Which assessment is subjective as it relates to the musculoskeletal system?
Vital signs: Temperature 98.2, Pulse 92 bpm, Respirations 18/min, BP 136/84 mm Hg, Oximeter reading 98%.
Patient has been taking nonsteroidal anti-inflammatory drugs (NSAIDs) for his right elbow pain.
Pain 7 to 8.
Grimacing and holding affected body part.
The Correct Answer is C
Choice A reason: Vital signs are objective, measurable data, not specific to musculoskeletal assessment or subjective experience. Pain, a subjective report, better fits the question. Assuming vital signs are subjective risks misclassifying data, leading to errors in prioritizing patient-reported symptoms like pain, critical for musculoskeletal care planning and intervention.
Choice B reason: Taking NSAIDs is a factual history, not a subjective assessment. Subjective data, like pain severity, reflect patient experience. Assuming medication use is subjective misaligns with assessment principles, risking neglect of patient-reported symptoms like pain, essential for evaluating musculoskeletal conditions and guiding effective pain management strategies.
Choice C reason: Pain rated 7 to 8 is subjective, based on the patient’s personal experience, central to musculoskeletal assessment for conditions like arthritis or injury. This guides pain management, like adjusting NSAIDs. Accurate identification ensures patient-centered care, addressing discomfort and improving function, critical for musculoskeletal health outcomes.
Choice D reason: Grimacing and holding a body part are objective, observable signs, not subjective reports. Pain severity, reported by the patient, is subjective. Assuming grimacing is subjective risks misclassification, potentially overlooking patient-reported pain levels, critical for tailoring interventions like analgesics in musculoskeletal assessment and care planning.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Difficulty initiating urination, incomplete bladder emptying, and dribbling in a 75-year-old male, with likely prostate enlargement on rectal exam, indicate benign prostatic hyperplasia (BPH). BPH obstructs the urethra, common in aging men. Accurate diagnosis guides treatments like alpha-blockers, preventing complications like urinary retention or kidney damage in elderly patients.
Choice B reason: Urinary tract infections cause burning or cloudy urine, not primarily dribbling or initiation issues, which suggest BPH in older males. Assuming UTI risks missing prostate issues, delaying BPH treatment. This could lead to untreated obstruction, increasing risks of retention or infection, requiring distinct diagnostic and therapeutic approaches.
Choice C reason: Stage 4 prostate cancer may cause urinary symptoms, but initiation difficulty and dribbling in older males typically indicate BPH, especially without systemic symptoms. Assuming cancer risks unnecessary invasive testing, delaying BPH management like medications, critical for relieving obstruction and improving quality of life in elderly patients.
Choice D reason: Renal disease causes systemic symptoms like edema or hypertension, not primarily urinary flow issues like dribbling, which point to BPH. Misdiagnosing as renal disease risks overlooking prostate obstruction, delaying treatments like tamsulosin, potentially worsening urinary retention or kidney strain in older males with BPH symptoms.
Correct Answer is D
Explanation
Choice A reason: The Snellen chart tests visual acuity (cranial nerve II), not balance, which is assessed by cranial nerve VIII via the Romberg test. Misidentifying this risks incorrect neurological evaluation, potentially missing vestibular deficits, critical for diagnosing balance disorders like vertigo or labyrinthitis in patients with cranial nerve issues.
Choice B reason: The Rinne test assesses hearing (cranial nerve VIII) by comparing air and bone conduction, not balance, which the Romberg test evaluates. Assuming Rinne tests balance misguides assessment, risking oversight of vestibular dysfunction, essential for diagnosing conditions affecting equilibrium in patients with suspected nerve VIII issues.
Choice C reason: The Weber test evaluates hearing lateralization (cranial nerve VIII), not balance, assessed by the Romberg test. Misidentifying Weber risks missing balance deficits, potentially delaying diagnosis of vestibular disorders like Meniere’s disease, critical for managing symptoms and preventing falls in patients with cranial nerve VIII dysfunction.
Choice D reason: The Romberg test assesses balance (cranial nerve VIII’s vestibular component) by evaluating posture with eyes closed, detecting vestibular or proprioceptive deficits. It’s critical for diagnosing balance disorders, guiding interventions like vestibular therapy, essential for preventing falls and managing conditions affecting equilibrium in patients with nerve VIII issues.
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