Question 1 of 10
Report content error
Which concern is the nurse’s priority when providing care for a patient with a level 2 cervical vertebrae (C2) injury?
-
- Loss of control of upper bodyLoss of control of the upper body is a concern, but it is not the priority concern for the nurse.
-
- Loss of bowel and bladder controlLoss of bowel and bladder control is a concern, but it is not the priority concern for the nurse.
-
- Inability to move without assistanceThe inability to move without assistance is a concern, but it is not the priority concern for the nurse.
- Correct
- Inability to breathe without respiratory assistanceThe priority concern that the nurse would have regarding the care of a patient with a C2 injury is the patient’s inability to breathe without respiratory assistance.
Question 2 of 10
Report content error
Which response would the nurse utilize when the family asks why the patient has Crutchfield tongs for traction after sustaining a cervical spine injury?
-
- “This type of traction is used to relieve intracranial pressure.”The traction does not relieve intracranial pressure.
- Correct
- “This type of traction is used to keep the vertebrae in alignment.”Treatment of a cervical spinal cord injury sometimes includes traction to immobilize the affected vertebrae and maintain alignment. Crutchfield or Gardner-Wells tongs with ropes, pulleys, and weights or a halo ring and fixation pins are examples of skeletal traction used to treat cervical spinal cord injuries.
-
- “This type of traction is used to allow for safe turning of the patient by splinting the head and neck.”The traction does not splint the head and neck.
-
- “This type of traction is used to provide a means of relieving the pressure of blood within the skull.”The traction does not relieve pressure of blood within the skull.
Question 3 of 10
Report content error
Which medical term describes a partial dislocation of the vertebral column?
-
- HyperextensionHyperextension occurs when a joint is forced to move beyond its normal range of motion.
-
- DislocationDislocation occurs when the bones of a joint become separated or are forced out of place.
- Correct
- SubluxationSubluxation is the partial dislocation of a joint.
-
- FractureA fracture is a complete or partial break in a bone.
Question 4 of 10
Report content error
Which assessment finding would the nurse expect when caring for a patient with interruption of the thoracic spinal cord through L1 and L2?
-
- TetraplegiaTetraplegia occurs when there is damage to the cervical region of the spine.
- Correct
- ParaplegiaParaplegia occurs when there is interruption of the spinal cord through L1 and L2.
-
- Damage to the phrenic nervesThe phrenic nerves innervate the diaphragm and originate in the third, fourth, and fifth cervical segments.
-
- Use of a ventilatorWhen there is damage to the phrenic nerves, mechanical ventilation may be required to maintain respirations.
Question 5 of 10
Report content error
Which statement made by students of a course on caring for accident victims with a suspected spinal cord injury demonstrates a need for further education?
- Correct
- “I will place a pillow under the victim’s head for better neck support.”To avoid flexion of the neck, no pillow or other kind of support should be placed under the head.
-
- “I will treat the victim as if they have a spinal cord injury if they complain of neck or back pain or cannot move their legs.”It is best practice to treat any victim complaining of neck or back pain, or if they are unable to move their legs or have no feeling in their legs, as if they might have a spinal cord injury.
-
- “I will only move the patient if there is a life-threatening circumstance.”The patient should never be moved unless there is a life-threatening condition or situation that requires the patient to be moved.
-
- “I will allow a trained emergency medical technician (EMT) to transfer the victim to the hospital.”Transfer of the patient to the hospital should be done only by trained EMTs.
Question 6 of 10
Report content error
Which response will be given by the nurse when a family asks why their loved one was breathing normal when admitted to the hospital, but now they are being placed on a ventilator?
-
- “It will conserve energy so they can breathe on their own later.”Mechanical ventilation helps to relieve the work of breathing and conserve energy; this is an outcome but not the reason for the change in the patient’s breathing.
-
- “Mechanical ventilation will force the patient to breathe with the machine.”Mechanical ventilation will actually relieve the patient’s work of breathing.
-
- “They might have a more serious injury than we initially thought.”This is an insensitive comment and not the correct response.
- Correct
- “As swelling progresses throughout the spinal cord, breathing can become impaired.”Swelling can progress as time passes from the time of the injury and can cause issues with breathing.
Question 7 of 10
Report content error
Which type of device might be used for a patient who suffered a spinal cord injury but will not require surgery?
-
- Buck’s tractionBuck’s traction is generally used for femoral fractures.
-
- Crutchfield tongsCrutchfield tongs are a type of skeletal traction used after spinal surgery to stabilize the spine.
- Correct
- Halo ringThe halo ring with fixation pins and vest is useful for spinal cord injuries not requiring surgery as it allows for early mobilization.
-
- Gardner-Wells tongsGardner-Wells tongs are a device used for immobilization of the cervical spine after spinal surgery.
Question 8 of 10
Report content error
Which stage of grief does a nurse suspect when caring for a patient using vulgar language and refusing to discuss paralysis related to their spinal cord injury?
-
- BargainingIn the bargaining stage of grief, the patient might plead with a higher power or fate.
-
- DepressionIn the depression stage of grief, the patient may be sad, withdrawn, agitated, and refuse to participate in education for self-care.
-
- Shock and denialIn the initial shock and denial stage of grief, the patient might be completely depending on others for care, may sleep excessively, and may have unrealistic expectations.
- Correct
- AngerIn the anger stage of grief, the patient may display hostility toward caregivers, use manipulative behavior and abusive language, and refuse to discuss paralysis and losses.
Question 9 of 10
Report content error
Which spinal cord injury complication has occurred in a patient presenting with flaccid paralysis and loss of sensation below the level of their spinal cord injury?
- Correct
- Spinal shockSpinal shock occurs immediately after injury and is characterized by flaccid paralysis and loss of reflex activity and of sensation below the level of the spinal injury.
-
- TetraplegiaTetraplegia is the inability of the patient to voluntarily move the upper and lower parts of the body.
-
- Neurogenic shockNeurogenic shock is caused by a loss of vasomotor tone and is characterized by bradycardia, hypotension, and venous pooling with decreased cardiac output.
-
- Autonomic dysreflexiaAutonomic dysreflexia is an exaggerated reflex response that produces vasoconstriction and an immediate elevation in blood pressure.
Question 10 of 10
Report content error
Which medication would the nurse anticipate the provider ordering for a patient struggling with neuropathic pain after a spinal cord injury?
-
- DexmedetomidineDexmedetomidine is used for sedation.
- Correct
- GabapentinGabapentin and pregabalin are the primary medications used to treat neuropathic pain.
-
- BaclofenBaclofen is used to relieve muscle spasms.
-
- MannitolMannitol is an osmotic diuretic used to promote diuresis.
