TCRN TCRN Spinal Cord and Vertebral Trauma

Question 1

A patient arrives following a diving accident with suspected cervical spine injury. What is the FIRST priority for the trauma nurse?

Accepted Answer

Maintain cervical spine immobilization while managing the airway

Answer

Establish two large-bore IV lines immediately

Answer

Perform a complete ASIA neurological assessment

Answer

Administer high-dose methylprednisolone within 8 hours

Question 2

Using the ASIA Impairment Scale, a patient with incomplete SCI whose key muscles below the injury level have a motor grade less than 3 in the majority is classified as:

Accepted Answer

ASIA C — motor incomplete, most muscles grade < 3

Answer

ASIA A — complete injury

Answer

ASIA B — sensory incomplete only

Answer

ASIA D — motor incomplete, most muscles grade ≥ 3

Question 3

Which clinical finding best distinguishes neurogenic shock from hemorrhagic shock in a trauma patient with spinal cord injury?

Accepted Answer

Hypotension with bradycardia and warm vasodilated skin

Answer

Hypotension with tachycardia and cool clammy skin

Answer

Hypertension with bradycardia and flushing

Answer

Hypotension with tachycardia and diaphoresis

Question 4

Current evidence-based guidelines regarding high-dose methylprednisolone for acute spinal cord injury state that it:

Accepted Answer

Is no longer recommended as standard care due to complications outweighing benefit

Answer

Should be given within 8 hours for all complete cervical injuries

Answer

Is recommended as standard of care within 24 hours of injury

Answer

Should be reserved for thoracic injuries only

Question 5

A patient sustains a complete C5 spinal cord injury. Which functional finding would the nurse expect on assessment?

Accepted Answer

Intact elbow flexion but inability to extend the wrist

Answer

Loss of shoulder shrug with intact elbow flexion

Answer

Complete loss of all upper extremity function with intact diaphragm

Answer

Full hand function with paralysis limited to the lower extremities

Question 6

Which spinal cord syndrome is characterized by disproportionately greater motor weakness in the upper extremities than the lower extremities following a hyperextension mechanism?

Accepted Answer

Central cord syndrome

Answer

Brown-Séquard syndrome

Answer

Anterior cord syndrome

Answer

Posterior cord syndrome

Question 7

Current guidelines recommend maintaining a mean arterial pressure (MAP) of at least _____ for the first 7 days after acute spinal cord injury to optimize cord perfusion:

Accepted Answer

85 mmHg

Answer

65 mmHg

Answer

75 mmHg

Answer

95 mmHg