Spinal cord injury group NCLEX questions .docx

Spinal cord injury group NCLEX questions (1).docx 2021

• A client with tetraplegia has a spinal cord injury (SCI) at C4. He experiences severe orthostatic hypotension with

any elevation of his head. Which of the following interventions will the nurse employ to reduce the hypotension?

• Apply anti-embolytic stockings prior to elevation of the head.
• Avoid binders around the abdominal area.
• Practice with the client raising the head in one smooth, quick motion.
• Avoid vasopressor medication for 2 hours prior to the client sitting up.

• A nurse on the neurologic unit is providing care for a patient who has spinal cord injury at the level of C4. When

planning the patient’s care, what aspect of the patient’s neurologic and functional status should the nurse consider?

• The patient will be unable to use a wheelchair
• The patient will be unable to swallow food
• The patient will be continent of urine, but incontinent of bowel
• The patient will require full assistance for all aspects of elimination

• A client with spinal trauma tells the nurse they cannot cough. What nursing intervention should the nurse

perform when a client with spinal trauma may not be able to cough?

• Administer oxygen as prescribed
• Use mechanical ventilation
• Maintain a patent airway
• Suction the airway

• The nurse recognizes that a patient with a spinal cord injury is at risk for muscle spasticity. How can the nurse

best prevent this complication of spinal cord injury?

• Position the client in high Fowler’s position while in bed
• Support the knees with a pillow when the patient is in bed
• Perform passive ROM exercises as ordered
• Administer NSAIDs as ordered

• For a patient with a spinal cord injury, why is it beneficial to administer oxygen to maintain a high partial

pressure of oxygen (PaO2)?

• So the patient will not have respiratory arrest
• Because hypoxemia can create or worsen a neurological deficit of the spinal cord
• To increase cerebral perfusion pressure
• To prevent secondary brain injury

• A patient with a spinal cord injury is at risk or the development of UTIs. Which of the following would the nurse

instruct the client to report if the client is concerned a UTI is occurring?

• Dark or amber colored urine
• Cloudy, foul smelling urine
• Burning with urination
• Hesitancy with urination

• A nurse is planning care for a client who has a spinal cord injury involving a T12 fracture 1 week ago. The client

has no muscle control of the lower limbs, bowel or bladder. Which of the following should be the nurse’s priority?

• Prevention of further damage to the spinal cord
• Prevention of contractures of the lower extremities
• Prevention of skin breakdown of areas that lack sensation
• Prevention of postural hypotension when placing the client in a wheelchair

• A nurse is caring for a client who experienced a cervical spine injury 24 hours ago. Which of the following

medications should the nurse clarify with the provider?

• Dexamethasone to suppress the inflammatory response
• Plasma expanders to treat hypotension and shock
• Raniditine to prevent gastric ulcers
• Hydralazine hydrochloride for hypotension

• A nurse is caring for a male client who experienced a cervical spine injury 3 months ago. The nurse should plan

to implement which of the following types of bladder management methods?

• Condom catheter
• Intermittent urinary catheterization
• Crede’s method
• Indwelling urinary catheter