Question 1

When asked why the patient is receiving the methylprednisolone,the nurse explains that the drug is used in the patient with a SCI to:

Accepted Answer

A)  Reduce spinal cord cellular damage. 
B)  Counteract spinal shock. 
C)  Increase blood supply to the injured cord. 
D)  Enhance sexual function. 
A)  Reduce spinal cord cellular damage. 
B)  Counteract spinal shock. 
C)  Increase blood supply to the injured cord. 
D)  Enhance sexual function.

Question 2

The nurse refers to the ___________ __________ to assess the extent of sensory loss and specific nerve root enervation.

Accepted Answer

Dermatone chart
The assessment

Question 3

After spinal shock has been resolved,the indwelling catheter is removed.The nurse tells the patient to expect the bladder to empty by:

Accepted Answer

A)  Manual expression (Credé method) 
B)  Spontaneous reflexive action 
C)  Normal voluntary control 
D)  Self-catheterization 
A)  Manual expression (Credé method) 
B)  Spontaneous reflexive action 
C)  Normal voluntary control 
D)  Self-catheterization

Question 4

On admission to the emergency department,the patient with a C5 compression fracture can move only his head and has flaccid paralysis of all extremities.The distraught family asks if the paralysis is permanent.The nurse's best response would be:

Accepted Answer

A)  "Yes. In all likelihood, the paralysis is probably permanent." 
B)  "No. Significant recovery of function should occur in a few days." 
C)  "It is too early to tell. When the spinal shock subsides, we will know more." 
D)  "You should talk to your physician about things of that nature." 
A)  "Yes. In all likelihood, the paralysis is probably permanent." 
B)  "No. Significant recovery of function should occur in a few days." 
C)  "It is too early to tell. When the spinal shock subsides, we will know more." 
D)  "You should talk to your physician about things of that nature."

Question 5

The Brown-Séquard syndrome results in which neurologic deficit?

Accepted Answer

A)  Bilateral loss of pain sensation below the level of injury 
B)  Bilateral loss of temperature and motor function below the level of injury 
C)  Motor and sensory loss in the upper extremities only 
D)  Ipsilateral loss of motor function and contralateral loss of pain sensation and temperature 
A)  Bilateral loss of pain sensation below the level of injury 
B)  Bilateral loss of temperature and motor function below the level of injury 
C)  Motor and sensory loss in the upper extremities only 
D)  Ipsilateral loss of motor function and contralateral loss of pain sensation and temperature

Question 6

The nurse explains that the major advantage of the halo device over the Gardner-Wells tongs is that the halo device:

Accepted Answer

A)  Separates the cervical vertebrae. 
B)  Allows the patient out of bed. 
C)  Aligns the cervical spine. 
D)  Relieves pain. 
A)  Separates the cervical vertebrae. 
B)  Allows the patient out of bed. 
C)  Aligns the cervical spine. 
D)  Relieves pain.

Question 7

A distressed family member asks about the purpose of the Gardner-Wells tongs.The most helpful explanation by the nurse would be that the Gardner-Wells tongs:

Accepted Answer

A)  Compress the cervical vertebrae. 
B)  Immobilize the head. 
C)  Allow the patient to be moved out of bed. 
D)  Align the cervical vertebrae. 
A)  Compress the cervical vertebrae. 
B)  Immobilize the head. 
C)  Allow the patient to be moved out of bed. 
D)  Align the cervical vertebrae.

Question 8

The nurse explains to the family of a patient with quadriplegia that intravenous (IV)drugs are the most effective method of administration,because drugs injected intramuscularly (IM)are:

Accepted Answer

A)  Too concentrated 
B)  Too irritating to poorly perfused tissue 
C)  Not absorbed well below the level of the injury 
D)  Too small a dose to be effective 
A)  Too concentrated 
B)  Too irritating to poorly perfused tissue 
C)  Not absorbed well below the level of the injury 
D)  Too small a dose to be effective

Question 9

The nurse cautions an 85-year-old golfer that he should take care to protect his back during his backswing because the intervertebral disks in older adults undergo changes to the point that they:

Accepted Answer

A)  Fill with calcium deposits. 
B)  Are less shock absorbent. 
C)  Are herniated. 
D)  Enlarge and swell. 
E)  Lose water. 
A)  Fill with calcium deposits. 
B)  Are less shock absorbent. 
C)  Are herniated. 
D)  Enlarge and swell. 
E)  Lose water.

