EXAM 3: SPINAL CORD INJURY NCLEX
QUESTIONS WITH CORRECT ANSWERS GRADED
A+ LATEST UPDATE
A 22-yr-old woman with paraplegia after a spinal cord injury tells the home
care nurse she experiences bowel incontinence two or three times each day.
Which action by the nurse is most appropriate?
a. Insert a rectal stimulant suppository.
b. Teach the patient to gradually increase intake of high-fiber foods.
c. Assess bowel movements for frequency, consistency, and volume.
d. Instruct the patient to avoid all caffeinated and carbonated beverages.
c
The nurse is caring for a patient admitted with a spinal cord injury after a motor
vehicle accident. The patient exhibits a complete loss of motor, sensory, and
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,reflex activity below the injury level. The nurse recognizes this condition as
which of the following?
a. Central cord syndrome
b. Spinal shock syndrome
c. Anterior cord syndrome
d. Brown-Séquard syndrome
b
Which clinical manifestation would the nurse interpret as a manifestation of
neurogenic shock in a patient with acute spinal cord injury?
a. Bradycardia
b. Hypertension
c. Neurogenic spasticity
d. Bounding pedal pulses
a
When planning care for a patient with a cervical spinal cord injury (C5), which
nursing diagnosis has the highest priority?
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, a. Impaired urinary elimination related to tetraplegia
b. Risk for impaired tissue integrity related to paralysis
c. Disabled family coping related to the extent of trauma
d. Ineffective airway clearance related to cervical spinal cord injury
d
Which manifestations in a patient with a thoracic spinal cord injury (T4) should
alert the nurse to possible autonomic dysreflexia?
a. Headache and rising blood pressure
b. Irregular respirations and shortness of breath
c. Decreased level of consciousness or hallucinations
d. Abdominal distention and absence of bowel sounds
a
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QUESTIONS WITH CORRECT ANSWERS GRADED
A+ LATEST UPDATE
A 22-yr-old woman with paraplegia after a spinal cord injury tells the home
care nurse she experiences bowel incontinence two or three times each day.
Which action by the nurse is most appropriate?
a. Insert a rectal stimulant suppository.
b. Teach the patient to gradually increase intake of high-fiber foods.
c. Assess bowel movements for frequency, consistency, and volume.
d. Instruct the patient to avoid all caffeinated and carbonated beverages.
c
The nurse is caring for a patient admitted with a spinal cord injury after a motor
vehicle accident. The patient exhibits a complete loss of motor, sensory, and
Page 1 of 30
,reflex activity below the injury level. The nurse recognizes this condition as
which of the following?
a. Central cord syndrome
b. Spinal shock syndrome
c. Anterior cord syndrome
d. Brown-Séquard syndrome
b
Which clinical manifestation would the nurse interpret as a manifestation of
neurogenic shock in a patient with acute spinal cord injury?
a. Bradycardia
b. Hypertension
c. Neurogenic spasticity
d. Bounding pedal pulses
a
When planning care for a patient with a cervical spinal cord injury (C5), which
nursing diagnosis has the highest priority?
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, a. Impaired urinary elimination related to tetraplegia
b. Risk for impaired tissue integrity related to paralysis
c. Disabled family coping related to the extent of trauma
d. Ineffective airway clearance related to cervical spinal cord injury
d
Which manifestations in a patient with a thoracic spinal cord injury (T4) should
alert the nurse to possible autonomic dysreflexia?
a. Headache and rising blood pressure
b. Irregular respirations and shortness of breath
c. Decreased level of consciousness or hallucinations
d. Abdominal distention and absence of bowel sounds
a
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