TCRN TCRN Spinal Cord and Vertebral Trauma 2

Question 1

A patient with a T4 SCI suddenly develops a pounding headache, profuse sweating above the injury level, and BP of 210/110 mmHg. What is the FIRST nursing action?

Accepted Answer

Sit the patient upright and assess for bladder distension or fecal impaction

Answer

Autonomic dysreflexia is first managed by sitting the patient upright (orthostatic BP reduction) and identifying and removing the triggering noxious stimulus, most commonly bladder distension.

Question 2

In Brown-Séquard syndrome from right-sided spinal cord hemisection, the nurse expects which deficits on the RIGHT (ipsilateral) side?

Accepted Answer

Loss of motor function and proprioception

Answer

Brown-Séquard syndrome causes ipsilateral loss of motor function and dorsal column function (proprioception, vibration, fine touch), with contralateral loss of pain and temperature because those fibers cross immediately.

Question 3

Which incomplete spinal cord syndrome has the POOREST prognosis for functional motor recovery?

Accepted Answer

Anterior cord syndrome

Answer

Anterior cord syndrome has the worst prognosis because anterior cord ischemia destroys both the corticospinal (motor) and spinothalamic (pain/temperature) tracts while sparing only posterior column function.

Question 4

At which level of complete cervical spinal cord injury would a patient most likely require permanent mechanical ventilation?

Accepted Answer

C3

Answer

Injuries at C3 and above disrupt the phrenic nerve origin (C3-C5), eliminating diaphragmatic function and requiring permanent ventilatory support.

Question 5

A patient with a high thoracic SCI is noted to have a body temperature that mirrors the room temperature. The nurse documents this as:

Accepted Answer

Poikilothermia

Answer

Poikilothermia occurs when high-level SCI disrupts the autonomic hypothalamic-to-peripheral thermoregulation pathway, causing the patient's temperature to passively equilibrate with the environment.

TCRN Exam Practice Test

TCRN Exam Practice Test

TCRN TCRN Spinal Cord and Vertebral Trauma 2