When assessing the thyroid gland, which technique is most appropriate?
Use deep palpation with both hands simultaneously
Percuss the thyroid for size and tenderness.
Ask the patient to swallow water while palpating the gland
Palpate the thyroid with the patient in a supine position
The Correct Answer is C
Palpation of the thyroid gland utilizes the isthmus and lobes' upward movement during deglutition to confirm location and consistency. The nurse typically stands behind the patient and uses the pads of the fingers to identify the cricoid cartilage before palpating the lobes. Abnormalities such as goiters or nodules are more easily detected as the gland glides beneath the fingers.
A. Use deep palpation with both hands simultaneously: Simultaneous deep pressure with both hands can be uncomfortable and may compress the trachea. The correct technique involves using one hand to gently displace the trachea while the other hand palpates the opposite thyroid lobe. This allows for a more focused and detailed assessment of each lobe.
B. Percuss the thyroid for size and tenderness: Percussion is not a standard technique for assessing the thyroid gland, as it does not provide useful information about the soft tissue structure or presence of nodules. Palpation and inspection are the primary methods used to evaluate thyroid anatomy and pathology.
C. Ask the patient to swallow water while palpating the gland: Swallowing causes the thyroid gland and the surrounding cartilages to rise. This movement allows the nurse to feel the size, shape, and consistency of the thyroid as it moves against the fingertips. It is a critical step in the specialized palpation of the neck.
D. Palpate the thyroid with the patient in a supine position: Thyroid assessment is traditionally and most effectively performed with the patient sitting upright. This position allows the neck muscles to relax and makes the anatomical landmarks of the larynx more prominent. The supine position makes it significantly more difficult to access and move the gland during swallowing.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
The plantar reflex is a superficial spinal reflex elicited by stroking the lateral aspect of the sole. In a neurologically intact adult, the normal response is plantarflexion of the digits. An abnormal Babinski sign, characterized by dorsiflexion of the hallux, indicates upper motor neuron dysfunction or pyramidal tract lesions.
A. Extending the lower leg: This movement describes the patellar or "knee-jerk" reflex, which is a deep tendon reflex involving the L2 to L4 spinal segments. It is triggered by tapping the patellar tendon with a reflex hammer. It is not the physiological response associated with stimulating the plantar surface of the foot.
B. Flexing the elbow: Elbow flexion is the expected response when testing the biceps or brachioradialis reflexes. These assessments target the C5 and C6 nerve roots through percussion of the respective tendons. This upper extremity motor response is entirely unrelated to the cutaneous stimulation of the lower extremity's sole.
C. Extending the great toe: Extension (dorsiflexion) of the great toe, often accompanied by fanning of the other toes, is known as a positive Babinski sign. While this is a response to the plantar stimulus, it is considered pathological in adults. It suggests damage to the corticospinal tract rather than a healthy response.
D. Flexing the toes: The physiological and expected response in a healthy adult is the curling or flexing of the toes toward the sole of the foot. This indicates an intact reflex arc and the absence of central nervous system suppression issues. It is the correct description of a negative Babinski result.
Correct Answer is A
Explanation
Pronation of the hand occurs when the radius rotates medially around its longitudinal axis, crossing over the ulna. This movement results in the palm facing posteriorly (downward) and the thumb pointing toward the body's midline. It is controlled by the pronator teres and pronator quadratus muscles and is a key component of the neurological motor exam.
A. Pronation: The image in "image_b56957.png" displays the hand with the dorsum (back) facing the viewer and the palm facing downward. This is the hallmark anatomical position of a pronated forearm. It is the correct term for the orientation shown.
B. Extension: Extension at the wrist would involve moving the hand toward the dorsal surface of the forearm. While the hand is straight, "extension" describes a joint angle rather than the rotational orientation of the palm. It does not describe the specific cross-over of the forearm bones seen here.
C. Supination: Supination is the opposite of the position shown; it would feature the palm facing upward (anteriorly) with the radius and ulna parallel. Since the back of the hand is visible and the palm is hidden, the hand is not in supination.
D. Flexion: Wrist flexion involves bending the palm toward the ventral surface of the forearm. The hand in the image is held in a neutral, straight line with the arm. Therefore, the term "flexion" does not apply to the position depicted.
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