A nurse is reviewing the medical records of clients on a hospital floor. Which client would the nurse expect is most at risk for hyperthyroidism?

Choice A reason:

Measuring the circumference of the thigh can be part of the assessment for swelling or edema, which may indicate compartment syndrome or other issues. However, it is not a direct measure of neurovascular status, which focuses on blood flow and nerve function.

Choice B reason:

Palpating the femoral pulse is important for assessing blood flow to the leg, but for a midshaft femur fracture, more distal pulses such as the popliteal, dorsalis pedis, or posterior tibial pulses would be more indicative of the neurovascular status of the affected limb.

Choice C reason:

Monitoring the client's calf for edema is a useful technique for identifying signs of swelling that could suggest complications like deep vein thrombosis or compartment syndrome. However, it does not provide a complete picture of neurovascular integrity, which also includes sensory and motor function assessment.

Choice D reason:

Instructing the client to wiggle his toes is a direct assessment of motor function, which is a key component of neurovascular status. This action, along with checking for sensation and capillary refill, helps to determine if there is any impairment in nerve function or blood supply to the affected area.

Choice A reason:
Difficulty with abduction of the arm at the shoulder is a common finding in clients with a rotator cuff injury. The rotator cuff is a group of muscles and tendons that stabilize the shoulder joint and facilitate its movement. When these muscles or tendons are injured, movements such as lifting the arm away from the body (abduction) can become painful and difficult.

Choice B reason:
Alteration in the contour of the joint is not typically associated with a rotator cuff injury. This finding is more indicative of conditions that cause changes in the bone structure, such as arthritis or dislocation.

Choice C reason:
A positive Tinel's sign is used to diagnose nerve compression or nerve damage, particularly in conditions like carpal tunnel syndrome. It is not a test used to assess rotator cuff injuries.

Choice D reason:
A negative drop arm test would suggest that the client does not have a rotator cuff injury. The drop arm test is performed by having the client lift the arm to 90 degrees and then slowly lower it. If the client can control the motion and lower the arm smoothly, the test is negative. A positive drop arm test, where the client cannot control the descent of the arm, would indicate a rotator cuff injury.