Today’s NCLEX-RN® question of the day focuses on carpal tunnel. Do you know the answer? Let’s find out!
The nurse is caring for a patient being evaluated for carpal tunnel syndrome. The patient states, “I read about the Phalen maneuver online. What is this?” Which is the best response by the nurse?
A. “This test involves a special X-ray of your forearm and hand.”
B. “This test involves your health care provider repeatedly tapping on the wrist.”
C. “This test involves the application of a nerve stimulator to your wrist.”
D. “This test involves flexing both wrists at 90 degrees for over a minute.”
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The correct answer to today’s NCLEX-RN® Question is…
D. “This test involves flexing both wrists at 90 degrees for over a minute.”
Rationale: The Phalen maneuver is a test where both wrists are flexed to 90 degrees and maintained in that position for more than one minute. When the symptoms of carpal tunnel syndrome are reproduced, the test is considered positive.
Main Takeaway
Carpal tunnel syndrome is a condition in which the median nerve is compressed inside the carpal tunnel of the wrist, causing pain and tingling in the hand. The diagnosis of carpal tunnel syndrome starts with the patient’s history and physical assessment, which includes two tests. The first is the Phalen maneuver, where both wrists are flexed to 90 degrees and maintained for more than one minute. When the symptoms of carpal tunnel syndrome are reproduced, the test is considered positive. Another test, known as the Tinel test, is performed by repeatedly percussing firmly over the carpal tunnel, and if carpal tunnel symptoms appear, that is considered a positive test. Electrophysiological testing of the median nerve is used to confirm carpal tunnel syndrome diagnosis and to assess the degree of nerve damage.
Incorrect Answer Explanations
A. “This test involves a special X-ray of your forearm and hand.”
Rationale: Although the Phalen maneuver is a diagnostic test performed to rule out carpal tunnel syndrome, it does not involve imaging studies like X-rays.
B. “This test involves your health care provider repeatedly tapping on the wrist.”
Rationale: Repeated taps over the carpal tunnel by the healthcare provider is known as the Tinel test. This is another test to evaluate for signs and symptoms of carpal tunnel syndrome but is not the same as the Phalen maneuver.
C. “This test involves the application of a nerve stimulator to your wrist.”
Rationale: Although the Phalen maneuver is a diagnostic test performed to rule out carpal tunnel syndrome, it does not involve the application of a nerve stimulator. Instead, electrophysiological testing of the median nerve is used to assess the degree of nerve damage through a nerve stimulator.
Want to learn more about this topic?
Watch the Osmosis video: Carpal tunnel syndrome: Nursing
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