Chapter 40 Practice Questions -Concepts of Care for Patients With Problems of the Central Nervous System

Question 1

The nurse is preparing to teach a client recently diagnosed with multiple sclerosis about taking glatiramer acetate. Which statement by the client indicates a need for further teaching?

a. “I will rotate injection sites to prevent skin irritation.”
b. “I need to avoid large crowds and people with infection.”
c. “I should report any flulike symptoms to my primary health care provider.”
d. “I will report any signs of infection to my primary health care provider.”

Answer 1

c. “I should report any flulike symptoms to my primary health care provider.”

Question 2

A nurse assesses a client with multiple sclerosis after administering prescribed fingolimod. For which common side effect would the nurse monitor?

a. Peripheral edema
b. Facial flushing
c. Tachycardia
d. Fever

Answer 2

b. Facial flushing

Question 3

A client who has multiple sclerosis reports increased severe muscle spasticity and tremors. What nursing action is most appropriate to manage this client’s concern?

a. Request a prescription for an antispasmodic drug such as baclofen.
b. Prepare the client for deep brain stimulation surgery.
c. Refer the client to a massage therapist to relax the muscles.
d. Consult with the occupational therapist for self-care assistance.

Answer 3

a. Request a prescription for an antispasmodic drug such as baclofen.

Question 4

A client with multiple sclerosis is being discharged from rehabilitation. Which statement would the nurse include in the client’s discharge teaching?

a. “Be sure that you use a wheelchair when you go out in public.”
b. “Wear an undergarment brief at all times in case of incontinence.”
c. “Avoid overexertion, stress, and extreme temperature if possible.”
d. “Avoid having sexual intercourse to conserve energy.”

Answer 4

c. “Avoid overexertion, stress, and extreme temperature if possible.”

Question 5

A nurse assesses a client with a spinal cord injury at level T5. The client’s blood pressure is 184/95 mm Hg, and the client presents with a flushed face and blurred vision. After raising the head of the bed, what action would the nurse take next?

a. Initiate oxygen via a nasal cannula.
b. Recheck the client’s blood pressure.
c. Palpate the bladder for distention.
d. Administer a prescribed beta blocker

Answer 5

c. Palpate the bladder for distention.

Question 6

The nurse initiates care for a client with a cervical spinal cord injury who arrives via emergency medical services. What action would the nurse take first?

a. Assess level of consciousness.
b. Obtain vital signs.
c. Administer oxygen therapy.
d. Evaluate respiratory status

Answer 6

d. Evaluate respiratory status

Question 7

A client who had a complete spinal cord injury at level L5-S1 is admitted with a sacral pressure injury. What other assessment finding will the nurse anticipate for this client?

a. Quadriplegia
b. Flaccid bowel
c. Spastic bladder
d. Tetraparesis

Answer 7

b. Flaccid bowel

Question 8

The nurse is collaborating with the occupational therapist to assist a client with a complete cervical spinal cord injury to transfer from the bed to the wheelchair. What ambulatory aid would be most appropriate for the client to meet this outcome?

a. Rolling walker
b. Quad cane
c. Adjustable crutches
d. Sliding board

Answer 8

d. Sliding board

Question 9

The nurse is caring for a 60-year-old female client who sustained a thoracic spinal cord injury 10 years ago. For which potential complication will the nurse assess during this client’s care?

a. Fracture
b. Malabsorption
c. Delirium
d. Anemia

Answer 9

a. Fracture

Question 10

A nurse is caring for a client with paraplegia who is scheduled to participate in a rehabilitation program. The client states, “I don’t understand the need for rehabilitation; the paralysis will not go away and it will not get better.” How would the nurse respond?

a. “If you don’t want to participate in the rehabilitation program, I’ll let your primary health care provider know.”
b. “Rehabilitation programs have helped many patients with your injury. You should give it a chance.”
c. “The rehabilitation program will teach you how to maintain the functional ability you have and prevent further disability.”
d. “When new discoveries are made regarding paraplegia, people in rehabilitation programs will benefit first.”

Answer 10

c. “The rehabilitation program will teach you how to maintain the functional ability you have and prevent further disability.”

