Question 1

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

Accepted Answer

Dexamethasone is a corticosteroid that was previously used for spinal cord injuries, but recent guidelines do not recommend it due to lack of evidence for benefit and potential for harm.

Question 2

Which statement by the patient with multiple sclerosis (MS) indicates the need for additional teaching?

Accepted Answer

The statement "MS causes my nerves to die" indicates a misunderstanding. MS primarily causes damage to the myelin sheath, the protective covering of nerves in the brain and spinal cord, rather than causing the nerves themselves to die. This damage disrupts the normal flow of electrical impulses along the nerves, leading to the symptoms of MS.

Question 3

The nurse correlates which clinical manifestations to autonomic dysreflexia in a patient with a spinal cord injury?

Accepted Answer

Autonomic dysreflexia is a condition that can occur in individuals with spinal cord injuries above the T6 level. It is characterized by a sudden and severe increase in blood pressure (hypertension) and a reflexive slowing down of the heart rate (bradycardia) in response to a stimulus below the level of the injury.

Question 4

The nurse notes crusting of secretions around the pins of a patient with a halo device. What action is indicated for this finding?

Accepted Answer

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

Question 5

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

Accepted Answer

Bending at the knees with a straight back helps reduce strain on the back and can alleviate pain associated with a herniated disk.

Question 6

The nurse provides care for a patient who is 4 hours postoperative after surgery to correct a herniated nucleus pulposus. Which assessment finding causes the nurse to notify the healthcare provider?

Accepted Answer

A respiratory rate of nine breaths per minute is significantly lower than the normal range (12-20 breaths per minute) and could indicate respiratory depression, possibly due to anesthesia or pain medication effects, which is a critical situation requiring immediate attention from the healthcare provider.

Question 7

In providing care to a patient with multiple sclerosis who is developing speech difficulties, the nurse correlates this new finding to which factor?

Accepted Answer

Medications used in the treatment of multiple sclerosis can sometimes affect speech as a side effect, contributing to difficulties in articulation or speech production.

Question 8

A patient has arrived by ambulance at the emergency department after a cervical spinal cord injury. Which assessment is a priority for the nurse to perform at this time?

Accepted Answer

Following a cervical spinal cord injury, the priority is to assess the patient's respiratory pattern and airway. This is because injuries at the cervical level can impair the diaphragm and other muscles involved in breathing, potentially leading to respiratory failure.

Question 9

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?

Accepted Answer

Raising the head of the bed 45 degrees is the first action to take to help lower blood pressure and reduce the risk of complications in a patient with autonomic dysreflexia, a common issue in spinal cord injury patients.

Question 10

A patient is diagnosed with spinal stenosis. The nurse recognizes which clinical manifestation that is caused by age-related loss of spinal muscle strength?

Accepted Answer

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

Question 11

A patient asks what smoking cigarettes has to do with low back pain. What is the best response to the patient?

Accepted Answer

The answer of A patient asks what smoking cigarettes has...

Question 12

The nurse teaches a patient about computed tomography (CT scan) to diagnose a potential spinal cord disorder. Which patient statement indicates a correct understanding of the information presented?

Accepted Answer

A CT scan is particularly effective for visualizing the bony structures of the spine, allowing healthcare providers to assess for fractures, tumors, or other abnormalities in the spine's bone tissue.

Question 13

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

Accepted Answer

Encouraging range-of-motion exercises helps increase venous return, prevent stiffness, and maintain muscle strength and endurance in patients with multiple sclerosis.

Question 14

A patient recently diagnosed with amyotrophic lateral sclerosis is having difficulty with swallowing and has been choking and coughing excessively at mealtimes. The nurse implements which action first?

Accepted Answer

Auscultating breath sounds is the first action the nurse should take to assess for aspiration, which is a common risk for patients with amyotrophic lateral sclerosis (ALS) who have difficulty swallowing. This initial assessment helps determine the immediate needs for maintaining airway patency and breathing.

Question 15

A patient with amyotrophic lateral sclerosis is prescribed riluzole (Rilutek). What statement by the patient indicates that further teaching is needed about this treatment?

Accepted Answer

Riluzole (Rilutek) does not cure amyotrophic lateral sclerosis (ALS) but may slow the disease's progression and delay the need for a ventilator by affecting nerve conduction. The statement indicating a cure suggests misunderstanding.

Question 16

The nurse directs a patient with a herniated disk to notify the healthcare provider immediately if the patient experiences which clinical manifestation?

Accepted Answer

New onset urinary incontinence in a patient with a herniated disk may indicate cauda equina syndrome, a serious condition requiring immediate medical attention. This symptom suggests nerve root compression, which can lead to permanent damage if not treated promptly.

Question 17

A patient with multiple sclerosis experiences exacerbations of new symptoms that last a few days and then disappear. The nurse correlates these clinical manifestations to which type of multiple sclerosis?

Accepted Answer

Relapsing-remitting multiple sclerosis is characterized by clear relapses of disease activity followed by periods of partial or complete recovery (remissions). The description of new symptoms appearing for a few days and then disappearing fits this pattern.

Question 18

The nurse correlates which clinical manifestation to a definitive diagnosis of multiple sclerosis?

Accepted Answer

Multiple sclerosis (MS) is diagnosed based on evidence of damage in at least two separate areas of the central nervous system (including the brain, spinal cord, and optic nerves) at two different times, with no other better explanation for the symptoms. MRI changes in two separate locations are indicative of this damage and are a key diagnostic criterion for MS.

Question 19

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

Accepted Answer

Nerve conduction studies measure the speed and strength of electrical signals in nerves, which helps assess nerve damage.

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?

Accepted Answer

Aspirin works by inhibiting the enzyme cyclooxygenase, which results in the decreased synthesis of prostaglandins and thromboxanes. This action helps to reduce inflammation and pain in the body.

Quiz 37: Coordinating Care for Patients With Spinal Cord Disorders