A client is complaining of low back pain that radiates down the left posterior thigh. The nurse would ask the client if the pain is worsened or aggravated by which factor?

1.Bed rest

2.Ibuprofen

3.Bending or lifting

4.Application of heat

3.Bending or lifting

A client has just undergone spinal fusion after experiencing herniation of a lumbar disk. The nurse would include which interventions in the plan of care to maintain client safety after this procedure? Select all that apply.

1.Use the overhead trapeze.

2.Keep the head of the bed flat.

3.Place pillows under the length of the legs.

4.Use a logrolling technique for repositioning.

5.Assist the client with eating meals and drinking fluids.

2.Keep the head of the bed flat.

3.Place pillows under the length of the legs.

4.Use a logrolling technique for repositioning.

5.Assist the client with eating meals and drinking fluids.

The nurse is caring for a client admitted for a herniated intervertebral lumbar disk who is complaining about stabbing pain radiating to the lower back and the right buttock. The nurse determines that the client's signs/symptoms are most likely due to which condition?

1.Pressure on the spinal cord

2.Pressure on the spinal nerve root

3.Muscle spasm in the area of the herniated disk

4.Excess cerebrospinal fluid production in the area

3.Muscle spasm in the area of the herniated disk

The nurse has a prescription to place a client with a herniated lumbar intervertebral disk on bed rest in Williams' position to minimize the pain. The nurse would put the bed in what position?

1.Flat with the knees raised

2.In high-Fowler's position, with the foot of the bed flat

3.In semi-Fowler's position, with the foot of the bed flat

4.In semi-Fowler's position, with the knees slightly flexed

4.In semi-Fowler's position, with the knees slightly flexed

A client with a herniated disk who has had spinal fusion and insertion of hardware is extremely concerned with the perceived lengthy rehabilitation period. The client expresses concerns about finances and the ability to return to prior employment. The nurse understands that the client's needs could best be addressed by referral to which member of the health care team?

1.The surgeon

2.A social worker

3.The physical therapist

4.The clinical nurse specialist

2.A social worker

The nurse is monitoring a client with a suspected intervertebral disc problem who has returned to the nursing unit after a myelogram. Which client complaint would indicate the need to notify the primary health care provider (PHCP)?

1.Backache

2.Headache

3.Neck stiffness

4.Feelings of fatigue

3.Neck stiffness

The nurse has taught a client with a herniated lumbar disk about proper body mechanics and other items pertinent to low back care. The nurse determines that further teaching is needed if the client states the need to take which action?

1.Bend at the knees to pick up objects.

2.Increase fiber and fluid intake in the diet.

3.Strengthen the back muscles by swimming or walking.

4.Get out of bed by sitting straight up and swinging the legs over the side of the bed.

4.Get out of bed by sitting straight up and swinging the legs over the side of the bed.

The nurse cares for a client immediately following a lumbar laminectomy procedure. The client reports numbness and tingling down the left lateral thigh and knee. What is the next action for the nurse to take?

1.Document the assessment.

2.Inform the client that this is to be expected.

3.Contact the primary health care provider (PHCP).

4.Question the client about preoperative symptoms.

4.Question the client about preoperative symptoms.

A client with an intervertebral disc problem is scheduled for myelography. Following myelography, how would the nurse plan to best position the client?

1.On the left side

2.On the right side

3.Head slightly elevated

4.Head lower than the rest of the body

3.Head slightly elevated

The nurse provides discharge instructions to a client suspected of having an intervertebral disc problem following myelography. Which instructions would the nurse provide? Select all that apply.

1.Restrict fluid intake.

2.Avoid bending over.

3.Avoid strenuous exercise.

4.Rest with the head elevated.

5.Expect some clear drainage from the dressing site.

2.Avoid bending over.

3.Avoid strenuous exercise.

4.Rest with the head elevated.

A client with a suspected intervertebral disc problem requires a myelogram, and the ambulatory care nurse is providing instructions to the client regarding preparation for the procedure. Which statement by the client indicates a need for further instruction?

1."My jewelry will need to be removed."

2."An informed consent form will need to be signed."

3"My procedure will take approximately 45 minutes."

4."I need to be sure to eat a full meal before the procedure."

4."I need to be sure to eat a full meal before the procedure."

The nurse is assessing the status of pain in an alert older client who was recently admitted to the hospital with a diagnosis of ruptured lumbar disc. What are some of the beliefs and concerns older adults have about pain? Select all that apply.

1.Pain is something that must be lived with.

2.Nurses are too busy to listen to reports of pain.

3.Pain signifies a serious illness or impending death.

4.Reporting pain will result in being labeled as a "bad" client.

4Expressing pain is only done by people who want attention.

6.Nurses and other caregivers often give too much medication to older clients.

1.Pain is something that must be lived with.

2.Nurses are too busy to listen to reports of pain.

3.Pain signifies a serious illness or impending death.

4.Reporting pain will result in being labeled as a "bad" client.

A client has been prescribed cyclobenzaprine for the treatment of painful muscle spasms accompanying a herniated intervertebral disk. The nurse would withhold the medication and question the prescription if the client has a concurrent prescription for which medication?

1.Ibuprofen

2.Furosemide

3.Valproic acid

4.Tranylcypromine

4.Tranylcypromine