Chapter 29: Spinal Cord Injury

Chapter 29: Spinal Cord Injury

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A nurse explains that the spinal cord extends from the brainstem to the level of which vertebra?

a.	Last thoracic
b.	Second lumbar
c.	First sacral
d.	Coccygeal

 

 

ANS:  B

The cord starts at the brainstem and extends to the second lumbar vertebra.

 

DIF:    Cognitive Level: Knowledge            REF:   p. 510             OBJ:   N/A

TOP:   Anatomy and Physiology of the Central Nervous System (CNS)

KEY:  Nursing Process Step: N/A              MSC:  NCLEX: N/A

 

2. 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?

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.”

 

 

ANS:  C

Spinal shock caused by swelling may last from a few days to months, clouding the issue of the true extent of the injury.

 

DIF:    Cognitive Level: Application           REF:   p. 516             OBJ:   3

TOP:   Spinal Shock                                   KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

3. Which assessment would indicate the resolution of spinal shock?

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

 

 

ANS:  B

Spastic involuntary movements after a period of flaccid paralysis announce the end of spinal shock.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 516             OBJ:   3

TOP:   Resolution of Spinal Shock              KEY:  Nursing Process Step: Assessment

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

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

a.	Voluntary eye movement
b.	Ability to blink the eyelids
c.	Unlabored respiration
d.	Ability to make a facial grimace

 

 

ANS:  C

The phrenic nerve, which is at C1 to C4, controls the diaphragm and intercostal function for ventilation.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 516             OBJ:   3

TOP:   Level of SCIs                                  KEY:  Nursing Process Step: Assessment

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

5. 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?

a.	C4 to C5
b.	L2 to L4
c.	L5
d.	S1

 

 

ANS:  C

The muscle group that controls the feet is at L5.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 515-517      OBJ:   2

TOP:   Neurologic Assessment                   KEY:  Nursing Process Step: Assessment

MSC:  NCLEX: Physiological Integrity: Basic Care and Comfort