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?&#10;A) Meningitis&#10;B) Spinal cord tumor&#10;C) Multiple sclerosis&#10;D) Amyotrophic lateral sclerosis&#10;

Accepted Answer

Back pain radiating down the leg is a common symptom of a spinal cord tumor, which is a mass of abnormal cells that grows in or around the spinal cord. Meningitis, multiple sclerosis, and amyotrophic lateral sclerosis do not typically present with this type of symptom.

Question 2

A patient receives a definitive diagnosis of multiple sclerosis.What finding occurred to validate this diagnosis?&#10;A) Onset of double vision&#10;B) Loss of bowel and bladder control&#10;C) Numbness and tingling of one limb&#10;D) MRI changes in two separate locations&#10;

Accepted Answer

Definitive diagnosis of multiple sclerosis is made by the presence of MRI changes in two separate locations in the brain and/or spinal cord. Onset of double vision, loss of bowel and bladder control, and numbness and tingling of one limb are possible symptoms of multiple sclerosis, but alone they do not confirm the diagnosis.

Question 3

A patient asks what smoking cigarettes has to do with low back pain.How should the nurse respond to this patient?&#10;A) &#34;Smoking is a sedentary activity.&#34;&#10;B) &#34;Smoking is linked to nutritional disorders.&#34;&#10;C) &#34;Nicotine in cigarettes interferes with nutrients that supply the disk spaces.&#34;&#10;D) &#34;Nicotine hinders the mobility of the vertebral spaces and interferes with nerve function.&#34;&#10;

Accepted Answer

Nicotine in cigarettes interferes with the nutrients that supply the disk spaces, causing them to degenerate faster, and increasing the risk for low back pain.

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?&#10;A) Relapsing-remitting&#10;B) Primary progressive&#10;C) Progressive relapsing&#10;D) Secondary progressive&#10;

Accepted Answer

The patient is experiencing exacerbations of new symptoms that last a few days and then disappear, which is characteristic of relapsing-remitting multiple sclerosis. In this type of MS, patients experience relapses or exacerbations followed by periods of remission where symptoms may lessen or disappear entirely.

Question 5

A patient with multiple sclerosis is developing speech difficulties.What should the nurse realize as being the reason for this new manifestation?&#10;A) Depression&#10;B) Medications&#10;C) Nerve regeneration&#10;D) Mental status changes&#10;

Accepted Answer

Medications can cause speech difficulties as a side effect. Additionally, multiple sclerosis can affect the nerves responsible for speech and language, leading to difficulties in communication. Depression and mental status changes may also be present in patients with multiple sclerosis but are not the primary reason for speech difficulties. Nerve regeneration is not likely to cause sudden onset speech difficulties.

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?&#10;A) Administer interferon&#10;B) Administer corticosteroids&#10;C) Turn and reposition every two hours&#10;D) Encourage range-of-motion exercises&#10;

Accepted Answer

Encouraging range-of-motion exercises will help prevent stiffness and maintain muscle strength and endurance. Administering interferon and corticosteroids may be part of the patient's medication regimen but do not specifically address venous return or prevention of stiffness. Turning and repositioning every two hours is important for preventing pressure ulcers but does not specifically address the other concerns mentioned in the question.

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?&#10;A) Corticosteroids&#10;B) Beta interferons&#10;C) Muscle relaxants&#10;D) Immunosuppressive agents&#10;

Accepted Answer

The answer of A patient with multiple sclerosis is admitted...

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?&#10;A) Bladder dysfunction&#10;B) Loss of proprioception&#10;C) Ipsilateral loss of motor function&#10;D) Pain below the level of the injury&#10;

Accepted Answer

The answer of A victim of a motor vehicle crash...

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?&#10;A) Brain tumor&#10;B) Spinal cord tumor&#10;C) Multiple sclerosis&#10;D) Amyotrophic lateral sclerosis (ALS)&#10;

Accepted Answer

The increasing flaccid upper arms, along with periodic cramping and contracting of the lower extremities, are symptoms commonly seen in ALS. This neurodegenerative disease affects the motor neurons that control voluntary muscle movement and often leads to muscle weakness and atrophy. It typically starts in the extremities and spreads to other parts of the body, including the upper arms, and can eventually lead to paralysis. The other options listed are also neurological conditions, but their symptoms do not match those described in the scenario.

