Which test would be done to check balance in a patient with ataxia?

Appeared in: PGIMER Sangrur NO - 2023

Explanation

The Romberg test is a specific neurological assessment used to evaluate balance and proprioception.
Ataxia is a condition involving lack of coordination, and assessing balance is a key part of its evaluation.
The test procedure involves observing a patient's stability while standing with feet together, first with eyes open and then with eyes closed.
A loss of balance when the eyes are closed (a positive Romberg test) points towards sensory ataxia, where the sense of body position is impaired.

Option B: The Braden test (or scale) is an assessment tool for predicting the risk of developing pressure ulcers; it does not measure balance or neurological function.
Option C: The Schick test is an immunological skin test used to determine susceptibility to diphtheria. It has no connection to assessing balance or ataxia.
Option D: The Weber test is a quick screening test for hearing. It uses a tuning fork to help differentiate between conductive and sensorineural hearing loss.

Clinical Relevance

Nursing practice connection: Use the key finding related to Neurological assessment for balance and coordination to guide bedside assessment, documentation, and the next nursing action.
Assessing balance with the Romberg test is a critical nursing skill for identifying fall risk in patients with neurological conditions like ataxia, peripheral neuropathy, or vestibular disorders.
A positive Romberg test helps differentiate sensory ataxia (problem with proprioception) from cerebellar ataxia, which can guide further diagnostic workup and specific therapeutic interventions.
Patient safety is paramount. Always perform this test in an environment free of hazards and be prepared to support the patient to prevent injury from a fall.

How to Approach the Question

First, identify the key concepts in the question stem: 'check balance' and 'ataxia'.
Recognize that ataxia is a neurological disorder that directly impairs balance and coordination.
The question asks for the specific clinical test used to assess this function.
Systematically review each option to determine its purpose.
Recall or deduce that the Braden test is for pressure ulcers, the Schick test is for diphtheria, and the Weber test is for hearing.
Identify the Romberg test as the classic neurological test for balance and proprioception, making it the correct answer for a patient with ataxia.

Concept Tested & Keywords

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E6 Nursing Brunner Adult Health 3SA Vol 2 Part 2 p. 9-11

E6 Nursing Fundamentals Potter Perry 12e Part 3 p. 125-127

E6 Medicine Harrison 22e Part 2 p. 1286-1288

Practise the full PGIMER Sangrur NO - 2023

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