Back Pain Low Back Pain And Vital Signs 5 — Questions and Answers
Question 1: A patient with back pain after a fall from a ladder has BP 88/54, HR 128, and cool clammy skin. These findings suggest:
- Hypovolemic shock, possibly from internal bleeding (Correct answer)
- Normal post-exercise response
- Simple anxiety
- Well-controlled chronic pain
Correct answer: Hypovolemic shock, possibly from internal bleeding
Hypotension, tachycardia, and cool clammy skin after trauma indicate shock from possible internal hemorrhage.
Question 2: Which route of temperature measurement gives the best core estimate in a critically ill back-trauma patient?
- Rectal (or another core route) (Correct answer)
- Axillary
- Skin strip on the forehead
- Temperature of the room
Correct answer: Rectal (or another core route)
Rectal and other core routes most accurately reflect true core body temperature.
Question 3: A patient taking a beta-blocker has severe low back pain but a heart rate of only 62 bpm. Why might tachycardia be absent?
- Beta-blockers blunt the heart rate response to pain and stress (Correct answer)
- Pain never raises heart rate in anyone
- The thermometer was faulty
- Beta-blockers cause fever instead
Correct answer: Beta-blockers blunt the heart rate response to pain and stress
Beta-blockers block sympathetic stimulation, masking the expected pain-induced tachycardia.
Question 4: When assessing pain as part of vital signs in a nonverbal older adult with suspected back pain, the best approach is to:
- Use behavioral cues such as grimacing, guarding, and restlessness (Correct answer)
- Skip pain assessment entirely
- Assume pain is zero
- Ask the patient to write an essay
Correct answer: Use behavioral cues such as grimacing, guarding, and restlessness
Behavioral pain scales relying on facial expression, guarding, and vocalization are used when patients cannot self-report.
Question 5: A 22-year-old with morning back stiffness lasting over an hour has normal vital signs. Which condition does this pattern suggest?
- Ankylosing spondylitis (inflammatory back pain) (Correct answer)
- Ruptured aortic aneurysm
- Spinal fracture
- Kidney stone
Correct answer: Ankylosing spondylitis (inflammatory back pain)
Prolonged morning stiffness in a young adult with normal vital signs is characteristic of inflammatory back pain like ankylosing spondylitis.
Question 6: Which blood pressure measurement error is most likely to falsely elevate a reading in an anxious back pain patient?
- Using a cuff that is too small for the arm (Correct answer)
- Using a cuff that is too large
- Measuring while the patient sleeps
- Deflating the cuff too slowly only
Correct answer: Using a cuff that is too small for the arm
An undersized cuff produces falsely high blood pressure readings.
Question 7: A patient with a kidney stone causing flank and back pain typically shows which vital sign pattern during a colic episode?
- Tachycardia and elevated blood pressure from severe intermittent pain (Correct answer)
- Persistent hypothermia
- Bradycardia with hypotension
- Completely flat, unchanging vitals
Correct answer: Tachycardia and elevated blood pressure from severe intermittent pain
Severe colicky pain triggers sympathetic surges producing tachycardia and hypertension during episodes.
Back Pain Low Back Pain And Vital Signs 5
A patient with back pain after a fall from a ladder has BP 88/54, HR 128, and cool clammy skin.
These findings suggest: