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A nurse is assessing a client who reports numbness and pain in his right palm, index finger, and middle finger. The client reports working with a keyboard most of the time while at work. The nurse suspects carpal tunnel syndrome. Which of the following tests should the nurse request that the client perform?
- A. Hold the wrist at a 90-degree flexion.
- B. Perform a straight leg raise test.
- C. Tap the wrist for tenderness.
- D. Hold the arm in an elevated position.
Correct Answer: A
Rationale: The correct answer is A: Hold the wrist at a 90-degree flexion. This test, known as the Phalen's test, is used to assess for carpal tunnel syndrome. By holding the wrist in a flexed position for about 60 seconds, the test can reproduce symptoms of numbness and tingling in the affected fingers. This occurs due to increased pressure on the median nerve, which is characteristic of carpal tunnel syndrome.
Choices B, C, and D are incorrect:
B: Performing a straight leg raise test is used to assess for sciatic nerve irritation in the lower back, not carpal tunnel syndrome.
C: Tapping the wrist for tenderness is not a specific test for carpal tunnel syndrome.
D: Holding the arm in an elevated position is not a recognized test for carpal tunnel syndrome and would not provide relevant information in this context.
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A nurse is assessing a client for hypoxemia during an asthma attack. Which of the following manifestations should the nurse expect?
- A. Cyanosis
- B. Agitation
- C. Hypotension
- D. Dizziness
Correct Answer: B
Rationale: The correct answer is B: Agitation. During an asthma attack, hypoxemia can lead to decreased oxygen supply to the brain, causing agitation due to hypoxia. Cyanosis (A) is a bluish discoloration of the skin and mucous membranes, indicating severe hypoxemia. Hypotension (C) is not typically associated with hypoxemia in asthma. Dizziness (D) is more commonly seen in conditions like hyperventilation rather than hypoxemia. In summary, agitation is the most likely manifestation of hypoxemia during an asthma attack due to decreased oxygen supply to the brain.
A nurse is caring for a client who is experiencing menopausal symptoms and asks the nurse about menopausal hormone therapy (HT). The nurse should inform the client that HT is not recommended due to which of the following findings in the client's medical history?
- A. History of breast cancer
- B. History of hypertension
- C. History of diabetes
- D. History of osteoarthritis
Correct Answer: A
Rationale: The correct answer is A: History of breast cancer. Menopausal hormone therapy (HT) is contraindicated in women with a history of breast cancer due to the potential risk of hormone-dependent cancer recurrence. Hormones can stimulate the growth of estrogen-sensitive breast cancer cells, increasing the risk of cancer recurrence. Therefore, it is crucial for the nurse to inform the client with a history of breast cancer that HT is not recommended. Choices B, C, and D are not directly contraindications for HT in menopausal clients, as long as these conditions are well-controlled and monitored.
A nurse is planning a teaching session about hysterosalpingography for a client who has a diagnosis of infertility. The nurse should include which of the following information in the teaching plan?
- A. The client might experience shoulder pain following the procedure.
- B. The client might experience nausea and vomiting after the procedure.
- C. The client will need to stay in bed for 24 hours post-procedure.
- D. The client should avoid drinking fluids before the procedure.
Correct Answer: A
Rationale: The correct answer is A: The client might experience shoulder pain following the procedure. This is because hysterosalpingography involves the injection of contrast dye into the uterus and fallopian tubes, which can cause referred pain to the shoulder due to irritation of the diaphragm. This information is crucial for the client to be aware of potential side effects.
The other choices are incorrect:
B: The client might experience nausea and vomiting after the procedure - This is not a common side effect of hysterosalpingography.
C: The client will need to stay in bed for 24 hours post-procedure - There is no requirement for prolonged bed rest after the procedure.
D: The client should avoid drinking fluids before the procedure - In fact, it is recommended to drink plenty of fluids before the procedure to help flush out the contrast dye.
The nurse is caring for a postoperative client who has a chest tube connected to suction and a water-seal drainage system. Which of the following indicates to the nurse that the chest tube is functioning properly?
- A. Fluctuation of the fluid level within the water seal chamber
- B. Continuous bubbling in the water seal chamber
- C. Absence of bubbling in the water seal chamber
- D. No drainage in the collection chamber
Correct Answer: A
Rationale: Fluctuation (tidaling) in the water-seal chamber during inspiration and expiration indicates the chest tube is functioning properly.
A nurse is reviewing the EKG strip of a client who has prolonged vomiting. Which of the following abnormalities on the client's EKG should the nurse interpret as a sign of hypokalemia?
- A. Flat T wave
- B. Prominent U wave
- C. ST elevation
- D. Wide QRS complex
Correct Answer: B
Rationale: The correct answer is B: Prominent U wave. Hypokalemia, or low potassium levels, can cause the U wave to become more prominent on an EKG strip. This is due to delayed repolarization of the ventricles. A flat T wave (choice A) is typically associated with ischemia or infarction. ST elevation (choice C) is often seen in conditions like myocardial infarction. A wide QRS complex (choice D) is indicative of conduction abnormalities. Choices E, F, and G are not relevant to the interpretation of hypokalemia on an EKG strip.