Question 10

During a neurologic assessment,the nurse asks the patient to dorsiflex the foot against the resistance of the nurse's hand.The inability to perform this action confirms that cord damage has occurred at:

Accepted Answer

A)  C4-C5 
B)  L2-L4 
C)  L5 
D)  S1 
A)  C4-C5 
B)  L2-L4 
C)  L5 
D)  S1

Question 11

The nurse should emphasize that the rehabilitation of the patient with a SCI:

Accepted Answer

A)  Is usually achieved within a few months after stabilization. 
B)  Will return the patient with a SCI to the preaccident functional level. 
C)  Focuses on adjustments necessary to reenter society and the workplace. 
D)  Completely targets self-care. 
A)  Is usually achieved within a few months after stabilization. 
B)  Will return the patient with a SCI to the preaccident functional level. 
C)  Focuses on adjustments necessary to reenter society and the workplace. 
D)  Completely targets self-care.

Question 12

When the patient with a SCI inquires what the physician means by a cone-down,the nurse explains that:

Accepted Answer

A)  A cone is surgically placed over the spine to protect the cord. 
B)  Marks will be placed on either side of the injury to mark the area. 
C)  A cone-shaped wedge of bone will be placed between the vertebrae. 
D)  A detailed x-ray image will be taken of the spinal injury. 
A)  A cone is surgically placed over the spine to protect the cord. 
B)  Marks will be placed on either side of the injury to mark the area. 
C)  A cone-shaped wedge of bone will be placed between the vertebrae. 
D)  A detailed x-ray image will be taken of the spinal injury.

Question 13

The nurse assures a despondent young female patient with a SCI who is at risk for sexual dysfunction that although her lesion is at C5,she can still have:

Accepted Answer

A)  Vaginal sensation 
B)  Vaginal orgasm 
C)  Normal menses 
D)  Intercourse 
E)  Children 
A)  Vaginal sensation 
B)  Vaginal orgasm 
C)  Normal menses 
D)  Intercourse 
E)  Children

Question 14

The home health nurse encourages the family of a patient with a SCI to use the assisted cough technique,which requires the caregiver to:

Accepted Answer

A)  Assist the patient to inhale a bronchodilator spray and then cough. 
B)  Forcefully press on patient's back below the rib cage while the patient is in the prone position. 
C)  Assist the patient to lean forward, breathe deep, and then cough. 
D)  Apply pressure to diaphragm as the patient coughs. 
E)  Slap the patient on upper back while the patient is in the prone position. 
A)  Assist the patient to inhale a bronchodilator spray and then cough. 
B)  Forcefully press on patient's back below the rib cage while the patient is in the prone position. 
C)  Assist the patient to lean forward, breathe deep, and then cough. 
D)  Apply pressure to diaphragm as the patient coughs. 
E)  Slap the patient on upper back while the patient is in the prone position.

Exam 29: Spinal Cord Injury

When asked why the patient is receiving the methylprednisolone,the nurse explains that the drug is used in the patient with a SCI to:

The nurse refers to the ___________ __________ to assess the extent of sensory loss and specific nerve root enervation.

After spinal shock has been resolved,the indwelling catheter is removed.The nurse tells the patient to expect the bladder to empty by:

On admission to the emergency department,the patient with a C5 compression fracture can move only his head and has flaccid paralysis of all extremities.The distraught family asks if the paralysis is permanent.The nurse's best response would be:

The Brown-Séquard syndrome results in which neurologic deficit?

The nurse explains that the major advantage of the halo device over the Gardner-Wells tongs is that the halo device:

A distressed family member asks about the purpose of the Gardner-Wells tongs.The most helpful explanation by the nurse would be that the Gardner-Wells tongs:

The nurse explains to the family of a patient with quadriplegia that intravenous (IV)drugs are the most effective method of administration,because drugs injected intramuscularly (IM)are:

The nurse cautions an 85-year-old golfer that he should take care to protect his back during his backswing because the intervertebral disks in older adults undergo changes to the point that they:

During a neurologic assessment,the nurse asks the patient to dorsiflex the foot against the resistance of the nurse's hand.The inability to perform this action confirms that cord damage has occurred at:

The nurse should emphasize that the rehabilitation of the patient with a SCI:

When the patient with a SCI inquires what the physician means by a cone-down,the nurse explains that:

The nurse assures a despondent young female patient with a SCI who is at risk for sexual dysfunction that although her lesion is at C5,she can still have:

The home health nurse encourages the family of a patient with a SCI to use the assisted cough technique,which requires the caregiver to:

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Cultural Aspects of Nursing Care

The Nurse and the Family

Health and Illness

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Fluids and Electrolytes

Pain Management

First Aid, emergency Care, and Disaster Management

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Intravenous Therapy

Shock

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Immobility

Confusion

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The nurse refers to the _ to assess the extent of sensory loss and specific nerve root enervation.