moving it side to side. This is the nerve specifically assessed by the described action.

A. Warm the client's foot and determine whether circulation improves. B. Reposition the client with the affected foot dependent. C. Reassess the client's neurovascular status in 15 minutes. D. Promptly inform the primary care provider.

Correct Answer is D

Explanation

A. Warm the client's foot and determine whether circulation improves: Warming the foot may promote peripheral circulation but does not address the potential for compartment syndrome caused by the cast. Delaying action could lead to irreversible tissue damage.

B. Reposition the client with the affected foot dependent: Positioning the foot downward may slightly improve venous return, but it is not sufficient to address the absence of palpable pulses or pallor. This situation indicates a possible vascular emergency.

C. Reassess the client's neurovascular status in 15 minutes: Waiting 15 minutes to reassess is inappropriate when signs of compromised circulation such as pallor and absent pulses are already present. Immediate intervention is required to preserve limb function.

D. Promptly inform the primary care provider: Absence of pulses and pallor in a casted extremity suggest impaired arterial perfusion, possibly from compartment syndrome or cast constriction. Immediate medical evaluation is necessary to prevent permanent damage.

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A client tells the nurse about pain and numbness in the thumb, first finger, and second finger of the right hand. The nurse discovers that the client is employed as an auto mechanic, and that the pain is increased while working. This may indicate that the client has what health problem?

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A client is admitted to the medical unit with an exacerbation of multiple sclerosis. When assessing this client, the nurse has the client stick out her tongue and move it back and forth. What is the nurse assessing?

Correct Answer is D

Explanation

A nurse is assessing the neurovascular status of a client who has had a leg cast recently applied. The nurse is unable to palpate the client's dorsalis pedis or posterior tibial pulse and the client's foot is pale. What is the nurse's most appropriate action?

Correct Answer is D

Explanation

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