Back Pain Low Back Pain And Vital Signs 3 — Questions and Answers
Question 1: A back pain patient reports dizziness on standing. Orthostatic vital signs show a systolic drop of 25 mmHg upon standing. What does this indicate?
- Orthostatic hypotension (Correct answer)
- Normal postural response
- Hypertensive urgency
- Malignant hyperthermia
Correct answer: Orthostatic hypotension
A systolic drop of 20 mmHg or more on standing defines orthostatic hypotension.
Question 2: Which patient with low back pain most urgently needs vital signs and emergency evaluation?
- One with new urinary retention and saddle anesthesia (Correct answer)
- One with pain after gardening that improves with rest
- One with stiffness in the morning lasting 10 minutes
- One with mild pain after a long car ride
Correct answer: One with new urinary retention and saddle anesthesia
Urinary retention with saddle anesthesia suggests cauda equina syndrome, a surgical emergency.
Question 3: A patient in severe back pain has a blood pressure of 178/98 mmHg. What is the best initial interpretation?
- Pain may be transiently elevating the blood pressure; reassess after pain control (Correct answer)
- The patient definitely has chronic hypertension
- The reading is normal for adults
- The cuff must be broken
Correct answer: Pain may be transiently elevating the blood pressure; reassess after pain control
Acute pain commonly causes transient blood pressure elevation, so reassessment after analgesia is appropriate.
Question 4: Which pain assessment tool asks a patient to rate low back pain from 0 to 10?
- Numeric Rating Scale (Correct answer)
- Glasgow Coma Scale
- Apgar Score
- Braden Scale
Correct answer: Numeric Rating Scale
The Numeric Rating Scale asks patients to score pain intensity from 0 (no pain) to 10 (worst pain).
Question 5: Night sweats, unexplained weight loss, and back pain unrelieved by rest in a patient with a history of cancer suggest:
- Spinal metastasis (Correct answer)
- Simple lumbar strain
- Postural back pain
- Sciatica from prolonged sitting
Correct answer: Spinal metastasis
Constitutional symptoms with rest-unrelieved back pain in a cancer patient are red flags for spinal metastasis.
Question 6: A normal oral temperature to expect in a patient with uncomplicated mechanical low back pain is about:
- 98.6°F (37°C) (Correct answer)
- 95.0°F (35°C)
- 101.5°F (38.6°C)
- 103.0°F (39.4°C)
Correct answer: 98.6°F (37°C)
Uncomplicated mechanical back pain does not cause fever, so temperature should be near the normal 98.6°F (37°C).
Question 7: Shallow, guarded breathing in a patient with severe low back pain can cause which vital sign finding?
- Decreased oxygen saturation (Correct answer)
- Increased body temperature
- Widened pulse pressure only
- Bradycardia
Correct answer: Decreased oxygen saturation
Pain-related shallow breathing reduces ventilation and can lower oxygen saturation.
Back Pain Low Back Pain And Vital Signs 3
A back pain patient reports dizziness on standing.
Orthostatic vital signs show a systolic drop of 25 mmHg upon standing.
What does this indicate?