TCRN TCRN Spinal Cord and Vertebral Trauma 3

Question 1

Autonomic dysreflexia is a potentially life-threatening complication that occurs primarily in patients with spinal cord injuries at what level or above?

Accepted Answer

T6

Answer

T10

Answer

L1

Answer

C1 only

Question 2

When caring for a patient in a halo vest cervical stabilization device, what item is MOST critical to keep immediately at the bedside at all times?

Accepted Answer

A wrench or tool to quickly remove the anterior vest bolts for chest access

Answer

A spare set of halo pins and torque wrench for tightening

Answer

A rigid cervical collar as a backup immobilization device

Answer

A spare sheepskin liner for pressure management

Question 3

A patient with a complete T2 SCI is 48 hours post-injury. Which early complication poses the GREATEST immediate threat to life?

Accepted Answer

Deep vein thrombosis and pulmonary embolism

Answer

Adjustment disorder and depression

Answer

Urinary tract infection

Answer

Heterotopic ossification

Question 4

Spinal shock is defined as which of the following phenomena following acute spinal cord injury?

Accepted Answer

Transient depression of all spinal reflexes and flaccid paralysis below the injury level

Answer

Cardiovascular collapse from loss of sympathetic vasomotor tone

Answer

Severe neuropathic pain radiating from the spinal cord injury site

Answer

Vasodilation with hypotension and compensatory tachycardia

Question 5

A ventilator-dependent C5 SCI patient develops increased secretions and diminished breath sounds in the right lower lobe. What is the PRIORITY nursing intervention?

Accepted Answer

Perform chest physiotherapy and assisted (quad) cough technique

Answer

Increase PEEP on the ventilator settings

Answer

Request urgent bedside bronchoscopy

Answer

Increase FiO2 to 100% until secretions clear

Question 6

In the acute trauma setting, which imaging modality is MOST appropriate for initial evaluation of suspected thoracic vertebral injury in a hemodynamically unstable patient?

Accepted Answer

CT scan of the chest and thoracic spine

Answer

MRI of the thoracic spine with contrast

Answer

Plain anteroposterior and lateral X-rays of the thoracic spine

Answer

Myelography to assess cord compression

Question 7

A patient with a complete C6 SCI is preparing for discharge. Which functional skill is a realistic independent goal for this injury level?

Accepted Answer

Independent intermittent self-catheterization using a tenodesis grip technique

Answer

Ambulation with knee-ankle-foot orthoses and forearm crutches

Answer

Unsupported sitting balance without upper extremity prop support

Answer

Complete independence in bathing without any adaptive equipment