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?

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?

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?

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?

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?

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?

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?

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?

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?

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?

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?

Accepted Answer

Wrapping the pins with gauze soaked with normal saline will help to soften the crusting and make it easier to remove without causing trauma to the surrounding tissue. Picking off the crusting with a dry gauze pad or using hydrogen peroxide can be painful and cause damage to the skin. Syringing hydrogen peroxide and sterile water to the crusted areas is not necessary and can be potentially harmful.

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?

Accepted Answer

An MRI (magnetic resonance imaging) is the diagnostic test of choice for spinal cord tumors as it provides detailed images of the spinal cord and can detect tumors and other abnormalities. A myelogram (B) is sometimes used in conjunction with an MRI to enhance the image, but it is not used as a standalone test. A cerebral angiogram (C) is used to detect abnormalities in blood vessels in the brain, which is not relevant to spinal cord tumors. Nerve conduction studies (D) are used to evaluate nerve function and are not specific to spinal cord tumors.

Question 13

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

Accepted Answer

New onset urinary incontinence may indicate cauda equina syndrome, which is a serious complication of a herniated disk and requires immediate medical attention. Sleepiness after taking pain medication, difficulty with having a bowel movement, and transient pain with walking and changing position are common side effects and symptoms associated with herniated disks and do not require immediate medical attention unless they are severe or prolonged.

Question 14

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

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?

Accepted Answer

Dexamethasone is a corticosteroid, and its use in acute spinal cord injury is controversial due to potential side effects and lack of clear benefit. The nurse should question this order to ensure it aligns with current best practices and guidelines.

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?

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?

Accepted Answer

Nerve conduction studies are used to evaluate nerve damage or dysfunction.

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?

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, which is common in spinal cord injury patients.

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?

Accepted Answer

Since spasticity and flaccidity of the extremities can have multiple potential causes, such as spinal cord injury, stroke, multiple sclerosis, or cerebral palsy, a variety of tests will be needed to help diagnose the underlying condition. This may include imaging tests, such as an MRI of the neck or CT scan of the head, as well as analysis of cerebrospinal fluid from a lumbar puncture. However, no single test will definitively determine the patient's health problem, so a comprehensive approach is necessary.

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 is a nonsteroidal anti-inflammatory drug (NSAID) that works by blocking the production of enzymes and chemicals in the body called prostaglandins that are involved in pain and inflammation. By inhibiting these substances, aspirin can decrease pain and inflammation.

Quiz 37: Coordinating Care for Patients With Spinal Cord Disorders