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?

Pallor of the affected extremity

Alteration in the appearance of the shoulder joint

Numbness of the thumb and index finger

Increased pain with lifting the arm

Answer and Explanation

The Correct Answer is D

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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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. Fat embolism syndrome B. Osteomyelitis C. Pulmonary embolism D. Acute compartment syndrome

Correct Answer is D

Explanation

A. Fat embolism syndrome: Fat embolism syndrome can occur after fractures, particularly long bone fractures, but it typically presents with symptoms such as respiratory distress, petechiae, and neurological symptoms rather than severe pain and tingling in the affected extremity.
B. Osteomyelitis. Osteomyelitis, an infection of the bone, is characterized by localized pain, swelling, and fever but does not usually present immediately with severe pain and tingling following a fracture.
C. Pulmonary embolism. Pulmonary embolism is a blockage in one of the pulmonary arteries in the lungs and presents with chest pain, shortness of breath, and possibly coughing up blood, not localized extremity pain and tingling.
D. Acute compartment syndrome. Acute compartment syndrome is a serious condition that involves increased pressure within a muscle compartment. It can lead to severe pain, tingling, and decreased blood flow, which is consistent with the symptoms described.

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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?

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Correct Answer is B

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