A nurse in a provider's office is assessing a client who reports shoulder pain. Which of the following findings by the nurse indicates a rotator cuff injury?

Inability to abduct the arm at the shoulder.

Negative drop arm test.

Alteration in the contour of the joint.

A positive Tinel's sign.

Answer and Explanation

The Correct Answer is A

Choice A reason:

The inability to abduct the arm at the shoulder is a classic sign of a rotator cuff injury. The rotator cuff is responsible for stabilizing the shoulder joint and aiding in various movements, including abduction. When there is a tear or significant weakness in the rotator cuff muscles, especially the supraspinatus muscle, the patient may be unable to lift the arm away from the body or may experience pain while doing so.

Choice B reason:

A negative drop arm test would actually indicate that there is no rotator cuff injury. The drop arm test is performed by asking the patient to fully abduct the arm to 90 degrees and then slowly lower it. If the patient can control the motion and lower the arm smoothly, the test is negative. A positive drop arm test, where the patient cannot control the descent of the arm, would suggest a rotator cuff tear.

Choice C reason:

While an alteration in the contour of the joint may indicate some form of shoulder pathology, it is not specific to a rotator cuff injury. Changes in the contour could be due to various conditions, including dislocation, arthritis, or other musculoskeletal disorders.

Choice D reason:

A positive Tinel's sign is used to diagnose nerve compression or nerve damage, not rotator cuff injuries. It is performed by tapping over the course of a nerve to elicit a tingling sensation or pain in the distribution of the nerve. This sign is commonly associated with conditions like carpal tunnel syndrome.

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Correct Answer is C

Explanation

Choice A reason:
Dark hair is not a recognized risk factor for developing malignant melanoma. Melanoma is more commonly associated with individuals having fair skin, light hair, and light-colored eyes because they have less melanin to protect their skin from UV radiation.

Choice B reason:
While female gender is not a direct risk factor for malignant melanoma, it is important to note that melanoma rates can vary between genders at different ages. Generally, before age 50, melanoma rates are higher in women, but by age 65, rates are twice as high in men.

Choice C reason:
A history of chronic skin irritation or inflammation can potentially increase the risk of developing skin cancer, including melanoma. Chronic inflammation can lead to DNA damage and contribute to the development of cancerous cells.

Choice D reason:
Age 19 to 30 years is not considered a high-risk age group for malignant melanoma. The risk of melanoma increases with age, and it is most frequently diagnosed in older adults, although it is not uncommon in younger people.

A. The client should anticipate scheduling the procedure 5 days prior to menstruation. B. The client might experience diarrhea as a result of the procedure. C. The client should be on a liquid diet for 1 day following the procedure. D. The client might experience shoulder pain following the procedure.

Correct Answer is D

Explanation

Choice A reason:Scheduling the procedure five days before the expected menses would place it in the late proliferative phase, which risks missing ongoing menstrual bleeding and could coincide with implantation if the client ovulated early. Best practice is to perform the test after menstruation ends but before ovulation—usually within 12 days of the first day of the last period—to ensure the client is not pregnant.

Choice B reason:
Diarrhea is not a common side effect of HSG. The procedure involves the insertion of a dye into the uterine cavity to visualize the fallopian tubes and uterus via X-ray. While some discomfort, cramping, or spotting may occur, diarrhea is not typically expected.

Choice C reason:
There is no requirement for a client to be on a liquid diet following an HSG procedure. The client can usually resume normal activities and diet immediately after the procedure unless otherwise instructed by their healthcare provider.

Choice D reason:
Referred shoulder pain can occur when contrast fluid spills through a patent tube into the peritoneal cavity, irritating the diaphragm’s undersurface and eliciting pain perceived at the shoulder via the phrenic nerve. Clients should be advised this is normal, short-lived, and relieved by positioning or mild analgesics.

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A nurse in a provider's office is assessing a client who reports shoulder pain. Which of the following findings by the nurse indicates a rotator cuff injury?

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