Nokea
The nurse is assisting with an examination of a client suspected of having carpal tunnel syndrome. The physician has the client flex the wrist for 30 seconds and percusses the median nerve. The client complains of pain and numbness when this is done. What does the nurse know this positive sign is documented as?
- A. Tinel sign
- B. Phalen sign
- C. Crepitus
- D. Spasm
Correct Answer: B
Rationale: Phalen sign involves having the client flex the wrist for 30 seconds to determine if pain or numbness occurs (a positive sign for carpal tunnel syndrome). The examiner percusses the median nerve, located on the inner aspect of the wrist, to elicit this response. Tinel sign is also a test that elicits pain and numbness in clients with carpal tunnel syndrome and occurs by lightly tapping the median nerve. Crepitus is a grating sound that is elicited when two bones rub together. Spasm is not indicative of carpal tunnel syndrome.
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The nurse in an orthopedic clinic is caring for a new client. What sign or symptom would lead a nurse to suspect that a client has a rotator cuff tear?
- A. Ability to stretch arm over the head
- B. Difficulty lying on affected side
- C. Pain worse in the morning
- D. Minimal pain with movement
Correct Answer: B
Rationale: Clients with a rotator cuff tear experience pain with movement and limited mobility of the shoulder and arm. They especially have difficulty with activities that involve stretching their arm above their head. Many clients find that the pain is worse at night and that they are unable to sleep on the affected side.
A client has sustained a left femur fracture in a skiing accident. When is the nurse aware that the complication of a fat emboli typically occurs and should be monitored for closely?
- A. The first hour after fracture of the long bone
- B. 8 to 12 hours
- C. 12 to 24 hours
- D. 48 to 72 hours
Correct Answer: D
Rationale: The client should be monitored for symptoms of a fat embolism, which typically occurs within 48 to 72 hours.
The nurse is designing a teaching plan for a client with a ruptured Achilles tendon. What education will the nurse provide?
- A. Dietary restrictions
- B. Activity restrictions
- C. Use of nonprescription medications
- D. Effective pin care
Correct Answer: B
Rationale: The nurse should emphasize information about the activity restrictions, the use of ambulatory aids, and pain management to a client with a ruptured Achilles tendon. The client need not be advised about his or her diet or the use of nonprescription medications. Teaching about pin care is also not necessary for such a client because pins are not used to treat a ruptured Achilles tendon.
A client with a fracture develops compartment syndrome that requires surgical intervention. What treatment will the nurse most likely prepare the client for?
- A. Bone graft
- B. Joint replacement
- C. Fasciotomy
- D. Amputation
Correct Answer: C
Rationale: Surgical treatment of compartment syndrome is achieved with a fasciotomy, a surgical incision of the fascia and separation of the muscle to relieve pressure and restore tissue perfusion. Bone graft, joint replacement or amputation may be done for a client who experiences avascular necrosis.
A client has had surgery to repair a fractured hip. What intervention is important for the nurse to perform when turning the client from side to side?
- A. Place abductor pillows between the legs
- B. Place 2 pillows between the legs
- C. Place 6 to 8 pillows between the legs
- D. Have client put weight on the operated side
Correct Answer: A
Rationale: The nurse places abductor pillows between the client's legs when turning the client from side to side to avoid dislocating the hip. Regular pillows do not provide the support required to avoid a dislocation. The client should not bear weight on the operated side immediately after surgery.