After a physical assessment, the nurse determines that a client has full range of motion of the temporomandibular joint. Which of the following assessments did the nurse complete with the client? Select all that apply.

Asked the client to swallow

Asked the client to extend the tongue

Asked the client to rock the jaw laterally

Asked the client to open and close the mouth

Asked the client to jut the jaw forward

Answer and Explanation

Correct Answer : C,D,E

A.   Swallowing involves the muscles of the throat and esophagus rather than the TMJ.
B.   Extending the tongue involves the muscles of the tongue and mouth, which are not directly related to the TMJ.
C.   Rocking the jaw laterally (side to side) is a specific movement that involves the TMJ. This movement tests the ability of the TMJ to move the jaw from side to side.
D.   Opening and closing the mouth involves the primary hinge movement of the TMJ. This movement assesses the vertical range of motion of the jaw.
E.   Jutting the jaw forward (protrusion) involves moving the lower jaw forward in relation to the upper jaw. This movement tests the ability of the TMJ to perform anterior movement.

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Correct Answer is A

Explanation

A. A grade of 4/5 indicates that the patient can move the upper arms against gravity and can tolerate some resistance. This aligns with the description of the patient being able to move the arms against gravity and some resistance. A grade of 4 suggests that the strength is less than normal but still functional.
B. A grade of 2/5 means the patient can move the arms only with gravity eliminated, meaning they can move the arm when it is in a horizontal position but not against gravity. Since the patient can move the arms against gravity and some resistance, this grade is too low.
C. A grade of 5/5 indicates normal strength, where the patient can move the arm against full resistance with no difficulty. The description states that the patient can move the arms against gravity and some resistance, but not necessarily against full resistance, so 5/5 might be too high of a grade in this case.
D. A grade of 0 indicates no muscle contraction or movement at all. This grade would not apply since the patient is able to move the arms against gravity and some resistance.

A. Bursitis B. Meningitis C. Spondylitis D. Arthritis

Correct Answer is B

Explanation

A. Bursitis is the inflammation of the bursa, a small fluid-filled sac that reduces friction between bones and soft tissues. It typically causes localized pain and tenderness in the area of the bursa, often in the shoulders, elbows, or hips.

B. Meningitis is an infection or inflammation of the protective membranes covering the brain and spinal cord (the meninges). It often presents with symptoms such as fever, headache, neck stiffness, and photophobia. The neck stiffness, particularly difficulty flexing the head forward (nuchal rigidity), is a classic sign.
C. Spondylitis refers to inflammation of the spine. It can present with chronic back pain and stiffness but is typically associated with long-term symptoms rather than acute systemic symptoms like fever and chills. Conditions such as ankylosing spondylitis can cause chronic back pain and stiffness but are less likely to present with acute fever and headache.
D. Arthritis is inflammation of the joints and can cause pain, swelling, and stiffness in the affected joints. While arthritis can affect the neck (cervical spine arthritis), it typically does not present with systemic symptoms such as fever and chills unless there is an associated infection or inflammatory process.

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After a physical assessment, the nurse determines that a client has full range of motion of the temporomandibular joint. Which of the following assessments did the nurse complete with the client? Select all that apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient is able to move both upper arms as follows: active movement against gravity, and some resistance. The nurse should document the muscle strength of the upper arms as:

Correct Answer is A

Explanation

Correct Answer is B

Explanation

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