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 A

Explanation

Choice A reason:
Morphine is an opioid analgesic that can cause a decrease in gastrointestinal motility, leading to constipation and exacerbation of paralytic ileus, a condition where there is a cessation of peristalsis in the intestine. In the case of paralytic ileus, the intestinal contents cannot move, which can lead to bowel distention, pain, and further complications. Therefore, morphine is contraindicated in clients with paralytic ileus due to the risk of worsening the condition..

Choice B reason:
While morphine can suppress cough and provide some relief in respiratory conditions, it is not contraindicated in bronchitis pleurisy unless respiratory depression is present. However, caution is advised as morphine can cause respiratory depression and should be used carefully in patients with underlying respiratory disorders.

Choice C reason:
Morphine is often used in the management of acute myocardial infarction (MI) to relieve chest pain, reduce anxiety, and decrease the workload on the heart by lowering blood pressure and heart rate. It is not contraindicated in MI; in fact, it can be beneficial in managing the symptoms associated with MI.

Choice D reason:
Postoperative pain management following hip arthroplasty often includes opioids like morphine. Morphine is not contraindicated in this situation and can be used to control postoperative pain, provided that the patient's respiratory function is closely monitored

A. Gingivitis B. Xerostomia C. Candidiasis D. Halitosis

Correct Answer is C

Explanation

Choice A reason:
Gingivitis, an inflammation of the gums, is not specifically associated with a decreased CD4+ T-cell count. While individuals with HIV/AIDS may have an increased risk for periodontal diseases due to a compromised immune system, gingivitis is not directly linked to the CD4+ T-cell count¹.

Choice B reason:
Xerostomia, or dry mouth, can be a side effect of medications or secondary to other conditions but is not an infectious condition. It is not directly related to a decreased CD4+ T-cell count, although it may be more common in individuals with HIV/AIDS due to various factors, including medication side effects¹.

Choice C reason:
Candidiasis, also known as oral thrush, is a common opportunistic infection in individuals with HIV/AIDS, especially when the CD4+ T-cell count is significantly decreased. It is caused by the fungus Candida and can lead to white patches in the mouth, soreness, and difficulty swallowing.

Choice D reason:
Halitosis, or bad breath, is not an infectious condition and is not directly associated with a decreased CD4+ T-cell count. It can result from various factors, including oral hygiene, diet, or underlying health conditions, but it is not a specific concern related to HIV/AID.

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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?

Nursing Test Bank

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