A client states “I can hear a crunching or grating sound when I kneel and have difficulty getting out the bed in the morning because of pain and stiffness”. Which of the following should the nurse expect as an assessment finding?

Bone spur

Crepitation

Tendonitis

Fluid in the knee joint

Answer and Explanation

The Correct Answer is B

Choice A rationale: While a bone spur could contribute to joint symptoms, the description provided by the client is more indicative of crepitation.

Choice B rationale: The client's complaint of a crunching or grating sound when kneeling and difficulty getting out of bed in the morning is indicative of crepitation, which is often associated with joint degeneration.

Choice C rationale: Tendonitis typically presents with inflammation and pain associated with specific tendons but may not produce a crunching sound.

Choice D rationale: Fluid in the knee joint (effusion) may cause swelling and limited range of motion but may not necessarily produce crepitation.

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Correct Answer is C

Explanation

Choice A rationale: Anorexia refers to a lack of appetite or desire for food, not difficulty swallowing.

Choice B rationale: Aphasia is a language disorder, affecting the ability to understand or express speech, and is not related to swallowing difficulties.

Choice C rationale: Difficulty swallowing medications and food is indicative of dysphagia, which is a swallowing disorder.

Choice D rationale: Dysphasia is another term for aphasia and is not specific to swallowing difficulties.

A. When the client sticks out the tongue it is in the midline and without tremors or deviation B. Client follows an object with eyes without nystagmus or strabismus. C. Client demonstrates the ability to hear normal conversation D. Client moves the head and shoulders against resistance with equal strength.

Correct Answer is D

Explanation

Choice A rationale: Sticking out the tongue without tremors or deviation is related to Cranial Nerve XII (hypoglossal nerve), not Cranial Nerve XI.

Choice B rationale: Following an object with the eyes without nystagmus or strabismus is more related to visual tracking and coordination, not Cranial Nerve XI.

Choice C rationale: Hearing ability is primarily associated with Cranial Nerve VIII (vestibulocochlear nerve), not Cranial Nerve XI.

Choice D rationale: Cranial Nerve XI, also known as the accessory nerve, is responsible for the movement of the head and shoulders against resistance. If intact, the client should be able to perform this action with equal strength on both sides.

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A client states “I can hear a crunching or grating sound when I kneel and have difficulty getting out the bed in the morning because of pain and stiffness”. Which of the following should the nurse expect as an assessment finding?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has difficulty swallowing medications and food. The nurse should recognize that the client is experiencing which of the following:

Correct Answer is C

Explanation

The nurse tests the function of Cranial Nerve XI while performing a physical examination on a client. Which statement best describes the response the nurse should expect if Cranial Nerve XI is intact?

Correct Answer is D

Explanation

The nurse is assessing a client who reports an abnormal sensation of burning or tingling in extremities. Which of the following should the nurse document in the client's record?

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The student nurse is studying the functioning of the nervous system. Which of the following descriptions of the central nervous system is accurate?

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The nurse suspects that a client has carpal tunnel syndrome and prepares to conduct the Phalen test. What instructions should the nurse give the client to perform the Phalen test?