The trauma intensive care nurse suspects a client with a C6 fracture has developed neurogenic shock.
Which findings support the nurse's suspicion?
Hypotension, bradycardia, warm and pink extremities.
Hyperactive reflexes below C6.
Lack of sensation and movement below C6.
Involuntary spastic movement of extremities.
The Correct Answer is A
Evaluating a cervical spine injury for neurogenic shock requires knowledge of autonomic nervous system disruption. Specifically, loss of sympathetic tone below the level of injury must be identified. Differentiating neurogenic shock from spinal shock involves assessing hemodynamic parameters and thermoregulation.
Choice A rationale
Neurogenic shock involves loss of sympathetic vascular tone, causing massive vasodilation and hypotension. Unchecked parasympathetic activity leads to bradycardia. Normal heart rate is 60 to 100. Warm, pink skin results from peripheral blood pooling due to vasodilation.
Choice B rationale
Hyperactive reflexes are characteristic of the later stages of spinal cord injury after spinal shock resolves. They do not indicate the acute hemodynamic collapse seen in neurogenic shock, which specifically targets the cardiovascular regulatory systems.
Choice C rationale
Loss of sensation and movement defines spinal shock or the initial cord injury itself. While present in neurogenic shock, these findings are not specific to the autonomic failure that characterizes the life-threatening hemodynamic instability of shock.
Choice D rationale
Spasticity occurs due to upper motor neuron damage after the initial period of areflexia. This is a chronic or subacute finding and is not associated with the acute cardiovascular distributive failure seen in neurogenic shock.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["10"]
Explanation
Step 1 is (1 unit ÷ 10 units) × 100 mL.
Step 2 is 0.1 × 100 mL.
Step 3 is 10 mL.
Correct Answer is D
Explanation
Post stroke education focuses on secondary prevention through risk factor modification. Applying knowledge of pharmacology and lifestyle changes is necessary to ensure the patient understands how to manage hypertension, smoking cessation, and safe medication use to avoid recurrence.
Choice A rationale
Daily exercise is a recommended lifestyle modification that helps manage weight and lower blood pressure. It improves cardiovascular health and reduces the risk of recurrent ischemic events by enhancing vascular tone and reducing systemic inflammation.
Choice B rationale
Smoking cessation is critical because nicotine causes vasoconstriction and accelerates atherosclerosis. Stopping tobacco use significantly lowers the risk of thrombus formation and further ischemic damage to the cerebral vasculature in post stroke patients.
Choice C rationale
Reducing high fat intake and increasing fruits and vegetables helps manage cholesterol levels. Lowering low density lipoprotein levels prevents the progression of carotid artery plaque, which is a major contributor to the occurrence of ischemic strokes.
Choice D rationale
While aspirin is often prescribed for its antiplatelet properties, clients should not self medicate with over the counter versions without clinical supervision. Aspirin increases bleeding risks, and its use must be coordinated with other prescribed anticoagulants..
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