Question

The nurse on the orthopedic unit is observing a student perform an assessment of a client with a fractured tibia who is in skin traction. Which assessment result indicates adequate function of the peroneal nerve? A. Plantar flexion of the foot B. Inversion of the foot C. Dorsiflexion of the foot D. Strong posterior tibial pulses

Short answer

Answer: Dorsiflexion of the foot

Step-by-step solution

Understand the peroneal nerve function

The peroneal nerve, also referred to as the fibular nerve, is a branch of the sciatic nerve that innervates the muscles responsible for movements, including dorsiflexion and eversion of the foot. Understanding the function of the peroneal nerve helps to evaluate each available option in the question.

Evaluate each option

Now that we understand the peroneal nerve's function, let's evaluate each option: A. Plantar flexion of the foot - This movement is mainly controlled by the tibial nerve, not the peroneal nerve. B. Inversion of the foot - Although the peroneal nerve has some role in this movement, it's not the primary function for this nerve. Inversion of the foot is mainly controlled by the tibialis anterior muscle, which is innervated by the deep fibular (peroneal) nerve, a branch of the common fibular nerve. C. Dorsiflexion of the foot - This movement is mainly controlled by the peroneal nerve, specifically the deep fibular (peroneal) nerve division. The tibialis anterior muscle is responsible for this action and is innervated by the deep fibular nerve, suggesting that this option is the most appropriate answer. D. Strong posterior tibial pulses - This assessment is unrelated to the peroneal nerve function, as it evaluates blood flow, not nerve innervation.

Select the correct answer

Based on our evaluation, the correct answer is: C. Dorsiflexion of the foot

Key concepts

NCLEX-RN Exam Preparation

When preparing for the NCLEX-RN exam, understanding how to assess nerve function is essential. The NCLEX-RN tests a nurse’s ability to make judicious decisions regarding patient care, including orthopedic and neurological assessments. To adequately prepare for the exam, it's important to study the anatomy and function of nerves, and how they correlate with clinical assessments.

For example, in an orthopedic context, recognizing the movement associated with the peroneal nerve—dorsiflexion of the foot—can help identify the correct answer to a related NCLEX question. Memorization of facts is less valuable than a deep understanding of concepts, as the exam often presents practical scenarios that require critical thinking. Nursing candidates should regularly engage with practice questions, understand the rationale behind each answer, and familiarize themselves with the format of the exam.

Resources such as NCLEX review books, online practice tests, and study groups can significantly enhance preparation. Furthermore, time management and test-taking strategies are essential components for success on the exam.

Orthopedic Nursing Assessment

In orthopedic nursing assessment, the focus is on the musculoskeletal system, including bones, muscles, joints, tendons, and ligaments. An important part of the assessment is to evaluate the function of nerves that innervate these structures. For nurses working on an orthopedic unit, it's crucial to differentiate between the functions of various nerves to properly assess and monitor for signs of injury or complications.

The peroneal nerve, as outlined in the exercise, is assessed by checking for the ability to dorsiflex the foot. This can be impacted in cases such as a fractured tibia, especially in patients in skin traction. Therefore, a thorough assessment also involves checking for the ability to perform eversion, sensation over the dorsum of the foot, and between the first and second toes. Nurses should also observe for any swelling, deformities, and alterations in gait or mobility, indicating potential nerve impairment.

Neurological Assessment in Nursing

Neurological assessments in nursing are comprehensive evaluations that include checking mental status, cranial nerves, motor and sensory function, and reflexes. Part of this assessment includes peripheral nerves such as the peroneal nerve. When assessing nerve function, nurses should look for involuntary movements, asymmetry, and changes in sensation or strength.

In the context of the peroneal nerve assessment, a nurse would ask the patient to dorsiflex the foot against resistance and check for the strength of this movement. Additionally, it's vital to assess for any paresthesia or numbness along the nerve's distribution. Alertness to changes in neurological function can lead to early detection of complications and timely interventions.

As nurses conduct these assessments, they must document findings accurately and communicate any abnormalities to the healthcare team. Continuous education on neurological assessment tools and techniques can help nurses stay proficient in recognizing and responding to neurological deficits.