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A client who has lumbar radiculopathy due to spinal stenosis is scheduled for an interventional procedure to relieve their symptoms. The nurse explains to the client that they will receive an injection of a steroid and a local anesthetic into the epidural space of their spine. The client asks the nurse, "How will this help me?" Which of the following responses should the nurse give?

"The steroid will reduce the inflammation and swelling of the nerve root, which will decrease your pain and improve your function."

"The local anesthetic will block the transmission of pain signals from the nerve root to your brain, which will provide you with temporary relief."

"The combination of steroid and local anesthetic will shrink the size of the disc or bone spur that is compressing the nerve root, which will restore your mobility and sensation."

"The injection will deliver medication directly to the affected area of your spine, which will have fewer side effects than oral or intravenous medications."

Answer and Explanation

The Correct Answer is A

Choice A reason:

This is the correct answer because epidural steroid injections are used to treat radiculopathy by reducing inflammation and edema of the nerve root, which can relieve radicular pain and improve neurological function.

Choice B reason:

This is incorrect because local anesthetic alone can provide temporary pain relief by blocking nerve conduction, but it does not address the underlying cause of radiculopathy, which is nerve root compression.

Choice C reason:

This is incorrect because steroid and local anesthetic do not have any effect on the size or shape of the disc or bone spur that is compressing the nerve root. They only reduce inflammation and pain.

Choice D reason:

This is incorrect because although epidural injections may have fewer systemic side effects than oral or intravenous medications, they still have some risks and complications, such as infection, bleeding, nerve damage, or spinal headache.

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Correct Answer is ["A","B","C","E"]

Explanation

Choice A reason:
This is correct because monitoring the client's vital signs and neurological status frequently can help detect any changes in the client's condition, such as improvement or deterioration of symptoms, or complications such as bleeding or increased intracranial pressure.

Choice B reason:
This is correct because administering rtPA within 4.5 hours of symptom onset can increase the chances of restoring blood flow to the ischemic brain tissue and reducing neurological damage. The effectiveness and safety of rtPA decrease after this time window.

Choice C reason:
This is correct because maintaining the client's systolic blood pressure below 180 mm Hg can prevent further ischemia or hemorrhage in the brain. High blood pressure can increase the risk of bleeding or reperfusion injury after thrombolytic therapy.

Choice D reason:
This is incorrect because giving aspirin or other antiplatelet agents along with rtPA can increase the risk of bleeding or hemorrhagic transformation. Antiplatelet agents should be avoided for at least 24 hours after thrombolytic therapy.

Choice E reason:
This is correct because assessing the client for signs of bleeding or hemorrhagic transformation can help identify any adverse effects of thrombolytic therapy. Bleeding or hemorrhagic transformation can manifest as hematuria, hematemesis, melena, petechiae, ecchymosis, epistaxis, gingival bleeding, headache, altered mental status, or worsening neurological deficits.

A. Wear tight-fitting shoes to prevent foot injuries. B. Use a heating pad to relieve pain in the affected areas. C. Inspect your skin daily for cuts, blisters, or ulcers. D. Avoid taking vitamin B supplements to prevent toxicity.

Correct Answer is C

Explanation

Choice A reason:

This is incorrect because wearing tight-fitting shoes can cause pressure ulcers, blisters, or infections in clients with peripheral neuropathy, who have reduced sensation and blood flow in their feet. The nurse should advise the client to wear well-fitting shoes with cushioned socks and avoid walking barefoot.

Choice B reason:

This is incorrect because using a heating pad can cause burns or skin damage in clients with peripheral neuropathy, who have impaired temperature perception and pain sensation in their affected areas. The nurse should advise the client to avoid exposure to extreme heat or cold and use other methods to relieve pain, such as medications, massage, or acupuncture.

Choice C reason:

This is the correct answer because inspecting the skin daily for cuts, blisters, or ulcers can help prevent infection and complications in clients with peripheral neuropathy, who have reduced sensation and healing ability in their affected areas. The nurse should advise the client to wash their skin with mild soap and water, apply moisturizer, and report any signs of infection to their provider.

Choice D reason:

This is incorrect because taking vitamin B supplements can help prevent or treat peripheral neuropathy caused by vitamin B deficiency, which can occur in clients who receive chemotherapy. The nurse should advise the client to consult with their provider before taking any supplements and follow a balanced diet that includes foods rich in vitamin B, such as meat, eggs, dairy products, and fortified cereals.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has ischemic stroke and is receiving thrombolytic therapy with recombinant tissue plasminogen activator (rtPA). Which of the following actions should the nurse take? (Select all that apply.)

Correct Answer is ["A","B","C","E"]

Explanation

A nurse is providing education to a client who has peripheral neuropathy due to chemotherapy. The nurse should include which of the following instructions in the teaching plan?

Correct Answer is C

Explanation

A nurse is administering medication to a client who has Parkinson's disease. The client asks the nurse how the medication works. Which of the following responses by the nurse is appropriate?

A nurse is assessing a client who has a spinal cord injury at the level of T6. Which of the following functions are likely to be affected by this injury? (Select all that apply.)

A nurse is caring for a client who has multiple sclerosis (MS). Which of the following statements by the client indicates an understanding of this condition?

A nurse is reviewing the anatomy of the peripheral nervous system (PNS) with a group of nursing students. Which of the following statements by a student indicates a need for further teaching?

A client has been diagnosed with radiculopathy due to a herniated disc in the lumbar spine. The nurse should instruct the client to avoid which of the following activities? (Select all that apply.)

A nurse is reviewing the medical history of a client who has ischemic stroke. Which of the following conditions is the most common cause of ischemic stroke?