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.
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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Related Questions
Correct Answer is A
Explanation
Choice A reason:
Difficulty with abduction of the arm at the shoulder is a common finding in clients with a rotator cuff injury. The rotator cuff is a group of muscles and tendons that stabilize the shoulder joint and facilitate its movement. When these muscles or tendons are injured, movements such as lifting the arm away from the body (abduction) can become painful and difficult.
Choice B reason:
Alteration in the contour of the joint is not typically associated with a rotator cuff injury. This finding is more indicative of conditions that cause changes in the bone structure, such as arthritis or dislocation.
Choice C reason:
A positive Tinel's sign is used to diagnose nerve compression or nerve damage, particularly in conditions like carpal tunnel syndrome. It is not a test used to assess rotator cuff injuries.
Choice D reason:
A negative drop arm test would suggest that the client does not have a rotator cuff injury. The drop arm test is performed by having the client lift the arm to 90 degrees and then slowly lower it. If the client can control the motion and lower the arm smoothly, the test is negative. A positive drop arm test, where the client cannot control the descent of the arm, would indicate a rotator cuff injury.
Correct Answer is ["B","C","E"]
Explanation
Choice A reason:
Polyuria, or excessive urination, is not typically a direct complication of a cervical spinal cord injury. Polyuria can be related to other conditions such as diabetes or the use of diuretics.
Choice B reason:
A weakened gag reflex can be a complication of a cervical spinal cord injury, especially if the injury affects the nerves that supply the muscles involved in swallowing. This can increase the risk of aspiration and requires careful monitoring.
Choice C reason:
Hypotension, or low blood pressure, is a common complication following a spinal cord injury due to the disruption of the autonomic pathways that control blood pressure. This condition, known as neurogenic shock, can occur in the acute phase following the injury.
Choice D reason:
Hyperthermia, or elevated body temperature, is not a common direct complication of a cervical spinal cord injury. However, the injury can disrupt temperature regulation, leading to difficulty in either staying warm or cooling down, depending on the environment and level of injury.
Choice E reason:
An absence of bowel sounds can indicate a complication of a cervical spinal cord injury, as the injury may disrupt the normal functioning of the bowel. This can lead to ileus or bowel obstruction, which requires prompt medical attention.
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