NRS 450 – Spinal Cord Injuries
Practice Test Questions with ANSWERS
1. In planning community education for prevention of spinal cord injuries, the nurse should plan events where which population is mostly represented?
a. Adolescent and young adult males
b. Elementary age children
c. Middle aged women
d. Older adults still driving
Young adult males have the greatest risk of spinal cord injuries because they tend to be more risk takers than other populations.
2. A patient is admitted to critical care unit after falling from his roof while cleaning the gutters. What findings during the assessment identify the presence of
spinal shock?
a. Brady cardia and hypotension
b. Hypertensive crisis
c. Tetraplegia with total sensory loss
d. Spastic tetraplegia
Spinal shock is manifested by sensory loss and flaccid paralysis that is usually temporary and occurs up to 2weeks after the accident. Bradycardia and
hypotension occurs with neurogenic shock. Hypertensive crisis occurs with autonomic hyperreflexia. Spasms occurs as spinal shock resolves.
3. A patient arrives to the emergency department via squad with suspected spinal cord injury from a motor vehicle accident. What assessment finding is the
most concerning on the initial assessment of this patient?
a. Blood Pressure of 88/52mmHg
b. Heart Rate of 42bpm
c. Loss of sensory function in arms and legs
d. Pulse ox of 91%
In the initial 30minutes of spinal cord injury, the patient is at risk of neurogenic shock, which is demonstrated by hypotension and bradycardia. The patient will
need atropine and vasopressor to maintain perfusion during this phase of recovery. Loss of sensory function is not uncommon in acute phase of injury.
4. The nurse is doing a ride along with the squad when they receive a call of a motorcycle accident 5minutes away. When the squad arrives to the scene, what is
the nurses highest priority?
a. Assessing head and spine for injuries
b. Assessing motor and sensory function
c. Immobilizing the spine with C-collar
d. Maintaining a patent airway
Maintaining patent airway is the highest priority for any trauma, especially for spinal cord injuries as it can limit gag reflex/respiratory effort if experiencing a
high level injury.
5. The nurse working in a rehabilitation unit is assigned a patient with Brown-Sequard syndrome after experiencing a gun shot wound to the spine. The nurse
understands the patient will display which signs?
a. Complete motor paralysis with loss of function below the site of injury
b. Limited paralysis of the lower limbs and difficulty of elimination
c. Ipsilateral motor paralysis with loss of sensation below the injury
d. Issues with balance coordination with retention of pain sensation
Brown-Sequard syndrome is characterized by ipsilateral issues as the injury affects one side of the spinal cord. Damage to the most distal cord and roots with
difficulty in elimination is seen with cauda equine or conus medullaris. Posterior injuries results in issues with balance coordination as they can regain motor,
sensory, and temperature control. Anterior cord injuries tend to have complete motor paralysis with loss of function below the site of injury.
6. The nurse caring for a patient with a T4 spinal cord injury. What goal would be appropriate for optimal rehabilitation of this patient?
a. Ambulate with crutches and leg braces
b. Effective cough to remove secretions
c. Indoor mobility in manual wheelchair
d. Independent with ADLs and wheelchair use
Injury at T4, the optimal realistic goal would be as much independence as possible in a manual wheelchair because arm function will not be affected. Indoor
mobility and coughing is limited and not the highest level of ability a patient with T4 spinal cord injury. Ambulation with assistive devices is appropriate for
those with T6-12 or lumbar injuries.
7. How is urinary function maintained during the acute phase of a spinal cord injury?
a. An indwelling catheter
b. Intermittent straight catheterization
c. Suprapubic catheter
d. Incontinent briefs/pads
During the acute phase, the body is in shock causing urinary retention and risk of reflux of urine into kidney causing acute kidney injury. It is best to place a
continuous catheter for the first 7-10days after a spinal cord injury and then modify based on elimination needs with the level of injury.
8. During the patient’s process of grieving for losses resulting from spinal cord injury, what should the nurse do?
a. Assist the patient to move through all stages of the grief process to acceptance
b. Facilitate the grieving process so that is it completed by the time patient is discharged
c. Help the patient understand that working through grief will be a life long process
d. Set boundaries by stating anger directed toward staff is not a positive way to cope
This study source was downloaded by 100000820177218 from CourseHero.com on 04-04-2023 14:35:53 GMT -05:00
https://www.coursehero.com/file/82450157/Spinal-Cord-Injuries-Practice-Questions-with-ANSWERSdocx/
Practice Test Questions with ANSWERS
1. In planning community education for prevention of spinal cord injuries, the nurse should plan events where which population is mostly represented?
a. Adolescent and young adult males
b. Elementary age children
c. Middle aged women
d. Older adults still driving
Young adult males have the greatest risk of spinal cord injuries because they tend to be more risk takers than other populations.
