LEWIS MEDICAL-SURGICAL NURSING: SPINAL CORD INJURY EXAM
QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) | REVISED
EDITION 2026 |100% GUARANTEED PASS
You are caring for a patient admitted with a spinal cord injury after a motor vehicle accident. The patient exhibits a
complete loss of motor, sensory, and reflex activity below the injury level. What is this condition?
A. Central cord syndrome
B. Spinal shock syndrome
C. Anterior cord syndrome
D. Brown-Séquard syndrome - ✓✓Answer- B. Spinal shock syndrome
About 50% of people with acute spinal cord injury experience a temporary loss of reflexes, sensation, and motor
activity that is known as spinal shock. Central cord syndrome is manifested by motor and sensory loss greater in the
upper extremities than the lower extremities. Anterior cord syndrome results in motor and sensory loss but not loss
of reflexes. Brown-Séquard syndrome is characterized by ipsilateral loss of motor function and contralateral loss of
sensory function.
Which clinical manifestation do you interpret as representing neurogenic shock in a patient with acute spinal cord
injury?
A. Bradycardia
B. Hypertension
C. Neurogenic spasticity
D. Bounding pedal pulses - ✓✓Answer- A. Bradycardia
Neurogenic shock results from loss of vasomotor tone caused by injury and is characterized by hypotension and
bradycardia. Loss of sympathetic innervation causes peripheral vasodilation, venous pooling, and a decreased
cardiac output.
When planning care for a patient with a C5 spinal cord injury, which nursing diagnosis is the highest priority?
A. Impaired tissue integrity due to paralysis
B. Impaired urinary elimination due to quadriplegia
C. Ineffective coping due to the extent of trauma
1
,D. Ineffective airway clearance due to high cervical spinal cord injury - ✓✓Answer- D. Ineffective airway clearance
due to high cervical spinal cord injury
Maintaining a patent airway is the most important goal for a patient with a high cervical fracture. Although all of
these options are appropriate nursing diagnoses for a patient with a spinal cord injury, respiratory needs are always
the highest priority. Remember the ABCs.
Which signs and symptoms in a patient with a T4 spinal cord injury should alert you to the possibility of autonomic
dysreflexia?
A. Headache and rising blood pressure
B. Irregular respirations and shortness of breath
C. Decreased level of consciousness or hallucinations
D. Abdominal distention and absence of bowel sounds - ✓✓Answer- A. Headache and rising blood pressure
Among the manifestations of autonomic dysreflexia are hypertension (up to 300 mm Hg systolic) and throbbing
headache. Respiratory manifestations, decreased level of consciousness, and gastrointestinal manifestations are not
characteristic.
Which intervention should you perform in the acute care of a patient with autonomic dysreflexia?
A. Urinary catheterization
B. Administration of benzodiazepines
C. Suctioning of the patient's upper airway
D. Placement of the patient in the Trendelenburg position - ✓✓Answer- A. Urinary catheterization
Because the most common cause of autonomic dysreflexia is bladder irritation, immediate catheterization to relieve
bladder distention may be necessary. The patient should be positioned upright. Benzodiazepines are contraindicated,
and suctioning is likely unnecessary.
A patient is admitted to the hospital with a C4 spinal cord injury after a motorcycle collision. The patient's blood
pressure is 83/49 mm Hg and pulse is 39 beats/minute. He remains orally intubated. What is the cause of this
pathophysiologic response?
A. Increased vasomotor tone after the injury
B. A temporary loss of sensation and flaccid paralysis below the level of injury
C. Loss of parasympathetic nervous system innervation resulting in vasoconstriction
2
, D. Loss of sympathetic nervous system innervation resulting in peripheral vasodilation - ✓✓Answer- D. Loss of
sympathetic nervous system innervation resulting in peripheral vasodilation
eurogenic shock results from loss of vasomotor tone caused by injury, and it is characterized by hypotension and
bradycardia. Loss of sympathetic nervous system innervation causes peripheral vasodilation, venous pooling, and a
decreased cardiac output. These effects usually are associated with a cervical or high thoracic injury (T6 or higher).
What are the goals of rehabilitation for the patient with an injury at the C6 level (select all that apply)?
A. Stand erect with leg brace
B. Feed self with hand devices
C. Drive an electric wheelchair
D. Assist with transfer activities
E. Drive adapted van from wheel chair - ✓✓Answer- B. Feed self with hand devices
C. Drive an electric wheelchair
D. Assist with transfer activities
E. Drive adapted van from wheel chair
Rehabilitation goals for a patient with a spinal cord injury at the C6 level include ability to assist with transfer and
perform some self-care; feed self with hand devices; push wheelchair on smooth, flat surface; drive adapted van
from wheelchair; independent computer use with adaptive equipment; and needing attendant care only for 6 hours
per day.
A patient with a C7 spinal cord injury undergoing rehabilitation tells you he must have the flu because he has a bad
headache and nausea. What is your initial action?
A. Call the physician.
B. Check the patient's temperature.
C. Take the patient's blood pressure.
D. Elevate the head of the bed to 90 degrees. - ✓✓Answer- C. Take the patient's blood pressure.
Autonomic dysreflexia is a massive, uncompensated cardiovascular reaction mediated by the sympathetic nervous
system. Manifestations include hypertension (up to 300 mm Hg systolic), throbbing headache, marked diaphoresis
above the level of the lesion, bradycardia (30 to 40 beats/minute), piloerection, flushing of the skin above the level
of the lesion, blurred vision or spots in the visual fields, nasal congestion, anxiety, and nausea. It is important to
measure blood pressure when a patient with a spinal cord injury complains of a headache.
