The practical nurse (PN) is interviewing a client with a neuromuscular disease. Which question(s) is/are best for the PN to ask to assess for "disuse syndrome?" Select all that apply.
In what part of town is your home located?
On a scale 0-10, how would you rate overall pain level?
What is included in a typical day for you?
Do you feel you are financially stable?
How much assistance do you need to move around?
Correct Answer : C,E
Rationale:
A. In what part of town is your home located: This question assesses environmental or social context but does not provide information about the client’s level of physical activity or mobility. Disuse syndrome is related to prolonged immobility and inactivity, so location alone does not help evaluate risk or presence of muscle atrophy, contractures, or deconditioning.
B. On a scale 0-10, how would you rate overall pain level: Pain assessment is important in neuromuscular conditions because it can limit mobility. However, pain alone does not directly assess the extent of activity or immobility contributing to disuse syndrome. Additional functional questions are needed to determine how inactivity is affecting the client’s musculoskeletal system.
C. What is included in a typical day for you: This question directly evaluates the client’s level of daily activity, mobility, and engagement in physical tasks. Disuse syndrome develops from prolonged inactivity leading to muscle atrophy, decreased strength, and joint stiffness. Understanding daily routines provides insight into whether the client is at risk due to insufficient movement.
D. Do you feel you are financially stable: Financial stability relates to socioeconomic status and access to care but does not directly assess physical activity or immobility. While it may influence overall health outcomes, it does not provide specific information about the development of disuse syndrome.
E. How much assistance do you need to move around: This question assesses the client’s level of dependence in mobility and ability to perform transfers or ambulation. Increased reliance on assistance suggests reduced muscle use, which contributes to muscle wasting, decreased endurance, and joint contractures characteristic of disuse syndrome.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Rationale:
A. Pleural friction rub: A pleural friction rub is a low-pitched, dry, grating sound heard during both inspiration and expiration. It occurs when inflamed pleural surfaces rub together and is usually not cleared by coughing. It often indicates pleuritis or other conditions causing pleural inflammation and may be associated with pain during deep breaths.
B. Wheezing: Wheezing is a high-pitched, musical sound usually heard during expiration and sometimes inspiration, caused by narrowed airways due to bronchospasm, inflammation, or obstruction. It differs from a pleural friction rub in pitch, timing, and origin, and is often associated with asthma or COPD.
C. Coarse rhonchi: Coarse rhonchi are low-pitched, rattling lung sounds caused by secretions in larger airways. They may change or clear with coughing, unlike pleural friction rubs, which are persistent and unaffected by coughing.
D. Stridor: Stridor is a harsh, high-pitched sound heard primarily during inspiration and is caused by upper airway obstruction. It is distinct from a pleural friction rub in both location and mechanism, indicating obstruction rather than pleural inflammation.
Correct Answer is ["A","C","E"]
Explanation
Rationale:
A. Chronic obstructive pulmonary disease (COPD): Clubbing of the nails is a common manifestation in clients with chronic hypoxia, which occurs in advanced COPD. The chronic low oxygen levels stimulate vascular and connective tissue changes at the nail bed, leading to the characteristic spongy, widened appearance.
B. Flu: Influenza is an acute viral infection that typically resolves within days to weeks and does not cause chronic hypoxia or structural nail changes. Clubbing is not associated with short-term infections like the flu.
C. Lung cancer: Pulmonary malignancies, especially those causing chronic hypoxia or paraneoplastic syndromes, can lead to clubbed nails. Tumor-related hypoxemia and vascular factors contribute to soft tissue proliferation in the distal digits.
D. Pneumonia: Pneumonia is an acute infection that usually does not result in the prolonged hypoxia necessary to produce nail clubbing. While severe or recurrent infections may contribute indirectly, isolated episodes rarely cause this finding.
E. Chronic bronchitis: As a component of COPD, chronic bronchitis involves long-standing inflammation and impaired gas exchange. Persistent hypoxemia in this condition can lead to clubbing of the nails due to vascular and connective tissue changes in the distal fingers.
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