The nurse asks the client to "place one hand behind the back and touch the shoulder blade" in the position shown. The patient explains he cannot perform the movement. What MOST likely is causing the patient decreased range of motion (ROM) in this joint?
Pectoralis major tear
Arthritis
Rotator Cuff Tendinitis
Gout
The Correct Answer is C
A) Pectoralis major tear: A tear of the pectoralis major muscle would likely cause pain and weakness, particularly in activities involving pushing or lifting. While it may affect shoulder movements, it is less likely to specifically impair the ability to reach behind the back and touch the shoulder blade compared to rotator cuff issues.
B) Arthritis: Arthritis, particularly osteoarthritis, can cause decreased range of motion and pain in the shoulder joint. However, the specific movement described—placing one hand behind the back to touch the shoulder blade—is most commonly affected by issues with the rotator cuff rather than arthritis alone.
C) Rotator Cuff Tendinitis: Rotator cuff tendinitis is a common cause of shoulder pain and decreased range of motion, particularly affecting movements that require lifting the arm or reaching behind the back. Tendinitis in the rotator cuff can lead to pain and difficulty performing the movement described due to inflammation and impingement of the tendons.
D) Gout: Gout is a type of arthritis caused by the accumulation of uric acid crystals in the joints, often affecting the big toe but can affect other joints. While it can cause joint pain and inflammation, it is less likely to specifically impair the shoulder movement described compared to rotator cuff tendinitis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Bell's palsy: Bell's palsy is characterized by sudden, unilateral facial weakness or paralysis. It does not cause the specific physical signs described in the question, such as a "moon" face, buffalo hump, or velvety discoloration around the neck.
B. Myxedema: Myxedema is associated with severe hypothyroidism and can lead to symptoms such as facial swelling and changes in skin texture, but it does not typically cause a round face, buffalo hump, or velvety neck discoloration. The velvety discoloration around the neck is more characteristic of insulin resistance rather than hypothyroidism.
C. Cushing's syndrome: Cushing's syndrome is caused by excess cortisol and is known for the characteristic signs described. A "moon" face, buffalo hump, and skin changes such as velvety discoloration (often termed "acanthosis nigricans") are hallmark features of this condition. These symptoms align with the body’s response to prolonged high levels of cortisol.
D. Scleroderma: Scleroderma involves skin thickening and tightening, primarily affecting the hands and face, but it does not typically cause a "moon" face, buffalo hump, or velvety neck discoloration. The changes in scleroderma are more related to skin fibrosis and less to the specific physical features listed.
Correct Answer is D
Explanation
A) Light palpation of the abdominal right lower quadrant: While light palpation is generally the first step in an abdominal examination to assess for tenderness or abnormalities, the presence of pain with deep palpation of the right kidney indicates a more specific concern. This may warrant further investigation related to the kidney rather than focusing on the lower quadrant.
B) Auscultate sounds in the abdominal left lower quadrant: Auscultation is typically done before palpation to assess bowel sounds and other abnormalities. However, given the specific complaint of pain in the right kidney area, the priority should be addressing the suspected kidney issue rather than auscultating another quadrant.
C) Deep palpation of the abdominal left upper quadrant: Deep palpation in another quadrant is not immediately relevant to the complaint of pain in the right kidney. Instead, it’s crucial to focus on assessing the area directly related to the client's symptoms.
D) First percussion of the costovertebral angles: Percussion of the costovertebral angles (CVA) is a specific technique used to assess kidney tenderness and is appropriate for evaluating the potential causes of the pain in the right kidney. This examination can help determine if the pain is due to conditions like kidney infection or inflammation. Therefore, it is the most relevant next step in this situation.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today