A nurse is caring for a client who is postoperative following shoulder surgery. The client has a prescription to keep the affected arm adducted. Which of the following instructions should the nurse provide the client?

Use a pillow to prop your arm close to the ear.

Position your arm with the shoulder at a 90-degree angle.

Hold the arm against the side of your body.

Keep your arm bent at the elbow

Answer and Explanation

The Correct Answer is C

A. Use a pillow to prop your arm close to the ear. This instruction would position the arm in abduction, not adduction. Adduction involves bringing the arm closer to the body, not away from it.

B. Position your arm with the shoulder at a 90-degree angle. This would also position the arm in abduction, as a 90-degree angle would place the arm away from the body.

C. Hold the arm against the side of your body. Adduction means bringing the arm closer to the midline of the body, which is achieved by holding the arm against the side.

D. Keep your arm bent at the elbow. This instruction focuses on the elbow rather than the shoulder. Adduction refers to the shoulder's position relative to the body.

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Correct Answer is B

Explanation

A. Hypovolemic shock: While disorientation and low SaO2 could be signs of hypovolemic shock, the presence of petechiae is not a typical symptom. Hypovolemic shock is usually associated with blood loss and does not present with petechiae.

B. Fat embolism: Fat embolism syndrome (FES) is a common complication after fractures, especially long bones like the tibia. The classic triad includes respiratory distress, neurological symptoms, and petechiae, making this the most likely diagnosis.

C. Thrombophlebitis: Thrombophlebitis involves inflammation of a vein due to a blood clot, typically presenting with localized pain, swelling, and redness, not petechiae or disorientation.

D. Osteomyelitis: Osteomyelitis is an infection of the bone. Symptoms include pain, fever, and redness over the infected area, but it does not typically present with disorientation, low SaO2, or petechiae.

A. Pallor of the affected extremity B. Alteration in the appearance of the shoulder joint C. Numbness of the thumb and index finger D. Increased pain with lifting the arm

Correct Answer is D

Explanation

A. Pallor of the affected extremity: Pallor usually indicates vascular issues rather than a rotator cuff injury.

B. Alteration in the appearance of the shoulder joint: Visible deformity may suggest a dislocation or fracture, not specifically a rotator cuff injury.

C. Numbness of the thumb and index finger: Numbness of the thumb and index finger is more likely related to nerve compression, such as carpal tunnel syndrome.

D. Increased pain with lifting the arm: This is characteristic of a rotator cuff injury, which typically causes pain and weakness with shoulder movements, especially lifting the arm.

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A nurse is caring for a client who is postoperative following shoulder surgery. The client has a prescription to keep the affected arm adducted. Which of the following instructions should the nurse provide the client?

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Correct Answer is B

Explanation

A nurse is collecting data from a client who reports shoulder pain. Which of the following findings should cause the nurse to suspect that the client has a rotator cuff injury?

Correct Answer is D

Explanation

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