Spinal Surgeries (19 Questions)

1. Mr. Paul Gervais, 64 years old, is postoperative day 0 following a lumbar laminectomy (L3–L4).

His medical orders include:
*Acetaminophen 1,000 mg PO q6h scheduled
*Morphine 2 mg IV q3h PRN for severe pain (7–10/10)
*Log-roll technique for repositioning
*Head of bed flat for 6 hours
*Neuro checks q2h

The nurse enters the room and finds Mr. Gervais attempting to raise the head of the bed to eat. He reports pain 4/10 and denies dizziness.

Question:
What is the most appropriate nursing action? *
2. Mme. Isabelle Tremblay, 58 years old, is postoperative day 1 following an anterior cervical discectomy and fusion (ACDF).

Medical orders include:
*Hydromorphone 1 mg PO q4h PRN pain
*Soft cervical collar when out of bed
*Neuro checks q4h

The patient asks if she can lie flat to sleep.

Question:
What is the correct nursing instruction? *
3. Mr. Daniel Roy, 67 years old, is postoperative day 1 following a lumbar spinal fusion (L4–S1).

Orders include:
*Oxycodone 5 mg PO q4h PRN pain
*No bending, lifting, or twisting

The nurse observes the patient attempting to twist his torso to reach the bedside table.

Question:
What is the nurse’s priority action? *
4. Mme. Sophie Lambert, 62 years old, is postoperative day 2 following a lumbar discectomy. Medical orders include: Activity as tolerated

The nurse finds her lying on her stomach while resting.

Question:
What should the nurse do? *
5. Mr. Jean-Claude Martin, 70 years old, is postoperative day 1 following a lumbar laminectomy.

Orders include:
*Bed rest

The nurse notes clear drainage from the incision and the patient reports a headache that worsens when sitting upright.

Question:
What is the priority nursing action? *
6. Mme. Louise Pelletier, 65 years old, is postoperative day 2 following a lumbar laminectomy. Orders include: May sit in chair with assistance

The nurse prepares to assist the patient from bed to chair.

Question:
Which action is most appropriate? *
7. Mr. André Fournier, 69 years old, is postoperative day 1 following posterior cervical decompression.

Orders include:
*Head of bed elevated 30–45°
*Cervical collar at all times

The patient requests to lie flat because he feels tired.

Question:
What is the best response? *
8. Mr. Luc Morel, 60 years old, is postoperative day 1 following a lumbar discectomy.

Orders include:
*Hydromorphone 1 mg IV q3h PRN pain
*Side-lying or supine positioning

He reports increased pain when lying flat.

Question:
What is the most appropriate nursing intervention? *
9. Mme. Karine Dumas, 55 years old, is preparing for discharge after a lumbar discectomy.

Orders include:
*Avoid bending, lifting, twisting
*Side-lying or supine positioning for rest

She asks how she should position herself when resting at home.

Question:
Which instruction should the nurse emphasize? *
10. Mr. Pierre Leduc, 63 years old, is postoperative day 0 following a lumbar laminectomy (L4–L5).

Medical orders include:
*Acetaminophen 1,000 mg PO q6h scheduled
*Hydromorphone 0.5 mg IV q3h PRN pain (7–10/10)
*Position: supine with log-roll for turning
*Activity: bed rest until tomorrow
*Vital signs q2h

Two hours after surgery, he reports pain rated 8/10 when attempting to turn in bed.

Question:
What is the most appropriate nursing action? *
11. Mme. Caroline Fortier, 55 years old, is postoperative day 1 following a lumbar discectomy at L5–S1.

Medical orders include:
*Bed rest, flat for 24 hours
*Acetaminophen 650 mg PO q6h PRN headache
*Neuro checks q4h

She requests to sit upright for breakfast and reports a mild headache when raising her head.

Question:
What is the priority nursing action? *
12. Mr. Daniel Gagnon, 60 years old, is postoperative day 1 following a lumbar spinal fusion.

Orders include:
*Oxycodone 5 mg PO q4h PRN pain
*Log-roll for repositioning

The nurse observes the patient lying on his side.

Question:
What is the nurse’s initial intervention? *
13. Mme. Isabelle Tremblay, 68 years old, is postoperative day 1 following a cervical laminectomy (C5–C6).

Medical orders include:
*Head of bed elevated 30°
*Soft cervical collar while awake
*Acetaminophen 1,000 mg PO q6h scheduled

She asks if she can lie flat because her neck feels stiff.

Question:
What is the most appropriate response? *
14. Mr. Luc Pelletier, 57 years old, is postoperative day 1 following a lumbar discectomy.

Orders include:
*Activity: out of bed with assistance
*Log-roll to sitting position
*Hydromorphone 1 mg PO q4h PRN pain

The nurse prepares to assist him out of bed for the first time.

Question:
What is the correct method to position the patient before standing? *
15. Mme. Hélène Moreau, 72 years old, is postoperative day 2 following a posterior lumbar spinal fusion.

Orders include:
*Avoid prone position
*Position: supine or side-lying
*Neuro checks q4h

She asks if she can lie on her stomach to relieve pressure.

Question:
What is the most appropriate nursing response? *
16. Mr. André Côté, 74 years old, is postoperative day 3 following a lumbar laminectomy.

Orders include:
*Pressure-relieving mattress

The nurse plans his repositioning schedule to prevent pressure injuries.

Question:
What is the most appropriate repositioning strategy? *
17. Mme. Sylvie Paquin, 59 years old, is postoperative day 2 following a lumbar discectomy. She reports worsening headache when sitting up and clear drainage on the dressing.

Question:
What position should the nurse maintain? *
18. Mr. Robert Villeneuve, 65 years old, is postoperative day 1 following a lumbar spinal fusion.

Orders include:
*Hydromorphone 0.5 mg IV q3h PRN
*Position: neutral spine at all times

He reports pain rated 9/10 while lying in bed.

Question:
What is the most appropriate intervention? *
19. Mme. Nathalie Boucher, 54 years old, is preparing for discharge after a lumbar discectomy.

Orders include:
*Avoid bending, lifting, twisting
*Use log-roll technique at home

She asks which sleeping position is safest.

Question:
Which instruction should the nurse reinforce? *