A patient states, "I can hear a crunching or grating sound when I kneel." She also states that "it is very difficult to get out of bed in the morning because of stiffness and pain in my joints." The nurse should assess for signs of what problem?

Bone spur

Crepitation

Loose tendon

Fluid in the knee joint

Answer and Explanation

The Correct Answer is B

A.   A bone spur typically does not cause crunching or grating sounds and is not usually associated with morning stiffness.
B.   Crepitation is the medical term for a grating or crunching sound often caused by joint issues, such as osteoarthritis, which could be the cause of the symptoms described.
C.   A loose tendon would not typically cause a crunching or grating sound.
D.   Fluid accumulation in the knee (effusion) would likely cause swelling and pain, but it would not typically produce a grating sound

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Correct Answer is D

Explanation

A. Although the medical record can provide background information, it does not give the real-time assessment of the patient's current functional abilities.
B. While this information can be valuable, observing the patient directly provides the most accurate assessment of his abilities.
C. The physician’s perspective is important but may not fully capture the patient's day-to-day functional capacity.
D. Direct observation allows the nurse to assess the patient’s current functional status and make necessary adjustments to the care plan.

A. Extinction B. Tactile discrimination C. Stereognosis. D. Graphesthesia

Correct Answer is C

Explanation

A. This term refers to the inability to recognize stimuli presented to both sides of the body simultaneously, often seen in cases of neurologic damage.
B. This refers to the ability to differentiate between various sensations, but it is not the specific term for identifying objects by touch.
C. This is the correct term for the ability to recognize objects through touch alone. The nurse would describe the client's ability to identify the key as stereognosis.
D. This refers to the ability to recognize letters or numbers written on the skin, typically with a fingertip, not the identification of a physical object.

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A patient states, "I can hear a crunching or grating sound when I kneel." She also states that "it is very difficult to get out of bed in the morning because of stiffness and pain in my joints." The nurse should assess for signs of what problem?

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