Deck 37: Coordinating Care for Patients With Spinal Cord Disorders

Question 1

A patient has a new onset of back pain radiating down the left leg.For which health problem should the nurse expect this patient to be evaluated?

A) Meningitis
B) Spinal cord tumor
C) Multiple sclerosis
D) Amyotrophic lateral sclerosis

Answer 1

Spinal cord tumor

Question 2

A patient receives a definitive diagnosis of multiple sclerosis.What finding occurred to validate this diagnosis?

A) Onset of double vision
B) Loss of bowel and bladder control
C) Numbness and tingling of one limb
D) MRI changes in two separate locations

Answer 2

MRI changes in two separate locations

Question 3

A patient asks what smoking cigarettes has to do with low back pain.How should the nurse respond to this patient?

A) "Smoking is a sedentary activity."
B) "Smoking is linked to nutritional disorders."
C) "Nicotine in cigarettes interferes with nutrients that supply the disk spaces."
D) "Nicotine hinders the mobility of the vertebral spaces and interferes with nerve function."

Answer 3

"Nicotine in cigarettes interferes with nutrients that supply the disk spaces."

Question 4

A patient with multiple sclerosis experiences exacerbations of new symptoms that last a few days and then disappear.Which type of multiple sclerosis is this patient most likely experiencing?

A) Relapsing-remitting
B) Primary progressive
C) Progressive relapsing
D) Secondary progressive

Question 5

A patient with multiple sclerosis is developing speech difficulties.What should the nurse realize as being the reason for this new manifestation?

A) Depression
B) Medications
C) Nerve regeneration
D) Mental status changes

Question 6

The nurse is caring for a patient with multiple sclerosis.What should the nurse do to increase venous return,prevent stiffness,and maintain muscle strength and endurance?

A) Administer interferon
B) Administer corticosteroids
C) Turn and reposition every two hours
D) Encourage range-of-motion exercises

Question 7

A patient with multiple sclerosis is admitted for treatment of clinical manifestations.What should the nurse expect to be prescribed for this patient?

A) Corticosteroids
B) Beta interferons
C) Muscle relaxants
D) Immunosuppressive agents

Question 8

A victim of a motor vehicle crash is diagnosed with a neck whiplash.Which manifestation should the nurse expect to assess in this patient?

A) Bladder dysfunction
B) Loss of proprioception
C) Ipsilateral loss of motor function
D) Pain below the level of the injury

Question 9

A patient is experiencing increasing flaccid upper arms while the lower extremities periodically cramp and contract.On which health problem should the nurse focus when assessing this patient?

A) Brain tumor
B) Spinal cord tumor
C) Multiple sclerosis
D) Amyotrophic lateral sclerosis (ALS)

Question 10

The nurse is caring for a patient with unrelenting low back pain caused by a herniated disk.What instruction should the nurse provide to this patient to help with the pain?

A) Sit with the legs elevated
B) Reduce the intake of fluids
C) Limit activity until the pain subsides
D) Bend at the knees with a straight back

Question 11

The nurse notes crusting of secretions around the pins of a patient with a Halo device.What action should be taken at this time?

A) Wrap the pins with gauze soaked with normal saline
B) Gently pick the crusting off of the pins with a dry gauze pad
C) Apply gauze soaked with hydrogen peroxide around the pins
D) Syringe 1/2 strength hydrogen peroxide and sterile water to the crusted areas

Question 12

A patient is suspected as having a spinal cord tumor.Which diagnostic test should the nurse expect to be prescribed to definitively diagnose this patient's problem?

A) MRI
B) Myelogram
C) Cerebral angiogram
D) Nerve conduction studies

Question 13

The nurse directs a patient with a herniated disk to notify the health-care provider immediately if the patient experiences which presentation?

A) New onset urinary incontinence
B) Sleepiness after taking pain medication
C) Difficulty with having a bowel movement
D) Transient pain with walking and changing position

Question 14

A patient is diagnosed with spinal stenosis.Which manifestation is caused by age-related loss of spinal muscle strength?

A) Fatigue
B) Constipation
C) Muscle spasm
D) Decreased stamina

Question 15

The nurse is reviewing orders written for a patient with a new spinal cord injury.Which order should the nurse question before completing?

A) Place on air mattress
B) Insert a nasogastric tube and attach to low suction
C) Insert indwelling urinary catheter;strict intake and output
D) Dexamethasone (Decadron)
10 mg IVP now and repeat in 4 hours

Question 16

A client with amyotrophic lateral sclerosis is prescribed riluzole (Rilutek).What statement indicates additional teaching is required about the effects of this medication?

A) "This will cure my disease."
B) "This will help me stay awake."
C) "This will stop my bladder spasms."
D) "This will increase the progression of my disease."

Question 17

A patient with low back pain asks why nerve conduction studies are prescribed.What explanation should the nurse provide to the patient relative to this diagnostic test?

A) "It measures damage to nerves."
B) "It shows pressure on nerves from herniated disks."
C) "It measures electrical impulses within muscle tissue."
D) "It shows the structure of the vertebrae and joint outlines."

Question 18

The latest blood pressure reading for a patient with a spinal cord injury is 210/140 mm Hg.What action should the nurse take first?

A) Palpate for bladder distention
B) Assess for a bowel impaction
C) Re-measure the blood pressure
D) Raise the head of the bed 45 degrees

Question 19

A patient is admitted for diagnosis and treatment of ongoing spasticity and flaccidity of the extremities.Which diagnostic test should the nurse expect to be prescribed that will definitively determine this patient's health problem?

A) MRI of the neck
B) CT scan of the head
C) A variety of tests will be ordered to help rule out other causes
D) Analysis of cerebrospinal fluid from a lumbar puncture

Question 20

A patient with low back pain asks what aspirin is supposed to do help with the pain.How should the nurse respond to this patient?

A) "It depresses the central nervous system."
B) "It blocks sodium channels and stops the formation of nerve impulses."
C) "It blocks enzymes and chemicals in the body to decrease pain and inflammation."
D) "It blocks the production of substances that trigger allergic and inflammatory reactions."

Question 21

A patient has a 4 cm spinal cord tumor located at T10.Which therapeutic treatment should the nurse anticipate will be ordered for this patient?

A) Surgery
B) Radiation
C) Chemotherapy
D) Stereotactic radiosurgery

Question 22

The nurse is reviewing orders written for a patient returning from surgery to remove a spinal cord tumor.Which order should the nurse implement immediately?

A) Install a bed cradle
B) Apply heel protection
C) Dexamethasone (Decadron)10 mg IVP now and every 8 hours x 2 doses
D) Monitor bowel sounds;notify if unable to obtain or faint in any abdominal quadrant