A nurse is conducting a health history with a client who has recently had a stroke. The nurse notes the client is unable to speak, although his comprehension/ understanding is intact. Which disorder of speech is the nurse observing in this client?

A. The obturator sign is used to assess for appendicitis, not meningitis. To perform this test, the patient’s right knee is flexed to 90 degrees, and the nurse rotates the hip internally and externally. Pain during this maneuver can indicate irritation of the obturator muscle, which is associated with inflammation of the appendix.

B. The Brudzinski sign is a clinical test used to assess meningeal irritation. When the patient’s neck is passively flexed while lying supine, a positive Brudzinski sign is indicated if the patient involuntarily flexes their knees and hips in response to neck pain. This sign is often seen in meningitis as a result of irritation of the meninges.
C. The Phalen sign is used to diagnose carpal tunnel syndrome. The patient flexes their wrists and holds the position for a period of time to see if symptoms of numbness or tingling appear in the fingers, which would indicate median nerve compression at the wrist. This sign is unrelated to meningitis.
D. The Tinel sign is also used to diagnose carpal tunnel syndrome and other peripheral nerve issues. It involves tapping on the nerve (such as the median nerve at the wrist) to see if it causes tingling or a “pins and needles” sensation along the nerve’s distribution. Like the Phalen sign, it is not related to meningitis.

A. Lateral epicondylitis, commonly known as "tennis elbow," is an overuse injury characterized by pain and tenderness on the outer part of the elbow (lateral epicondyle). It results from repeated stress and

strain on the forearm muscles and tendons, often due to activities involving repetitive arm motions such as tennis. The pain typically worsens with activities involving gripping, extending, or lifting.
B. Rheumatoid arthritis (RA) is a chronic inflammatory disease that typically affects joints symmetrically, causing pain, swelling, and stiffness. It usually involves joints like the hands, wrists, and knees rather than the elbows alone. RA symptoms are generally more diffuse and persistent, rather than specifically linked to recent physical activity and localized pain associated with movement.
C. Gout is a form of arthritis caused by the accumulation of uric acid crystals in the joints. It often presents with sudden, severe pain, redness, and swelling, typically affecting the big toe but can also affect other joints. Gout attacks usually occur at night and are often very acute and localized. It is less likely to be associated with the type of pain described (pain during extension and flexion) and recent physical activity.
D. Medial epicondylitis, also known as "golfer’s elbow," is similar to lateral epicondylitis but affects the inner part of the elbow (medial epicondyle). It is more commonly associated with activities that involve gripping and wrist flexion rather than the generalized extension and flexion pain described.