TNCC - Trauma Nurse Core Curriculum Spinal Cord and Vertebral Trauma Questions and Answers

Question 1

A patient involved in a high-speed motor vehicle collision has a suspected C4-level spinal cord injury.
The patient's blood pressure is 82/44 mmHg, heart rate is 54 beats/min, and their skin is warm and dry below the level of the injury.
This clinical presentation is most consistent with which type of shock?

Accepted Answer

Neurogenic shock

Answer

Cardiogenic shock

Answer

Hypovolemic shock

Answer

Anaphylactic shock

Question 2

A patient with a penetrating injury to the right side of their thoracic spine presents with paralysis and loss of proprioception on the right side, and loss of pain and temperature sensation on the left side below the injury. These findings are characteristic of which spinal cord syndrome?

Accepted Answer

Brown-Séquard Syndrome

Answer

Anterior Cord Syndrome

Answer

Central Cord Syndrome

Answer

Cauda Equina Syndrome

Question 3

Which of the following clinical findings in an alert, non-intoxicated adult patient with blunt trauma is a primary indication for maintaining spinal motion restriction?

Accepted Answer

Midline cervical spine tenderness upon palpation

Answer

A large hematoma on the scalp

Answer

A closed fracture of the clavicle

Answer

Reported pain score of 8/10 from an extremity injury

Question 4

A patient with a known T5 spinal cord injury presents to the ED with a pounding headache, profuse sweating above the T5 level, flushed skin, a blood pressure of 200/105 mmHg, and a heart rate of 48 beats/min. Which of the following is the priority nursing action?

Accepted Answer

Assess for a noxious stimulus, such as a kinked urinary catheter.

Answer

Administer an IV beta-blocker immediately.

Answer

Place the patient in a flat, supine position.

Answer

Prepare for emergent endotracheal intubation.

Question 5

Which statement best differentiates spinal shock from neurogenic shock in the context of acute spinal cord injury?

Accepted Answer

Spinal shock is a temporary loss of all reflex and motor activity below the injury level, while neurogenic shock is a circulatory collapse due to loss of sympathetic tone.

Answer

Spinal shock is a hemodynamic state of hypotension and bradycardia, while neurogenic shock involves a loss of reflexes.

Answer

Spinal shock is permanent, whereas neurogenic shock is always transient and resolves within hours.

Answer

Neurogenic shock is characterized by flaccid paralysis, while spinal shock results in spasticity.

Question 6

During the primary survey (ABCDE) of a trauma patient who was a driver in a head-on collision and is complaining of neck pain and an inability to move their legs, what is the most critical assessment component under 'D' for Disability?

Accepted Answer

Performing a Glasgow Coma Scale (GCS) score, assessing pupils, and determining a gross motor and sensory level.

Answer

Obtaining a detailed history of the event from paramedics.

Answer

Checking for a positive Babinski reflex.

Answer

Removing the cervical collar to assess for tracheal deviation.