During a routine health screening of an adult female, the nurse notes several changes that have occurred over the past year. Which change indicates the need for a bone density screening?

15 lb (6.8 kg) weight loss.

Diminished appetite.

Decreased height.

Lower body mass index (BMI)

Answer and Explanation

The Correct Answer is C

A.   Significant weight loss can be a concern for overall health and may be related to various conditions, including nutritional deficiencies. However, weight loss alone does not specifically indicate the need for bone density screening. It may be a factor in a broader health assessment but is not a direct indicator for bone density measurement.
B.   A diminished appetite can affect nutritional intake, which in turn may impact bone health over time. However, diminished appetite itself does not directly suggest a need for a bone density screening unless it leads to significant weight loss or is part of a broader concern about nutritional status affecting bone health.
C.   Decreased height is a key indicator that may suggest osteoporosis or significant bone loss. This can be due to vertebral compression fractures, which are common in individuals with osteoporosis. A reduction in height over time can be a direct sign that warrants a bone density screening to assess bone health and risk for fractures.
D.   A lower BMI can be associated with lower bone mass and increased risk for osteoporosis, particularly in individuals who are underweight. However, while a low BMI can be a risk factor for osteoporosis, it is not as specific as decreased height for prompting a bone density screening.

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Correct Answer is A

Explanation

A. A grade IV systolic murmur is considered loud and may be associated with a palpable thrill. In mitral valve regurgitation, the murmur is often best heard at the apex of the heart. A thrill, which is a vibration felt on the chest wall, is a sign of a more significant murmur. This description is consistent with a grade IV murmur, which is typically loud and may indeed be associated with a thrill.
B. Very loud, with no stethoscope, thrill easily palpable, heave visible.
B. A grade V systolic murmur is very loud and can be heard with the stethoscope barely touching the chest. It often comes with a palpable thrill and may be accompanied by a visible heave or lift of the

chest wall. This description is consistent with a grade V murmur, not grade IV. Therefore, it’s not the
correct description for a grade IV murmur.
C. A soft murmur, barely audible, describes a grade I or grade II systolic murmur. This does not match the characteristics of a grade IV murmur, which is louder and more easily heard. Therefore, this description does not support a grade IV murmur.
D. A moderately loud murmur, without a thrill, could describe a grade III murmur. Additionally, a "machine-like rumble" is more characteristic of a diastolic murmur, such as those heard in conditions like aortic regurgitation or mitral stenosis, rather than a systolic murmur associated with mitral valve regurgitation.

A. Ask the client about progressive contractures of the 4th and 5th fingers. B. Compress the ulnar and radial arteries, then observe for flushing in the hand when ulnar pressure is released. C. Compare the client's hands bilaterally for pain, pallor, pulses, paralysis, and paresthesia. D. Instruct the client to place the backs of the hands together and flex both wrists.

Correct Answer is D

Explanation

A. Contractures of the 4th and 5th fingers are more indicative of ulnar nerve involvement, not median nerve compression. Carpal tunnel syndrome primarily affects the thumb, index finger, middle finger, and part of the ring finger. Thus, asking about contractures of the 4th and 5th fingers would not provide useful information about carpal tunnel syndrome.
B. This technique is used to assess the patency of the radial and ulnar arteries, commonly referred to as the Allen test. It is used to evaluate blood flow in the hand, particularly before performing procedures that may impact arterial circulation. This test is not specific to carpal tunnel syndrome and does not provide useful information about median nerve compression.
C. While comparing the hands bilaterally for various signs can be useful in assessing general hand function and circulation, this method does not specifically target the symptoms or diagnostic tests associated with carpal tunnel syndrome. It provides a broad overview but is not specific enough to confirm CTS.
D. This technique is known as the Phalen’s test, which is specifically used to assess for carpal tunnel
syndrome. During the Phalen’s test, the client is asked to flex their wrists and hold the position for about 60 seconds. If the client experiences tingling, numbness, or pain in the median nerve distribution (thumb, index, middle finger, and part of the ring finger), it suggests carpal tunnel syndrome.

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During a routine health screening of an adult female, the nurse notes several changes that have occurred over the past year. Which change indicates the need for a bone density screening?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse auscultates the precordium of a client who is diagnosed with mitral valve regurgitation and hears a grade IV systolic murmur. When documenting the comparison of systolic murmurs, which characteristics should the nurse use to support this systolic finding?

Correct Answer is A

Explanation

A client is concerned about developing carpal tunnel syndrome. Which screening technique should the nurse perform to provide the client with useful information?

Correct Answer is D

Explanation

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