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Adult Health II Quiz 4: SCI / TBI / Neuro / Endocrine Questions and Answers 100% Solved 2024/2025
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Adult Health II Quiz 4: SCI / TBI / Neuro / Endocrine Questions and Answers 100% Solved 2024/2025
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Adult Health II Quiz 4: SCI / TBI / Neuro /Endocrine
A patient is admitted with a spinal cord injury at the C7 level. During assessment the nurse
identifies the presence of spinal shock on finding
A) paraplegia with a flaccid paralysis
B) tetraplegia with total sensory loss
C) total hemiplegia with sensory and motor loss
D) spastic tetraplegia with loss of pressure sensation - ANSAnswer: B
Rationale: At the C7 level, spinal shock is manifested by tetraplegia and sensory loss. The
neurologic loss may be temporary or permanent. Paraplegia with sensory loss would occur a
the level of T1. A hemiplegia occurs with central (brain) lesions affecting motor neurons and
spastic paraplegia occurs when spinal shock resolves.
An initial incomplete spinal cord injury often results in complete cord damage because of
A) edematous compression of the cord resulting from damage to stabilizing ligaments
B) continued trauma to the cord resulting from damage to stabilizing ligaments
C) infarction and necrosis of the cord caused by edema, hemorrhage, and metabolites.
D) mechanical transection of the cord by sharp vertebral bone fragments after the initial injury. -
ANSAnswer: C
Rationale: The primary injury of the spinal cord rarely affects the entire cord, but the
pathophysiology of the secondary injury may result in damage that is the same as mechanical
severance of the cord. Complete cord dissolution occurs through auto destruction of the cord by
hemorrhage, edema, and the presence of metabolites and norepinephrine, resulting in anoxia
and infarction of the cord. Edema resulting from the inflammatory response may increase the
damage as it extends above and below the injury site.
A patient with a spinal cord injury has spinal shock. The nurse plans care for the patient based
on the knowledge that
A) rehabilitation measures cannot be initiated until spinal shock has resolved.
B) the patient will need continuous monitoring for hypotension, tachycardia, and hypoxemia.
C) resolution of spinal shock is manifested by spasticity, hyperreflexia, and reflex emptying of
the bladder.
D) the patient will have complete loss of motor and sensory functions below the level of the
injury, but autonomic functions are not affected. - ANSAnswer: C
, Rationale: Spinal shock occurs in about half of all people with acute spinal cord injury. In spinal
shock, the entire cord below the level of the lesion fails to function, resulting in a flaccid
paralysis and hypotonicity of most processes without any reflect activity. Return of reflex activity
signals the end of spinal shock. Sympathetic function is impaired below the level of the injury
because sympathetic nerves leave the spinal cord at the thoracic and lumbar areas and cranial
parasympathetic nerves predominate in control over respirations, heart, and all vessels and
organs below the injury. Neurogenic shock results from loss of vascular tone caused by the
injury and is manifested by hypotension, peripheral vasodilation, and decreased CO.
Rehabilitation activities are not contraindicated during spinal shock and should be instituted if
the patient's cardiopulmonary status is stable.
A patient is admitted to the emergency dept. with a spinal cord injury at the level of T2. Which of
the following findings is of most concern to the nurse?
A) SpO2 of 92%
B) HR of 42 beats / min
C) Blood pressure of 88/60
D) Loss of motor and sensory function in arms and legs - ANSAnswer: B
Rationale: Neurogenic shock associated with cord injuries above the level of T6 greatly
decrease the effect of the sympathetic nervous system, and bradycardia and hypotension occur.
A heart rate of 42 is not adequate to meet the oxygen requirements of the body, and while low,
the BP is not at a critical point. The oxygen saturation is satisfactory, and the motor and sensory
loss are expected.
A patient is admitted to the emergency department with a possible cervical spinal cord injury
following an automobile crash. During the admission of the patient, the nurse places highest
priority on
A) maintaining a patent airway
B) assessing the patient for head and other injuries
C) maintaining immobilization of the cervical spine
D) assessing the patient's motor and sensory function - ANSAnswer: A
Rationale: The need for a patent airway is the first priority for any injured patient, and a high
cervical injury may decrease the gag reflex and ability to maintain an airway, as well as the
ability to breathe. Maintaining cervical stability is then a consideration, along with assessing for
other injuries and the patient's neurological status.
The health care provider has ordered IV dopamine (Intropin) for a patient in the emergency
dept. with a spinal cord injury. The nurse determines that the drug is having the desired effect
when assessment findings include
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