Back Pain Low Back Pain And Vital Signs 4 — Questions and Answers
Question 1: An IV drug user presents with low back pain, fever of 102.5°F, and heart rate of 118 bpm. What is the highest-priority concern?
- Spinal epidural abscess (Correct answer)
- Muscle spasm from lifting
- Ankylosing spondylitis flare
- Poor posture
Correct answer: Spinal epidural abscess
IV drug use plus fever, tachycardia, and back pain strongly suggests a spinal epidural abscess.
Question 2: Which set of vital signs is most consistent with early sepsis in a patient with infectious back pain?
- Temperature 102°F, HR 124, RR 24, BP 92/58 (Correct answer)
- Temperature 98.6°F, HR 68, RR 14, BP 122/78
- Temperature 97.9°F, HR 60, RR 12, BP 130/85
- Temperature 99.0°F, HR 72, RR 16, BP 118/76
Correct answer: Temperature 102°F, HR 124, RR 24, BP 92/58
Fever, tachycardia, tachypnea, and hypotension together indicate a septic response.
Question 3: In chronic low back pain, vital signs are often normal because:
- The body physiologically adapts to persistent pain over time (Correct answer)
- Chronic pain destroys the sympathetic nervous system
- Chronic pain is always imaginary
- Blood pressure cannot change after age 40
Correct answer: The body physiologically adapts to persistent pain over time
Physiologic adaptation means chronic pain frequently produces no measurable vital sign changes.
Question 4: Before administering an NSAID such as ibuprofen for back pain, which vital-sign-related history is most important to review?
- Blood pressure history, since NSAIDs can raise blood pressure (Correct answer)
- Shoe size
- Hair color
- Handedness
Correct answer: Blood pressure history, since NSAIDs can raise blood pressure
NSAIDs can elevate blood pressure and worsen hypertension, so blood pressure history matters.
Question 5: A back pain patient's radial pulse is irregular at 112 bpm. What should be done next?
- Assess further, such as with an apical pulse or ECG (Correct answer)
- Ignore it because back pain explains everything
- Document it as normal
- Only recheck in one week
Correct answer: Assess further, such as with an apical pulse or ECG
An irregular tachycardia warrants further cardiac assessment regardless of the back pain complaint.
Question 6: Which vital sign finding would argue AGAINST simple mechanical low back pain?
- Temperature of 102.2°F (39°C) (Correct answer)
- Blood pressure of 118/76 mmHg
- Heart rate of 74 bpm
- Respiratory rate of 16 breaths per minute
Correct answer: Temperature of 102.2°F (39°C)
Fever is not caused by mechanical back pain and signals a systemic process.
Question 7: Why should vital signs be reassessed after giving pain medication for acute low back pain?
- To evaluate treatment response and detect adverse drug effects (Correct answer)
- Because insurance requires hourly weights
- To confirm the patient's identity
- Vital signs never change after medication
Correct answer: To evaluate treatment response and detect adverse drug effects
Reassessment confirms the medication worked and screens for side effects like hypotension or respiratory depression.
Back Pain Low Back Pain And Vital Signs 4
An IV drug user presents with low back pain, fever of 102.5°F, and heart rate of 118 bpm.
What is the highest-priority concern?