Question 11

A nurse cares for a client with a spinal cord injury. With which interprofessional health team member would the nurse collaborate to assist the client with activities of daily living?

a. Social worker
b. Physical therapist
c. Occupational therapist
d. Case manager

Answer 11

c. Occupational therapist

Question 12

After teaching a client with a high thoracic spinal cord injury, the nurse assesses the client’s understanding. Which statement by the client indicates a correct understanding of how to prevent respiratory problems at home?

a. “I’ll use my incentive spirometer every 2 hours while I’m awake.”
b. “I’ll drink thinned fluids to prevent choking.”
c. “I’ll take cough medicine to prevent excessive coughing.”
d. “I’ll position myself on my right side so I don’t aspirate.”

Answer 12

a. “I’ll use my incentive spirometer every 2 hours while I’m awake.”

Question 13

A client continues to have persistent low back pain even after using a number of nonpharmacologic pain management strategies. Which prescribed drug would the nurse anticipate that the client might need to manage the pain?

a. Oxycontin
b. Gabapentin
c. Lorazepam
d. Tramadol

Answer 13

d. Tramadol

Question 14

A client is scheduled for a percutaneous endoscopic lumbar discectomy. Which statement by the client indicates a need for further teaching?

a. “I should have a lot less pain after surgery.”
b. “I’ll be in the hospital for 2 to 3 days.”
c. “I should not have any major surgical complications.”
d. “I could possibly get an infection after surgery.”

Answer 14

b. “I’ll be in the hospital for 2 to 3 days.”

Question 15

A nurse assesses clients at a community center. Which client is at greatest risk for low back pain?

a. A 24-year-old female who is 25 weeks pregnant.
b. A 36-year-old male who uses ergonomic techniques.
c. A 53-year-old female who uses a walker.
d. A 65-year-old female with osteoarthritis.

Answer 15

d. A 65-year-old female with osteoarthritis.

Question 16

A nurse teaches a client who is recovering from an open traditional cervical spinal fusion. Which statement would the nurse include in this client’s postoperative instructions?

a. “Only lift items that are 10 lb (4.5 kg) or less.”
b. “Wear your neck brace whenever you are out of bed.”
c. “You must remain in bed for 3 weeks after surgery.”
d. “You will be prescribed medications to prevent graft rejection.”

Answer 16

b. “Wear your neck brace whenever you are out of bed.”

Question 17

A nurse assesses a client who is recovering from an open anterior cervical discectomy and fusion. Which complication would alert the nurse to urgently communicate with the primary health care provider?

a. Auscultated stridor
b. Weak pedal pulses
c. Difficulty swallowing
d. Inability to shrug shoulders

Answer 17

a. Auscultated stridor

Question 18

A nurse assesses the health history of a client who is prescribed ziconotide for chronic low back pain. Which assessment question would the nurse ask?

a. “Are you taking a nonsteroidal anti-inflammatory drug?”
b. “Have you been diagnosed with a mental health problem?”
c. “Are you able to swallow oral medications?”
d. “Do you smoke cigarettes or any illegal drugs?”

Answer 18

b. “Have you been diagnosed with a mental health problem?”

Question 19

A nurse promotes the prevention of lower back pain by teaching clients at a community center. Which statement(s) would the nurse include in this education? (Select all that apply.)

a. “Participate in an exercise program to strengthen back muscles.”
b. “Purchase a mattress that allows you to adjust the firmness.”
c. “Wear flat instead of high-heeled shoes to work each day.”
d. “Keep your weight within 20% of your ideal body weight.”
e. “Avoid prolonged standing or sitting, including driving.”

Answer 19

a. “Participate in an exercise program to strengthen back muscles.”
c. “Wear flat instead of high-heeled shoes to work each day.”
e. “Avoid prolonged standing or sitting, including driving.”

Question 20

A nurse assesses a client who recently experienced a traumatic spinal cord injury. Which assessment data would the nurse obtain to assess the client’s coping strategies? (Select all that apply.)

a. Spiritual beliefs
b. Level of pain
c. Family support
d. Level of independence
e. Annual income
f. Previous coping strategies

Answer 20

a. Spiritual beliefs
c. Family support
d. Level of independence
f. Previous coping strategies