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

Airway management with simultaneous cervical spine stabilization is the first priority in any suspected spinal cord injury, following the primary survey framework.

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 C denotes incomplete injury with preserved motor function below the level but with most key muscles graded below 3 (antigravity strength).

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

Neurogenic shock results from loss of sympathetic tone, producing hypotension paired with paradoxical bradycardia and peripheral vasodilation, contrasting with the tachycardia of hemorrhagic shock.

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

High-dose methylprednisolone has been removed from standard SCI protocols because risks — including infection, GI bleeding, and pulmonary complications — outweigh the marginal neurological benefit shown in older trials.

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

C5 preserves elbow flexion (biceps, C5-C6) but a complete C5 injury eliminates C6-innervated wrist extension, creating this characteristic pattern.

TCRN Exam Practice Test

TCRN Exam Practice Test

TCRN TCRN Spinal Cord and Vertebral Trauma