TNCC Spinal Cord Injury and Spinal Motion Restriction

Question 1

A patient with a cervical spine injury has hypotension, bradycardia, and warm, dry skin. Which condition does this suggest?

Accepted Answer

Neurogenic shock

Answer

Loss of sympathetic tone after a high spinal cord injury causes vasodilation and unopposed vagal activity, so the patient has hypotension and bradycardia with warm, dry skin. Hemorrhagic shock typically causes tachycardia and cool, clammy skin, so look for bleeding as well.

Question 2

Injury to which spinal level most threatens the patient's ability to breathe independently because it affects the phrenic nerve?

Accepted Answer

C3–C5

Answer

The phrenic nerve arises from C3–C5 and innervates the diaphragm. Injuries at or above this level can cause respiratory failure and often require ventilatory support.

Question 3

A patient has a spinal cord injury at T4 and develops severe hypertension, a pounding headache, bradycardia, and flushing above the injury. What is the first nursing action?

Accepted Answer

Check for and remove the trigger, such as a distended bladder, while sitting the patient upright

Answer

These are signs of autonomic dysreflexia, a medical emergency in injuries at T6 and above, usually triggered by bladder distention or bowel impaction. Sit the patient up to lower blood pressure, remove the stimulus (check the catheter), and treat persistent hypertension.

Question 4

Which cord syndrome is characterized by ipsilateral loss of motor function and proprioception, with contralateral loss of pain and temperature sensation?

Accepted Answer

Brown-Séquard syndrome

Answer

Brown-Séquard syndrome results from hemisection of the cord, often from penetrating trauma. Motor and proprioception are lost on the same side as the lesion, and pain and temperature are lost on the opposite side.

Question 5

Which technique is most appropriate for turning a trauma patient with suspected spinal injury?

Accepted Answer

Log roll with the head, torso, and pelvis kept in alignment, using adequate staff

Answer

Spinal motion restriction means moving the spine as a unit. Use a log roll with a designated person controlling the head and enough staff to keep the head, torso, and pelvis aligned.

(TNCC) Trauma Nursing Core Course Certified Practice Test

(TNCC) Trauma Nursing Core Course Certified Practice Test

TNCC Spinal Cord Injury and Spinal Motion Restriction