In a trauma emergency, a nurse has received a patient. To feel the skin temperature of her patient, the nurse uses?

Appeared in: MP CHO - 2022

Explanation

The dorsal surface (back) of the hand is the most appropriate part for assessing skin temperature.
This area has thinner skin compared to the palm, making it more sensitive to subtle variations in temperature.
Using the dorsum of the hand is a standard nursing practice for quick and accurate temperature assessment during a physical examination.
Comparing the temperature of symmetrical body parts (e.g., both arms) can help differentiate between localized and systemic temperature changes.

Option A: The base of the hand, specifically the ulnar surface, is less sensitive to temperature changes.
Option B: Fingertips are not the most sensitive part of the hand for assessing temperature.
Option C: The palmar surface is less sensitive to temperature than the dorsal surface due to thicker skin.

Visual 1: Diagram - An illustration of a hand with labels pointing to the dorsal surface, fingertips, and palmar surface, each with a brief description of its primary use in palpation (temperature, texture, vibration).

Clinical Relevance

Nursing practice connection: Prioritize focused assessment, early escalation, and real-time monitoring when managing The concept tested is the correct palpation technique for assessing skin temperature as part of a physical examination in acute care settings.
In a trauma patient, cool and clammy skin is a critical sign of shock, indicating peripheral vasoconstriction and poor perfusion, which requires immediate intervention.
Conversely, hot and dry skin could suggest sepsis or heatstroke, guiding the nurse toward different diagnostic and treatment pathways.
What if? If the nurse suspected a patient had an arteriovenous (AV) fistula for dialysis, she would use the palmar surface of her hand to palpate for a 'thrill' (a buzzing or vibrating sensation), not the dorsal surface.

How to Approach the Question

First, identify the key task in the question: 'feel the skin temperature'.
Next, recall the principles of physical assessment, specifically the different techniques of palpation.
Differentiate the specific uses for various parts of the hand (fingertips, dorsal surface, palmar surface).
Match the task (assessing temperature) with the part of the hand known to be most sensitive to temperature changes.
Eliminate the other options by remembering what they are used for (e.g., fingertips for texture, palmar surface for vibration).

Concept Tested & Keywords

Concept Tested: The concept tested is the correct palpation technique for assessing skin temperature as part of a physical examination.
Stem keywords: trauma emergency, feel, skin temperature
Lead-in keywords: uses
Clinical cues: The setting of a 'trauma emergency' highlights the need for rapid and accurate assessment of vital signs, including skin temperature, to detect conditions like shock.

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Practise the full MP CHO - 2022

Attempt every question from this paper in a timed mock, then review the full solution for each one.