NUR 397 Spinal cord problems (mobility)

A sudden and forceful acceleration of the head forward may cause which mechanism of spinal cord injury? 1.) Hyperflexion 2.) Hyperextension 3.) Excessive rotation 4.) Vertical compression

1 A sudden and forceful acceleration of the head forward may cause hyperflexion. Hyperextension occurs when the head is suddenly accelerated and then decelerated. Excessive rotation results from injuries that are caused by turning the head beyond the normal range. Axial loading or vertical compression injuries may result from diving accidents, falls on the buttocks, or a jump in which a person lands on the feet.Test-Taking Tip: You have at least a 25% chance of selecting the correct response in multiple choice items. If you are uncertain about a question, eliminate the choices you believe are wrong, and then call on your knowledge, skills, and abilities to choose from the remaining responses.

What term describes excessive inward curvature of the spine? 1.) Lordosis 2.) Scoliosis 3.) Spinal shock 4.) Spinal stenosis

1 Lordosis is excessive inward curvature of the spine. Scoliosis is excessive sideways curvature of the spine. Spinal shock is a combination of areflexia/hyporeflexia and autonomic dysfunction following spinal cord injury. Spinal stenosis is back pain associated with narrowing of the spinal canal, nerve root canals, or intervertebral foramina.

What assessment finding is associated with a lower thoracic spinal cord injury? 1.) Paraplegia 2.) Tetraplegia 3.) Hemiplegia 4.) Quadriplegia

1 Paraplegia is paralysis of the lower extremities that is seen in lower thoracic injuries. Tetraplegia is paralysis of all four extremities and is associated with cervical cord and upper thoracic injuries. Hemiplegia is paralysis of one side of the body and is associated with stroke. Quadriplegia is the same as tetraplegia, which is paralysis of all four extremities. Quadriplegia is associated with cervical cord and upper thoracic injuries.

What secondary spinal cord injury typically results from reduced or absent blood flow? 1.) Ischemia 2.) Hemorrhage 3.) Local edema 4.) Hypovolemia

1 Secondary spinal cord injuries include ischemia, or a lack of oxygen, typically from reduced or absent blood flow. Hemorrhage from excessive bleeding, local edema from swelling of soft tissues due to increased interstitial fluid, and hypovolemia from decreased circulating blood volume.

Following a spinal cord injury (SCI), what is the patient with weakness in the legs experiencing? 1.) Paraparesis 2.) Hypoesthesia 3.) Hyperesthesia 4.) Quadraparesis

1 The patient with weakness in the lower extremities following SCI is experiencing paraparesis. Hypoesthesia is decreased sensation. Hyperesthesia is increased sensation. Quadraparesis is weakness involving all four extremities.

Which statement about autonomic dysreflexia is accurate? 1.) It occurs when a spinal cord injury is present below T6. 2.) It can be caused by a distended bladder. 3.) It causes orthostatic hypotension in the patient. 4.) It increases the patient's heart rate.

2 Autonomic dysreflexia refers to an excessive, uncontrolled sympathetic output that is caused due to a noxious stimulus. This stimulus often arises from a distended bladder. It is seen in upper spinal cord injuries (SCI) above the level of T6. Orthostatic hypotension may occur due to interruption of the sympathetic innervations caused by SCI. Autonomic dysreflexia involves excessive sympathetic output, and therefore causes severe hypertension. It also causes bradycardia, which is a decrease in heart rate.

Which mechanism of spinal cord injury occurs when the head is suddenly accelerated and then decelerated? 1.) Hyperflexion 2.) Hyperextension 3.) Excessive rotation 4.) Vertical compression

2 Hyperextension occurs when the head is suddenly accelerated and then decelerated. A sudden and forceful acceleration of the head forward may cause hyperflexion. Excessive rotation results from injuries that are caused by turning the head beyond the normal range. Axial loading or vertical compression injuries may result from diving accidents, falls on the buttocks, or a jump in which a person lands on the feet.

A halo fixator with a jacket is used to immobilize the spine of a patient following a vertebral fracture. What nursing assessment monitors for neurogenic shock? 1.) Monitor for severe bradycardia every 2 to 4 hours. 2.) Monitor the patient every hour for severe hypotension. 3.) Assess the patient's breath sounds every 2 to 4 hours. 4.) Check if a finger can be inserted between the jacket and the patient's skin.

2 Neurogenic shock occurs due to decreased circulating blood volume following a spinal cord injury. The patient must be monitored at least hourly for severe hypotension to assess for neurogenic shock. The patient's breath sounds should be assessed every 2 to 4 hours to note if the airway is patent and ventilation is adequate. The patient should be monitored for severe bradycardia at least hourly to monitor for neurogenic shock. Inserting a finger between the jacket and the patient's skin ensures that the jacket is not causing pressure.

What term describes excessive sideways curvature of the spine? 1.) Lordosis 2.) Scoliosis 3.) Spinal shock 4.) Spinal stenosis

2 Scoliosis is excessive sideways curvature of the spine. Lordosis is excessive inward curvature of the spine. Spinal shock is a combination of areflexia/hyporeflexia and autonomic dysfunction following spinal cord injury. Spinal stenosis is back pain associated with narrowing of the spinal canal, nerve root canals, or intervertebral foramina.Test-Taking Tip: Sometimes the reading of a question in the middle or toward the end of an exam may trigger your mind with the answer or provide an important clue to an earlier question.

