Chapter 45: Care of Patients with Problems of the Central Nervous System: The Spinal Cord

Chapter 45: 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. The nurse is providing health education at a community center. Which instruction does the nurse include as part of client education for the prevention of low back pain?

a.	“Participate in a regular exercise program.”
b.	“Purchase a soft mattress for sleeping comfort.”
c.	“Wear high-heeled shoes only for special occasions.”
d.	“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:    Cognitive Level: Application/Applying or higher               REF:   N/A

TOP:   Client Needs Category: Physiological Integrity (Physiological Adaptation—Pathophysiology)

MSC:  Integrated Process: Teaching/Learning

 

2. The nurse is caring for a client who has low back pain (LBP) from a work-related injury. Which measures does the nurse incorporate into the client’s plan of care?

a.	Apply moist heat continuously to the affected area.
b.	Use ice packs or ice massage for 1 to 2 hours over the affected area.
c.	Apply heat packs for 20 to 30 minutes at least four times daily.
d.	Advise the client to avoid hot baths or showers.

 

 

ANS:  C

Heat increases blood flow to the affected area and promotes healing of injured nerves. However, continuous application of moist heat can promote skin breakdown.

 

DIF:    Cognitive Level: Comprehension/Understanding               REF:   p. 962

TOP:   Client Needs Category: Physiological Integrity (Physiological Adaptation—Illness Management)  MSC:           Integrated Process: Nursing Process (Implementation)

 

3. A client who has a herniated disk is being discharged after a percutaneous endoscopic discectomy. Which postprocedure instructions does the nurse provide before discharge?

a.	“You should begin an exercise routine which includes walking every day.”
b.	“You must sleep in a supine position until the bandage is removed.”
c.	“You may feel numbness or tingling in the legs for 24 hours.”
d.	“You will need to wear a lumbar brace for 1 week.”

 

 

ANS:  A

After this minimally invasive surgery, clients typically go home the same day or the day after surgery. Clients should be taught to begin the prescribed exercise program immediately after discharge, which includes walking every day. The client should not be restricted to one sleeping position. Clients generally have less pain with this procedure and do not experience numbness or tingling. The client may have a clear or gauze dressing but will not need to wear a lumbar brace.

 

DIF:    Cognitive Level: Application/Applying or higher               REF:   N/A

TOP:   Client Needs Category: Physiological Integrity (Reduction of Risk Potential—Potential for Complications from Surgical Procedures and Health Alterations)

MSC:  Integrated Process: Teaching/Learning

 

4. The nurse is assessing a client who had a discectomy 6 hours ago. Which client complaint requires priority action by the nurse?

a.	“I am feeling tired.”
b.	“My mouth is so dry.”
c.	“I can’t seem to relax and rest.”
d.	“I am unable to urinate.”

 

 

ANS:  D

Inability to void may indicate damage to the sacral spinal nerves. The other symptoms require the nurse to provide care but are not the priority or a complication of the procedure.

 

DIF:    Cognitive Level: Application/Applying or higher               REF:   N/A

TOP:   Client Needs Category: Physiological Integrity (Reduction of Risk Potential—Potential for Complications from Surgical Procedures and Health Alterations)

MSC:  Integrated Process: Nursing Process (Analysis)