2. A patient is admitted to critical care unit after falling from his roof while cleaning the gutters. What findings during the assessment identify the presence of
spinal shock?
a. Brady cardia and hypotension
b. Hypertensive crisis
c. Tetraplegia with total sensory loss
d. Spastic tetraplegia
Spinal shock is manifested by sensory loss and flaccid paralysis that is usually temporary and occurs up to 2weeks after the accident. Bradycardia and
hypotension occurs with neurogenic shock. Hypertensive crisis occurs with autonomic hyperreflexia. Spasms occurs as spinal shock resolves.
3. A patient arrives to the emergency department via squad with suspected spinal cord injury from a motor vehicle accident. What assessment finding is the
most concerning on the initial assessment of this patient?
a. Blood Pressure of 88/52mmHg
b. Heart Rate of 42bpm
c. Loss of sensory function in arms and legs
d. Pulse ox of 91%
In the initial 30minutes of spinal cord injury, the patient is at risk of neurogenic shock, which is demonstrated by hypotension and bradycardia. The patient will
need atropine and vasopressor to maintain perfusion during this phase of recovery. Loss of sensory function is not uncommon in acute phase of injury.
4. The nurse is doing a ride along with the squad when they receive a call of a motorcycle accident 5minutes away. When the squad arrives to the scene, what is
the nurses highest priority?
a. Assessing head and spine for injuries
b. Assessing motor and sensory function
c. Immobilizing the spine with C-collar
d. Maintaining a patent airway
Maintaining patent airway is the highest priority for any trauma, especially for spinal cord injuries as it can limit gag reflex/respiratory effort if experiencing a
high level injury.
5. The nurse working in a rehabilitation unit is assigned a patient with Brown-Sequard syndrome after experiencing a gun shot wound to the spine. The nurse
understands the patient will display which signs?
a. Complete motor paralysis with loss of function below the site of injury
b. Limited paralysis of the lower limbs and difficulty of elimination
c. Ipsilateral motor paralysis with loss of sensation below the injury
d. Issues with balance coordination with retention of pain sensation
Brown-Sequard syndrome is characterized by ipsilateral issues as the injury affects one side of the spinal cord. Damage to the most distal cord and roots with
difficulty in elimination is seen with cauda equine or conus medullaris. Posterior injuries results in issues with balance coordination as they can regain motor,
sensory, and temperature control. Anterior cord injuries tend to have complete motor paralysis with loss of function below the site of injury.
6. The nurse caring for a patient with a T4 spinal cord injury. What goal would be appropriate for optimal rehabilitation of this patient?
a. Ambulate with crutches and leg braces
b. Effective cough to remove secretions
c. Indoor mobility in manual wheelchair
d. Independent with ADLs and wheelchair use
Injury at T4, the optimal realistic goal would be as much independence as possible in a manual wheelchair because arm function will not be affected. Indoor
mobility and coughing is limited and not the highest level of ability a patient with T4 spinal cord injury. Ambulation with assistive devices is appropriate for
those with T6-12 or lumbar injuries.
7. How is urinary function maintained during the acute phase of a spinal cord injury?
a. An indwelling catheter
b. Intermittent straight catheterization
c. Suprapubic catheter
d. Incontinent briefs/pads
During the acute phase, the body is in shock causing urinary retention and risk of reflux of urine into kidney causing acute kidney injury. It is best to place a
continuous catheter for the first 7-10days after a spinal cord injury and then modify based on elimination needs with the level of injury.
8. During the patient’s process of grieving for losses resulting from spinal cord injury, what should the nurse do?
a. Assist the patient to move through all stages of the grief process to acceptance
b. Facilitate the grieving process so that is it completed by the time patient is discharged
c. Help the patient understand that working through grief will be a life long process
d. Set boundaries by stating anger directed toward staff is not a positive way to cope
This study source was downloaded by 100000820177218 from CourseHero.com on 04-04-2023 14:35:53 GMT -05:00
https://www.coursehero.com/file/82450157/Spinal-Cord-Injuries-Practice-Questions-with-ANSWERSdocx/