Which secondary spinal cord injury typically results from excessive bleeding? 1.) Ischemia 2.) Hemorrhage 3.) Local edema 4.) Hypovolemia

2 Secondary spinal cord injuries include hemorrhage (excessive bleeding), ischemia (lack of oxygen, typically from reduced or absent blood flow), local edema (swelling of soft tissues due to increased interstitial fluid), and hypovolemia (decreased circulating blood volume).

More than a third of spinal cord injuries (SCIs) result from which cause? 1.) Falls 2.) Vehicle crashes 3.) Gunshot wounds 4.) Sport-related accidents

2 Trauma is the leading cause of SCIs, with more than a third resulting from vehicle crashes. Other leading causes are falls, acts of violence (usually gunshot wounds), and sport-related accidents.

Which mechanism of spinal cord injury occurs when the head turns beyond the normal range? 1.) Hyperflexion 2.) Hyperextension 3.) Excessive rotation 4.) Vertical compression

3 Excessive rotation results from injuries that are caused by turning the head beyond the normal range. A sudden and forceful acceleration of the head forward may cause hyperflexion. Hyperextension occurs when the head is suddenly accelerated and then decelerated. Axial loading or vertical compression injuries may result from diving accidents, falls on the buttocks, or a jump in which a person lands on the feet.

Which secondary spinal cord injury typically results from swelling of soft tissues due to increased interstitial fluid? 1.) Ischemia 2.) Hemorrhage 3.) Local edema 4.) Hypovolemia

3 Secondary spinal cord injuries can result in local edema from swelling of soft tissues due to increased interstitial fluid. They can cause ischemia (lack of oxygen, typically from reduced or absent blood flow), hemorrhage (excessive bleeding), and hypovolemia (decreased circulating blood volume).

Following a spinal cord injury (SCI), what is the patient reporting increased sensory sensation experiencing? 1.) Paraparesis 2.) Hypoesthesia 3.) Hyperesthesia 4.) Quadraparesis

3 The patient reporting increased sensory perception following SCI is experiencing hyperesthesia. Paraparesis is weakness in the lower extremities. Hypoesthesia is decreased sensation. Quadraparesis is weakness involving all four extremities.

What mechanism of spinal cord injury may result from diving accidents, falls on the buttocks, or a jump in which a person lands on the feet? 1.) Hyperflexion 2.) Hyperextension 3.) Excessive rotation 4.) Vertical compression

4 Axial loading or vertical compression injuries may result from diving accidents, falls on the buttocks, or a jump in which a person lands on the feet. A sudden and forceful acceleration of the head forward may cause hyperflexion. Hyperextension occurs when the head is suddenly accelerated and then decelerated. Excessive rotation results from injuries that are caused by turning the head beyond the normal range.Test-Taking Tip: You have at least a 25% chance of selecting the correct response in multiple choice items. If you are uncertain about a question, eliminate the choices you believe are wrong, and then call on your knowledge, skills, and abilities to choose from the remaining responses.

Which secondary spinal cord injury typically results from decreased circulating blood volume? 1.) Ischemia 2.) Hemorrhage 3.) Local edema 4.) Hypovolemia

4 Secondary spinal cord injuries can cause hypovolemia resulting from decreased circulating blood volume. Ischemia (lack of oxygen, typically from reduced or absent blood flow), hemorrhage (excessive bleeding), and local edema (swelling of soft tissues due to increased interstitial fluid) can also occur.

What term describes back pain associated with narrowing of the spinal canal, nerve root canals, or intervertebral foramina? 1.) Lordosis 2.) Scoliosis 3.) Spinal shock 4.) Spinal stenosis

4 Spinal stenosis is back pain associated with narrowing of the spinal canal, nerve root canals, or intervertebral foramina. Lordosis is excessive inward curvature of the spine. Scoliosis is excessive sideways curvature of the spine. Spinal shock is a combination of areflexia/hyporeflexia and autonomic dysfunction following spinal cord injury.Test-Taking Tip: Do not worry if you select the same numbered answer repeatedly, because there usually is no pattern to the answers.

Following a spinal cord injury (SCI), what is the patient with weakness in the legs and arms experiencing? 1.) Paraparesis 2.) Hypoesthesia 3.) Hyperesthesia 4.) Quadraparesis

4 The patient with weakness in the upper and lower extremities following SCI is experiencing quadraparesis. Paraparesis is weakness involving the lower extremities. Hypoesthesia is decreased sensation. Hyperesthesia is increased sensation.Test-Taking Tip: Start by reading each of the answer options carefully. Usually at least one of them will be clearly wrong. Eliminate this one from consideration. Now you have reduced the number of response choices by one and improved the odds. Continue to analyze the options. If you can eliminate one more choice in a four-option question, you have reduced the odds to 50/50. While you are eliminating the wrong choices, recall often occurs. One of the options may serve as a trigger that causes you to remember what a few seconds ago had seemed completely forgotten.