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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason:
Dark hair is not a recognized risk factor for developing malignant melanoma. Melanoma is more commonly associated with individuals having fair skin, light hair, and light-colored eyes because they have less melanin to protect their skin from UV radiation.
Choice B reason:
While female gender is not a direct risk factor for malignant melanoma, it is important to note that melanoma rates can vary between genders at different ages. Generally, before age 50, melanoma rates are higher in women, but by age 65, rates are twice as high in men.
Choice C reason:
A history of chronic skin irritation or inflammation can potentially increase the risk of developing skin cancer, including melanoma. Chronic inflammation can lead to DNA damage and contribute to the development of cancerous cells.
Choice D reason:
Age 19 to 30 years is not considered a high-risk age group for malignant melanoma. The risk of melanoma increases with age, and it is most frequently diagnosed in older adults, although it is not uncommon in younger people.
Correct Answer is D
Explanation
Choice A reason:
Hyperplasia is an increase in the number of cells in an organ or tissue, which can lead to its enlargement. While hyperplasia can be a response to a stimulus and is not necessarily precancerous, it does not describe the abnormal changes in the shape, size, and organization of mature cells.
Choice B reason:
Metaplasia is a reversible change in which one differentiated cell type is replaced by another cell type. This process can be a response to chronic irritation and inflammation, and while it may predispose cells to cancerous changes, it is not in itself a precancerous condition.
Choice C reason:
The term 'malignant' refers to cancerous cells that have the ability to invade and destroy nearby tissue and spread to other parts of the body. The description of the cells as 'moderately abnormal' does not indicate that the cells are malignant but rather that they are showing signs of potentially precancerous changes.
Choice D reason:
Dysplasia refers to the presence of abnormal cells within a tissue or organ. It is characterized by changes in cell size, shape, uniformity, arrangement, and structure, particularly when such changes are strongly suggestive of developing neoplasia, or new, abnormal growth. In the context of a Pap smear, dysplasia is indicative of precancerous changes and is the term used to describe the abnormal development of cells on the cervix.
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