A nurse working in a busy orthopedic clinic is asked to perform ...

[ahriuashd]

A nurse working in a busy orthopedic clinic is asked to perform the Tinel sign on a patient having problems in his hand/wrist. In order to test Tinel sign, the nurse should give the patient which of the following directions?
 
  A)
  Stand tall, arms at your side, shut your eyes; place the tip of your index finger to your nose.
  B)
  Hold your wrist in complete flexion; keep it in this position for 60 seconds; how does your hand feel after placing it in a neutral position?
  C)
  I'm going to tap (percuss) over the median nerve in your wrist; tell me what sensation you feel while I am doing this. Does the sensation stay in the wrist or go anywhere else?
  D)
  I'm going to tap this tuning fork and place it on the side of your thumb; then tell me what you are feeling in your hand and wrist.

Question 2

Following a collision while mountain biking, the diagnostic workup of a 22-year-old male has indicated the presence of an acute subdural hematoma.
 
  Which of the following pathophysiological processes most likely underlies his diagnosis?
  A)
  Blood has accumulated between the man's dura and subarachnoid space.
  B)
  Vessels have burst between the client's skull and his dura.
  C)
  A traumatic lesion in the frontal or temporal lobe has resulted in increased ICP.
  D)
  Blood has displaced CSF in the ventricles as a consequence of his coup-contrecoup injury.

[ally]

Answer to Question 1

Ans:
C

Feedback:

A positive Tinel sign will help diagnose carpal tunnel syndrome. The patient will have a tingling sensation radiating into the palm of the hand when lightly percussed over the median nerve at the wrist. Answer choice B relates to Phalen sign, which is also a test to help diagnose carpel tunnel syndrome. Answer choice D is not the medical test for carpal tunnel syndrome.

Answer to Question 2

Ans:
A

Feedback:

A subdural hematoma develops in the area between the dura and the arachnoid space, while epidural hematomas exist between the skull and dura. Intracerebral hematomas are located most often in the frontal or temporal lobe, and the ventricles are not directly involved in a subdural hematoma.