Free NCLEX-RN® Nursing Sample Questions
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Your First Free NCLEX Question
The nurse is caring for a client with carpal tunnel syndrome. Which clinical finding will the nurse anticipate?
- Positive Tinel’s sign
- Negative Phalen’s sign
- Positive McMurray’s test
- Negative Lachman’s test
The Answer and Explanation
Did you get it right? The correct answer is: 1
Carpal tunnel syndrome is a musculoskeletal disorder involving the carpal tunnel in the wrist. The carpal tunnel is formed by wrist ligaments and bones. The median nerve travels through the carpal tunnel to the hand. Compression of the median nerve results in weakness, numbness, decreased sensation, pain, positive Tinel’s sign, and positive Phalen’s sign of the affected hand.
A positive Phalen’s test is a tingling sensation in the thumb, index finger, and middle finger of the affected hand following 60 seconds or more of maximum flexion of the wrist. A positive Phalen’s sign is indicative of carpal tunnel syndrome.
A positive Tinel’s sign is a tingling sensation in the thumb, index finger, and middle finger of the affected hand when the median nerve is tapped over the carpal tunnel. A positive Tinel’s sign is indicative of carpal tunnel syndrome.
Compression of the median nerve is caused by edema in the soft tissue associated with the carpal tunnel, trauma, rheumatoid arthritis, or other conditions. Commonly, carpal tunnel syndrome is caused by repetitive wrist movements and is frequently noticed in musicians, computer operators, and drivers.
Carpal Tunnel Syndrome
| Clinical Findings | Weakness, numbness, decreased sensation, and pain of the affected hand/fingersPositive Tinel’s signPositive Phalen’s test |
| Treatment | Treatment depends on the severity and progressive of nerve damage and may include: splinting of the wrist associated with the affected handglucocorticoid injections and or oral glucocorticoidssurgery |
| Key Nursing Care | Monitor the neurovascular status of the affected hand/fingersEducate the clienton the use of splintson the use of ordered medications to decrease inflammation and painto report changes in symptomsto avoid repetitive stress activities if possibleSurgical carePreoperative carePostoperative caremonitor neurovascular status and vital signsdressing and incision wound careuse of splints |
| Prevention | Preventing carpal tunnel syndrome may include: use ergonomically appropriate equipment and workstationstake breaks from repetitive stress activitiesstretch fingers and wrists frequently avoid repetitive stress activities if possible |
Answer 2: The nurse will not expect to observe a negative Phalen’s test in a client with carpal tunnel syndrome. The nurse will expect to observe a positive Phalen’s test and a positive Tinel’s sign in a client with carpal tunnel syndrome.
Answer 3: The nurse will not expect to observe a positive McMurray’s test in a client with carpal tunnel syndrome. A positive McMurray’s test is indicative of a meniscus injury in the knee. The nurse will expect to observe a positive Tinel’s sign and a positive Phalen’s test in a client with carpal tunnel syndrome.
Answer 4: The nurse will not expect to observe a negative Lachman’s test in a client with carpal tunnel syndrome. A Lachman’s test is performed to test for anterior cruciate ligament injuries in the knee. The nurse will expect to observe a positive Tinel’s sign and a positive Phalen’s test in a client with carpal tunnel syndrome.
Bottom Line
Clinical manifestations of carpal tunnel syndrome include weakness, numbness, decreased sensation, pain, positive Tinel’s sign, and positive Phalen’s test of the affected hand.
For more information, see:
- Lewis, S., Bucher, L., Heitkemper, M., & Harding, M. (2018). Medical-surgical nursing: Assessment and management of clinical problems (10th ed., pp. 1465-1466). St. Louis, MO: Elsevier.
- National Institute of Neurological Disorders and Stroke (2018). Carpal tunnel syndrome fact sheet.
- Ignatavicius, D. (2021). Concepts of care for patients with musculoskeletal trauma. In Ignatavicius, D., Workman, D., Rebar, C., & Heimgartner, N. (Eds.), Medical-surgical nursing: Concepts for interprofessional collaborative care (10th ed., pp. 1051-1053). St. Louis, MO: Elsevier.
- Kothari, M. (2020). Carpal tunnel syndrome: Treatment and prognosis. In UpToDate, Shefner, J., & Goddeau, R. (Eds.). Waltham, MA
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