Chapter 43: Care of Patients with Problems of the Central Nervous System: The Spinal Cord

Chapter 43: Care of Patients with Problems of the Central Nervous System: The Spinal Cord

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. A nurse promotes the prevention of lower back pain by teaching clients at a community center. Which instruction should the nurse include in this education?
   1. “Participate in an exercise program to strengthen muscles.”
   2. “Purchase a mattress that allows you to adjust the firmness.”
   3. “Wear flat instead of high-heeled shoes to work each day.”
   4. “Keep your weight within 20% of your ideal body weight.”

ANS:   A

Exercise can strengthen back muscles, reducing the incidence of low back pain. The other options will not prevent low back pain.

DIF:     Applying/Application                         REF:    886                   KEY: Pain| spinal cord/back injury   MSC:                                                  Integrated Process: Teaching/Learning NOT: Client Needs Category: Health Promotion and Maintenance

2. A nurse plans care for a client with lower back pain from a work-related injury. Which intervention should the nurse include in this client’s plan of care?
   1. Encourage the client to stretch the back by reaching toward the toes.
   2. Massage the affected area with ice twice a day.
   3. Apply a heating pad for 20 minutes at least four times daily.
   4. Advise the client to avoid warm baths or showers.

ANS:   C

Heat increases blood flow to the affected area and promotes healing of injured nerves. Stretching and ice will not promote healing, and there is no need to avoid warm baths or showers.

DIF:     Understanding/Comprehension         REF:    887                   KEY: Spinal cord/back injury| nonpharmacologic pain management             MSC: Integrated Process: Nursing Process: Implementation                                               NOT: Client Needs Category: Physiological Integrity: Physiological Adaptation

3. A nurse assesses a client who is recovering from a diskectomy 6 hours ago. Which assessment finding should the nurse address first?
   1. Sleepy but arouses to voice
   2. Dry and cracked oral mucosa
   3. Pain present in lower back
   4. Bladder palpated above pubis

ANS:   D

A distended bladder may indicate damage to the sacral spinal nerves. The other findings require the nurse to provide care but are not the priority or a complication of the procedure.

DIF:            Applying/Application                         REF:    889                   KEY: Back surgery| spinal cord/back injury                                                                  MSC:             Integrated Process: Nursing Process: Analysis                                                    NOT: Client Needs Category: Physiological Integrity: Reduction of Risk Potential

4. A nurse assesses clients at a community center. Which client is at greatest risk for lower back pain?
   1. A 24-year-old female who is 25 weeks pregnant
   2. A 36-year-old male who uses ergonomic techniques
   3. A 45-year-old male with osteoarthritis
   4. A 53-year-old female who uses a walker

ANS:           C

Osteoarthritis causes changes to support structures, increasing the client’s risk for low back pain. The other clients are not at high risk.

DIF:            Remembering/Knowledge                 REF:    886

KEY:          Spinal cord/back injury| pain

MSC:          Integrated Process: Nursing Process: Assessment                 NOT: Client Needs Category: Physiological Integrity: Physiological Adaptation

5. A nurse teaches a client who is recovering from a spinal fusion. Which statement should the nurse include in this client’s postoperative instructions?
   1. “Only lift items that are 10 pounds or less.”
   2. “Wear your brace whenever you are out of bed.”
   3. “You must remain in bed for 3 weeks after surgery.”
   4. “You are prescribed medications to prevent rejection.”

ANS:           B

Clients who undergo spinal fusion are fitted with a brace that they must wear throughout the healing process (usually 3 to 6 months) whenever they are out of bed. The client should not lift anything. The client does not need to remain in bed. Medications for rejection prevention are not necessary for this procedure.

DIF:            Applying/Application                         REF:    888                   KEY: Back surgery| spinal cord/back injury                                                                  MSC:             Integrated Process: Teaching/Learning                                                             NOT:              Client Needs Category: Physiological Integrity: Reduction of Risk Potential