Back Pain Low Back Pain And Vital Signs 2 — Questions and Answers
Question 1: A patient with low back pain has a temperature of 101.8°F (38.8°C). Which condition should be suspected first?
- Vertebral osteomyelitis or spinal epidural abscess (Correct answer)
- Lumbar muscle strain
- Degenerative disc disease
- Facet joint arthropathy
Correct answer: Vertebral osteomyelitis or spinal epidural abscess
Fever combined with back pain is a red flag for spinal infection such as osteomyelitis or epidural abscess.
Question 2: Which vital sign change is most expected in a patient experiencing acute severe low back pain?
- Elevated heart rate and blood pressure (Correct answer)
- Decreased respiratory rate
- Hypothermia
- Bradycardia
Correct answer: Elevated heart rate and blood pressure
Acute pain activates the sympathetic nervous system, raising heart rate and blood pressure.
Question 3: An older adult presents with sudden low back pain, hypotension, and a pulsatile abdominal mass. What is the most likely diagnosis?
- Ruptured abdominal aortic aneurysm (Correct answer)
- Lumbar disc herniation
- Spinal stenosis
- Sacroiliac joint dysfunction
Correct answer: Ruptured abdominal aortic aneurysm
The triad of back pain, hypotension, and a pulsatile abdominal mass is classic for a ruptured abdominal aortic aneurysm.
Question 4: Why is pain often called the 'fifth vital sign' in patients with low back pain?
- Because pain should be assessed routinely alongside standard vital signs (Correct answer)
- Because pain replaces blood pressure measurement
- Because pain is measured with a thermometer
- Because pain only matters in surgical patients
Correct answer: Because pain should be assessed routinely alongside standard vital signs
Pain is assessed as routinely as temperature, pulse, respirations, and blood pressure to guide treatment.
Question 5: A patient with back pain from a suspected kidney infection (pyelonephritis) would most likely show which vital sign pattern?
- Fever with tachycardia (Correct answer)
- Bradycardia with hypertension
- Hypothermia with bradypnea
- Normal vital signs in all cases
Correct answer: Fever with tachycardia
Pyelonephritis typically causes fever and a compensatory increase in heart rate.
Question 6: Which vital sign should be monitored most closely after giving an opioid for severe low back pain?
- Respiratory rate (Correct answer)
- Temperature
- Height
- Capillary refill
Correct answer: Respiratory rate
Opioids can cause respiratory depression, so respiratory rate is the priority assessment.
Question 7: A normal adult resting respiratory rate, useful as a baseline when assessing a back pain patient, is approximately:
- 12-20 breaths per minute (Correct answer)
- 4-8 breaths per minute
- 30-40 breaths per minute
- 50-60 breaths per minute
Correct answer: 12-20 breaths per minute
The normal adult resting respiratory rate is about 12-20 breaths per minute.
Back Pain Low Back Pain And Vital Signs 2
A patient with low back pain has a temperature of 101.8°F (38.8°C).
Which condition should be suspected first?