Family Nurse Practitioner Exam

In case of worsening sciatica symptoms, what is the appropriate initial management step?

1. Write a prescription for ibuprofen with a muscle relaxant

2. Order both a plain radiograph and CT scan of the spine

3. Refer to an orthopedic specialist immediately

4. Schedule a follow-up appointment in two weeks

The correct answer is: Order both a plain radiograph and CT scan of the spine

The appropriate initial management step for worsening sciatica symptoms involves assessing the situation to determine the underlying cause of the worsening symptoms. In such cases, obtaining imaging studies like plain radiographs or a CT scan can be crucial to identify potential structural issues, such as herniated discs or other abnormalities that may be contributing to the symptoms. This objective evaluation helps to formulate an appropriate treatment plan tailored to the patient's specific condition. Taking imaging studies as the first step is particularly important if there is a significant change in the patient's neurological status or if red flag symptoms are present, such as loss of bowel or bladder control, progressive neurological deficits, or severe pain. By diagnosing the underlying issue through imaging, healthcare providers can make informed decisions about whether non-surgical interventions, medications, or referral to a specialist are necessary. Ultimately, timely imaging can lead to earlier intervention, possibly preventing further complications or the need for more invasive procedures later on.