A client who works at a computer most of the working day comes to the clinic reporting pain in both hands that causes the client to wake during the night. Which action should the nurse implement to assess for carpal tunnel syndrome?

Compare the capillary refill in the hands

Determine the client's sleeping position

Apply firm pressure over the ulnar artery

Tap the client's wrists to locate the pain

Answer and Explanation

The Correct Answer is D

Choice A reason: Comparing the capillary refill in the hands is a useful assessment for evaluating peripheral circulation, but it is not specific to diagnosing carpal tunnel syndrome. Carpal tunnel syndrome involves compression of the median nerve, and capillary refill does not provide information about nerve compression.

Choice B reason: Determining the client's sleeping position may provide insight into factors that exacerbate symptoms, but it does not directly assess for carpal tunnel syndrome. While certain positions might worsen the condition, this information alone is not diagnostic.

Choice C reason: Applying firm pressure over the ulnar artery is not relevant to assessing carpal tunnel syndrome. The ulnar artery supplies blood to the hand, but carpal tunnel syndrome involves the median nerve, not the ulnar artery.

Choice D reason: Tapping the client's wrists to locate the pain, known as Tinel's sign, is a specific test for carpal tunnel syndrome. Tinel's sign is positive when tapping over the median nerve at the wrist elicits tingling or pain in the fingers, indicating nerve compression.

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Correct Answer is D

Explanation

Choice A reason: An old friend with eczema coming for a visit is unlikely to cause an exacerbation of the client's symptoms. Eczema is not contagious, so contact with another person who has eczema should not worsen the condition. This choice does not provide useful information about potential triggers for the eczema flare-up.

Choice B reason: Receiving an influenza immunization is generally safe for individuals with eczema and is unlikely to cause an exacerbation of symptoms. Vaccinations do not typically provoke eczema flare-ups. This choice does not offer relevant information regarding potential causes of the worsening eczema symptoms.

Choice C reason: The application of corticosteroid cream to eczema is a common treatment to reduce inflammation and alleviate symptoms. It is unlikely to cause an exacerbation of eczema; in fact, it should help improve the condition. This choice does not explain the recent worsening of the eczema.

Choice D reason: A recent visit from a grandson and his new dog is a plausible trigger for an eczema flare-up. Pets, particularly new ones, can introduce allergens such as pet dander and saliva, which can aggravate eczema. This choice provides the most relevant information for determining the potential cause of the exacerbation.

A. Overall fluid intake. B. Citrus fruit juices. C. Low-sodium sodas. D. Tea and hot chocolate.

Correct Answer is B

Explanation

Choice A reason: Overall fluid intake should not be limited. In fact, increasing fluid intake is generally recommended to help flush out the urinary system and prevent the formation of new stones. Adequate hydration is key to preventing urinary tract calculi.

Choice B reason: Citrus fruit juices, such as orange juice and grapefruit juice, should be limited because they can increase the acidity of the urine. High acidity can contribute to the formation of certain types of kidney stones, particularly uric acid stones. Limiting citrus fruit juices can help reduce the risk of stone recurrence.

Choice C reason: Low-sodium sodas are generally better than regular sodas, but it is important to note that many sodas, even low-sodium ones, contain high levels of phosphates and other substances that can contribute to kidney stone formation. While low-sodium sodas are a better option, the primary focus should be on overall healthy fluid choices.

Choice D reason: Tea and hot chocolate should be limited due to their oxalate content. Oxalates can bind with calcium in the urine to form calcium oxalate stones, which are the most common type of kidney stones. Limiting the intake of tea and hot chocolate can help reduce the risk of stone formation.

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A client who works at a computer most of the working day comes to the clinic reporting pain in both hands that causes the client to wake during the night. Which action should the nurse implement to assess for carpal tunnel syndrome?

Nursing Test Bank

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