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?&#10;A) Sit with the legs elevated&#10;B) Reduce the intake of fluids&#10;C) Limit activity until the pain subsides&#10;D) Bend at the knees with a straight back&#10;

Accepted Answer

Bending at the knees with a straight back is the best way to prevent further injury and aggravation of the herniated disk. Sitting with legs elevated or reducing fluid intake will not have any significant impact on the pain. Limiting activity can provide short-term relief, but long-term rest can actually make the pain worse.

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?&#10;A) Wrap the pins with gauze soaked with normal saline&#10;B) Gently pick the crusting off of the pins with a dry gauze pad&#10;C) Apply gauze soaked with hydrogen peroxide around the pins&#10;D) Syringe 1/2 strength hydrogen peroxide and sterile water to the crusted areas&#10;

Accepted Answer

The answer of The nurse notes crusting of secretions around...

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?&#10;A) MRI&#10;B) Myelogram&#10;C) Cerebral angiogram&#10;D) Nerve conduction studies&#10;

Accepted Answer

The answer of A patient is suspected as having a...

Question 13

The nurse directs a patient with a herniated disk to notify the health-care provider immediately if the patient experiences which presentation?&#10;A) New onset urinary incontinence&#10;B) Sleepiness after taking pain medication&#10;C) Difficulty with having a bowel movement&#10;D) Transient pain with walking and changing position&#10;

Accepted Answer

The answer of The nurse directs a patient with a...

Question 14

A patient is diagnosed with spinal stenosis.Which manifestation is caused by age-related loss of spinal muscle strength?&#10;A) Fatigue&#10;B) Constipation&#10;C) Muscle spasm&#10;D) Decreased stamina&#10;

Accepted Answer

The answer of A patient is diagnosed with spinal stenosis.Which...

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

Accepted Answer

The answer of The nurse is reviewing orders written for...

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?&#10;A) &#34;This will cure my disease.&#34;&#10;B) &#34;This will help me stay awake.&#34;&#10;C) &#34;This will stop my bladder spasms.&#34;&#10;D) &#34;This will increase the progression of my disease.&#34;&#10;

Accepted Answer

The answer of A client with amyotrophic lateral sclerosis is...

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?&#10;A) &#34;It measures damage to nerves.&#34;&#10;B) &#34;It shows pressure on nerves from herniated disks.&#34;&#10;C) &#34;It measures electrical impulses within muscle tissue.&#34;&#10;D) &#34;It shows the structure of the vertebrae and joint outlines.&#34;&#10;

Accepted Answer

The answer of A patient with low back pain asks...

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?&#10;A) Palpate for bladder distention&#10;B) Assess for a bowel impaction&#10;C) Re-measure the blood pressure&#10;D) Raise the head of the bed 45 degrees&#10;

Accepted Answer

The answer of The latest blood pressure reading for a...

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

Accepted Answer

The answer of A patient is admitted for diagnosis and...

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?&#10;A) &#34;It depresses the central nervous system.&#34;&#10;B) &#34;It blocks sodium channels and stops the formation of nerve impulses.&#34;&#10;C) &#34;It blocks enzymes and chemicals in the body to decrease pain and inflammation.&#34;&#10;D) &#34;It blocks the production of substances that trigger allergic and inflammatory reactions.&#34;&#10;

Accepted Answer

The answer of A patient with low back pain asks...

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?&#10;A) Surgery&#10;B) Radiation&#10;C) Chemotherapy&#10;D) Stereotactic radiosurgery&#10;

Accepted Answer

The answer of A patient has a 4 cm spinal...

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

Accepted Answer

The answer of The nurse is reviewing orders written for...

Deck 37: Coordinating Care for Patients With Spinal Cord Disorders