Patient Data
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<p>For each assessment finding, click to indicate whether the findings from the client's assessment are generally associated with rotator cuff injury and/or humeral fracture. Each column must have at least one response selected.</p>
Reduced pulse distal to injury
Decreased range of motion
Coolness of skin
Pain with movement
1+ strength in left upper extremity
The Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A,B"},"C":{"answers":"B"},"D":{"answers":"A,B"},"E":{"answers":"A"}}
Reduced pulse distal to injury: A humeral fracture can damage surrounding vasculature, especially the brachial artery, leading to compromised circulation. This results in weak or absent distal pulses, which requires urgent evaluation for possible neurovascular compromise.
• Decreased range of motion: Both rotator cuff injury and humeral fracture commonly cause impaired shoulder mobility. A rotator cuff tear limits abduction and overhead activities, while a fracture mechanically restricts movement due to pain, swelling, or bone displacement.
• Coolness of skin: A humeral fracture can impair blood flow by compressing or injuring vessels, producing ischemic changes such as cool skin. This finding signals inadequate perfusion, which can progress to serious complications if untreated.
• Pain with movement: Both a rotator cuff tear and humeral fracture are associated with pain on movement. In a tear, the pain stems from tendon injury and inflammation, while in a fracture, bone disruption and soft tissue trauma intensify pain when the joint is moved.
• 1+ strength in left upper extremity: Weakness in the affected arm is more typical of rotator cuff injury, as tendon disruption limits muscular function and reduces lifting ability. This differs from fracture-related pain, where strength may be preserved but restricted by pain.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"dropdown-group-1":"A"}
Explanation
A. Opioid analgesics: The client reports severe, sharp, stabbing pain with breathing and movement due to multiple rib fractures. Opioids are effective for managing moderate to severe pain, allowing the client to breathe deeply, cough effectively, and reduce the risk of complications such as atelectasis or pneumonia.
B. Antibiotics: There is no evidence of infection in this client’s presentation. Antibiotics are not indicated for pain management related to rib fractures or atelectasis without infection.
C. Antacids: Antacids are used to treat gastrointestinal upset or acid-related conditions. They do not address musculoskeletal pain or improve respiratory function in rib fractures.
D. Bronchodilators: Bronchodilators relieve airway constriction in conditions like asthma or COPD. This client’s shallow breathing is due to pain, not bronchospasm, so bronchodilators are not appropriate.
E. Antihypertensives: While the client has slightly elevated blood pressure, antihypertensives do not relieve pain or improve respiratory effort, making them irrelevant for the acute management of rib fracture–related symptoms.
Correct Answer is A
Explanation
A. Monitor an IV infusion rate on an established schedule: This task is appropriate for a UAP because it involves observation and reporting rather than clinical decision-making. The UAP can ensure the IV is running at the prescribed rate and alert the nurse if any deviations occur.
B. Titrate oxygen to the prescribed parameters: Adjusting oxygen requires clinical judgment and assessment of respiratory status, including oxygen saturation and signs of hypoxia. This is a nursing responsibility and cannot be delegated to a UAP.
C. Insert a urinary catheter for an uncomplicated client: Catheter insertion is a sterile procedure that requires nursing knowledge and skill. Delegation to a UAP is not permitted due to the risk of infection and need for proper technique.
D. Procure platelet products from the blood bank: Obtaining blood products involves verification of patient identifiers, blood type, and compatibility, which are nursing responsibilities. This task requires clinical accountability and cannot be delegated to a UAP.
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