The charge nurse is observing a new staff nurse who is assessing ...

[chandani]

The charge nurse is observing a new staff nurse who is assessing a patient with a traumatic spinal cord injury for sensation. Which action indicates a need for further teaching of the new nurse about neurologic assessment?
 
  a. The new nurse tests for light touch before testing for pain.
  b. The new nurse has the patient close the eyes during testing.
  c. The new nurse asks the patient if the instrument feels sharp.
  d. The new nurse uses an irregular pattern to test for intact touch.

Question 2

Which equipment will the nurse obtain to assess vibration sense in a diabetic patient who has peripheral nerve dysfunction?
 
  a. Sharp pin
  b. Tuning fork
  c. Reflex hammer
  d. Calibrated compass

[efwsefaw]

Answer to Question 1

ANS: C
When performing a sensory assessment, the nurse should not provide verbal clues. The other actions by the new nurse are appropriate.

Answer to Question 2

ANS: B
Vibration sense is testing by touching the patient with a vibrating tuning fork. The other equipment is needed for testing of pain sensation, reflexes, and two-point discrimination.

[chandani]

Thank you

[efwsefaw]

No problemo