Question 1

What has occurred in the past 10 years to enhance rehabilitation of individuals with SCIs? (Select all that apply.)

Accepted Answer

A)   Technologically advanced assistive aids
B)   Rehabilitation personnel
C)   Development of trauma centers
D)   Health insurance
E)   Rapid transport of victims A, C, E

Question 2

A patient with an SCI begins to have seizures, and the blood pressure (BP)rises rapidly to 210/160 mm Hg.Which is the third indicator of the syndrome of autonomic dysreflexia?

Accepted Answer

A)   Profuse vomiting
B)   Hives on face and neck
C)   Excessive urine output
D)   Bradycardia D

Question 3

Which technique of opening the airway in the newly admitted patient with an SCI is the most appropriate?

Accepted Answer

A)   Chin lift
B)   Head tilt
C)   Jaw thrust
D)   Neck flexion C

Question 4

What is the major advantage of the halo device over the Gardner-Wells tongs?

Accepted Answer

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

Question 5

A patient is receiving methylprednisolone.What purpose should the nurse explain this drug has in treating a patient with an SCI?

Accepted Answer

A)   Reduces spinal cord cellular damage
B)   Counteracts spinal shock
C)   Increases blood supply to the injured cord
D)   Enhances sexual function

Question 6

What should a nurse emphasize regarding the rehabilitation of the patient with an SCI?

Accepted Answer

A)   Rehabilitation is usually achieved within a few months after stabilization.
B)   Rehabilitation will return the patient with an SCI to the preaccident functional level.
C)   Rehabilitation focuses on adjustments necessary to reenter society and the workplace.
D)   Rehabilitation completely targets self-care.

Question 7

What technique should the nurse implement to move the impaired legs of a patient with an SCI to avoid stimulation muscle spasm?

Accepted Answer

A)   Firmly grasping the calf muscle and the thigh muscle
B)   Manipulating the limb by supporting the knee and ankle joints
C)   Holding the foot upright and slowly dragging the limb into position
D)   Requesting assistance to support the calf and thigh

Question 8

Which assessment leads the emergency department nurse to suspect that a patient's spinal cord injury (SCI)is below C4?

Accepted Answer

A)   Voluntary eye movement
B)   Ability to blink the eyelids
C)   Unlabored respiration
D)   Ability to make a facial grimace

Question 9

What changes occur with the intervertebral disks in older adults that increase the risk of injury? (Select all that apply.)

Accepted Answer

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

Question 10

A paraplegic patient excitedly reports seeing his foot move when he was being turned.How is this phenomenon best explained?

Accepted Answer

A)   Reflexive movement
B)   Return of motor function
C)   Early symptom of autonomic dysreflexia
D)   Result of hypertonicity of the muscle

Question 11

During a neurologic assessment, a nurse asks a patient to dorsiflex the foot against the resistance of the nurse's hand.The patient is unable to perform this action.Where does this assessment confirm that cord damage has occurred?

Accepted Answer

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

Question 12

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

Question 13

What should be the immediate intervention when a nurse recognizes autonomic dysreflexia in the patient with an SCI?

Accepted Answer

A)   Flex the patient's legs using the knee gatch of the bed.
B)   Cool the patient with alcohol solution.
C)   Raise the head of the bed to at least 45 degrees.
D)   Administer oxygen per mask.

Question 14

What should a nurse include in a patient's plan of care when considering interventions for the outcome of prevention of contractures in a patient with an SCI?

Accepted Answer

A)   Apply cold wraps to the limbs twice a day.
B)   Perform full ROM exercises every 2 hours.
C)   Use significant tactile stimuli each shift.
D)   Apply splints to the limbs.

Question 15

A nurse is caring for a despondent young female patient with an SCI at C5.The patient verbalizes concern regarding sexual dysfunction.What should the nurse assure this patient she can still experience? (Select all that apply.)

Accepted Answer

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

Question 16

Which assessment would indicate the resolution of spinal shock?

Accepted Answer

A)   Extension and rigidity in affected limbs
B)   Spastic involuntary movements in affected limbs
C)   Tingling and burning in affected limbs
D)   Voluntary purposeful movements of affected limbs

Question 17

After spinal shock has been resolved, an indwelling catheter is removed.What way should the nurse expect this patient to empty the bladder?

Accepted Answer

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

Question 18

On admission to the emergency department, a 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.What is the best response by the nurse?

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."

Question 19

Which intervention by a nurse is effective in the prevention of autonomic dysreflexia in the patient with an SCI?

Accepted Answer

A)   Ensure patency of the urinary catheter.
B)   Give warm baths to the patient to stimulate vasodilation.
C)   Keep lighting at a minimum to reduce stimulation.
D)   Offer the patient four or five small meals daily.

Question 20

The family of a patient with an SCI is concerned with the lack of bowel function 2 days after the injury.What is the best response by the nurse?

Accepted Answer

A)   "Because of his injury, he will always need to have enemas for bowel evacuation."
B)   "Medical management is delaying bowel action because it places pressure on the injury."
C)   "Bowel function should return in approximately 3 days after the accident."
D)   "We'll just have to wait and see if bowel action returns this week."

Exam 24: Spinal Cord Injury