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 B

Explanation

Choice A reason:
Purulent drainage at the intravenous site access site would indicate a more severe infection, possibly grade 3 or 4 on the Infusion Nurses Society's phlebitis scale. This would be associated with more advanced symptoms such as pus formation, which is not characteristic of grade 1 phlebitis.

Choice B reason:
Redness at the intravenous access site with pain is indicative of grade 1 phlebitis according to the Infusion Nurses Society's phlebitis scale. This grade is characterized by erythema and possible pain at the site of the IV insertion, without more severe symptoms such as swelling or streak formation.

Choice C reason:
Red streaks on the affected extremity suggest a progression of the inflammatory response, potentially indicating a higher grade of phlebitis, such as grade 2 or 3. This symptom suggests that the inflammation is spreading along the vein, which is more serious than grade 1 phlebitis.

Choice D reason:
A palpable venous cord in the affected extremity would also suggest a more severe form of phlebitis, likely grade 3. This occurs when a thrombus forms along with inflammation of the vein, leading to a palpable cord-like structure.

A. "Use closed-ended questions when obtaining the health history." B. "A client's reproductive health history is not needed for counseling purposes." C. "Refer the client to genetic counseling if they have had an STI." D. "Ask about the client's exposure to any past or present STIs."

Correct Answer is D

Explanation

Choice A reason:
Using closed-ended questions when obtaining a health history can be limiting and may not provide the full context of the patient's sexual health risks. Open-ended questions are generally recommended to encourage a more comprehensive discussion about sexual behaviors and risks.

Choice B reason:
A client's reproductive health history is crucial for counseling purposes. It provides insight into potential risks for STIs and helps tailor the counseling to the client's specific needs and circumstances.

Choice C reason:
Referring a client to genetic counseling for having had an STI is not typically necessary. Genetic counseling is more relevant for hereditary conditions and is not a standard part of STI management.

Choice D reason:
Asking about a client's exposure to past or present STIs is essential in STI counseling. It helps assess the client's risk level and informs the necessary prevention and treatment strategies.

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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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Correct Answer is B

Explanation

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Correct Answer is D

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