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

Autonomic dysreflexia occurs with injuries at T6 or above because the splanchnic sympathetic outflow (T6-L2) can no longer be modulated by descending supraspinal inhibitory signals.

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 wrench must be immediately accessible to rapidly remove the anterior halo vest bolts and access the chest for CPR in the event of cardiac arrest.

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

DVT and PE are leading causes of early mortality in acute SCI due to complete venous stasis from lower extremity paralysis; prophylaxis should be initiated within 72 hours.

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

Spinal shock is a transient state of depressed cord function below the injury, characterized by flaccidity and absent reflexes; return of the bulbocavernosus reflex marks its resolution.

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

Pulmonary hygiene with chest physiotherapy and assisted coughing is the priority nursing intervention to clear secretions in high-level SCI patients who have lost the independent ability to cough.

TCRN Exam Practice Test

TCRN Exam Practice Test

TCRN TCRN Spinal Cord and Vertebral Trauma 3