3
QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) | REVISED
EDITION 2026 |100% GUARANTEED PASS
You are caring for a patient admitted with a spinal cord injury after a motor vehicle accident. The patient exhibits a
complete loss of motor, sensory, and reflex activity below the injury level. What is this condition?
A. Central cord syndrome
B. Spinal shock syndrome
C. Anterior cord syndrome
D. Brown-Séquard syndrome - ✓✓Answer- B. Spinal shock syndrome
About 50% of people with acute spinal cord injury experience a temporary loss of reflexes, sensation, and motor
activity that is known as spinal shock. Central cord syndrome is manifested by motor and sensory loss greater in the
upper extremities than the lower extremities. Anterior cord syndrome results in motor and sensory loss but not loss
of reflexes. Brown-Séquard syndrome is characterized by ipsilateral loss of motor function and contralateral loss of
sensory function.
Which clinical manifestation do you interpret as representing neurogenic shock in a patient with acute spinal cord
injury?
A. Bradycardia
B. Hypertension
C. Neurogenic spasticity
D. Bounding pedal pulses - ✓✓Answer- A. Bradycardia
Neurogenic shock results from loss of vasomotor tone caused by injury and is characterized by hypotension and
bradycardia. Loss of sympathetic innervation causes peripheral vasodilation, venous pooling, and a decreased
cardiac output.
When planning care for a patient with a C5 spinal cord injury, which nursing diagnosis is the highest priority?
A. Impaired tissue integrity due to paralysis
B. Impaired urinary elimination due to quadriplegia
C. Ineffective coping due to the extent of trauma
1
,D. Ineffective airway clearance due to high cervical spinal cord injury - ✓✓Answer- D. Ineffective airway clearance
due to high cervical spinal cord injury
Maintaining a patent airway is the most important goal for a patient with a high cervical fracture. Although all of
these options are appropriate nursing diagnoses for a patient with a spinal cord injury, respiratory needs are always
the highest priority. Remember the ABCs.
Which signs and symptoms in a patient with a T4 spinal cord injury should alert you to the possibility of autonomic
dysreflexia?
A. Headache and rising blood pressure
B. Irregular respirations and shortness of breath
C. Decreased level of consciousness or hallucinations
D. Abdominal distention and absence of bowel sounds - ✓✓Answer- A. Headache and rising blood pressure
Among the manifestations of autonomic dysreflexia are hypertension (up to 300 mm Hg systolic) and throbbing
headache. Respiratory manifestations, decreased level of consciousness, and gastrointestinal manifestations are not
characteristic.
Which intervention should you perform in the acute care of a patient with autonomic dysreflexia?
A. Urinary catheterization
B. Administration of benzodiazepines
C. Suctioning of the patient's upper airway
D. Placement of the patient in the Trendelenburg position - ✓✓Answer- A. Urinary catheterization
Because the most common cause of autonomic dysreflexia is bladder irritation, immediate catheterization to relieve
bladder distention may be necessary. The patient should be positioned upright. Benzodiazepines are contraindicated,
and suctioning is likely unnecessary.
A patient is admitted to the hospital with a C4 spinal cord injury after a motorcycle collision. The patient's blood
pressure is 83/49 mm Hg and pulse is 39 beats/minute. He remains orally intubated. What is the cause of this
pathophysiologic response?
A. Increased vasomotor tone after the injury
B. A temporary loss of sensation and flaccid paralysis below the level of injury
C. Loss of parasympathetic nervous system innervation resulting in vasoconstriction
2
, D. Loss of sympathetic nervous system innervation resulting in peripheral vasodilation - ✓✓Answer- D. Loss of
sympathetic nervous system innervation resulting in peripheral vasodilation
eurogenic shock results from loss of vasomotor tone caused by injury, and it is characterized by hypotension and
bradycardia. Loss of sympathetic nervous system innervation causes peripheral vasodilation, venous pooling, and a
decreased cardiac output. These effects usually are associated with a cervical or high thoracic injury (T6 or higher).
What are the goals of rehabilitation for the patient with an injury at the C6 level (select all that apply)?
A. Stand erect with leg brace
B. Feed self with hand devices
C. Drive an electric wheelchair
D. Assist with transfer activities
E. Drive adapted van from wheel chair - ✓✓Answer- B. Feed self with hand devices
C. Drive an electric wheelchair
D. Assist with transfer activities
E. Drive adapted van from wheel chair
Rehabilitation goals for a patient with a spinal cord injury at the C6 level include ability to assist with transfer and
perform some self-care; feed self with hand devices; push wheelchair on smooth, flat surface; drive adapted van
from wheelchair; independent computer use with adaptive equipment; and needing attendant care only for 6 hours
per day.
A patient with a C7 spinal cord injury undergoing rehabilitation tells you he must have the flu because he has a bad
headache and nausea. What is your initial action?
A. Call the physician.
B. Check the patient's temperature.
C. Take the patient's blood pressure.
D. Elevate the head of the bed to 90 degrees. - ✓✓Answer- C. Take the patient's blood pressure.
Autonomic dysreflexia is a massive, uncompensated cardiovascular reaction mediated by the sympathetic nervous
system. Manifestations include hypertension (up to 300 mm Hg systolic), throbbing headache, marked diaphoresis
above the level of the lesion, bradycardia (30 to 40 beats/minute), piloerection, flushing of the skin above the level
of the lesion, blurred vision or spots in the visual fields, nasal congestion, anxiety, and nausea. It is important to
measure blood pressure when a patient with a spinal cord injury complains of a headache.
3
