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Nursing 354 Spinal Cord Injury Exam
Questions And Correct Answers (Verified
Answers) Plus Rationales 2026 Q&A
Instant Download Pdf
___________________________________________________________________
1. A client with an acute spinal cord injury arrives in the emergency
department. Which nursing action is the priority?
A. Assess bowel sounds
B. Maintain spinal immobilization
C. Offer oral fluids
D. Encourage active range-of-motion exercises
Answer: B. Maintain spinal immobilization
Rationale: Maintaining spinal alignment and preventing further movement are
priorities because spinal instability can cause additional neurological injury.
2. Which finding is most concerning for a cervical spinal cord injury?
A. Lower-extremity weakness only
B. Tingling in both feet
C. Respiratory difficulty with upper-extremity weakness
D. Mild low-back pain
Answer: C. Respiratory difficulty with upper-extremity weakness
,Rationale: Cervical spinal cord injuries can impair the diaphragm and accessory
respiratory muscles, making respiratory compromise an immediate concern.
3. Which assessment finding is most consistent with neurogenic shock after
spinal cord injury?
A. Hypertension and tachycardia
B. Hypotension and bradycardia
C. Fever and tachycardia
D. Hypertension and bradycardia
Answer: B. Hypotension and bradycardia
Rationale: Neurogenic shock results from loss of sympathetic vascular tone and
may produce hypotension, bradycardia, and warm skin.
4. A client with a thoracic spinal cord injury suddenly develops severe
hypertension, headache, and sweating. Which complication should the
nurse suspect?
A. Hypovolemic shock
B. Neurogenic shock
C. Autonomic dysreflexia
D. Septic shock
Answer: C. Autonomic dysreflexia
Rationale: Autonomic dysreflexia is a medical emergency associated with spinal
cord injuries above the T6 level and commonly causes sudden severe
hypertension, headache, and sweating.
5. What is the nurse's first action when autonomic dysreflexia is suspected?
A. Place the client flat
B. Sit the client upright
C. Administer a sedative
D. Encourage oral fluids
Answer: B. Sit the client upright
,Rationale: Sitting the client upright helps lower blood pressure while the nurse
rapidly searches for and removes the triggering stimulus.
6. Which stimulus is a common cause of autonomic dysreflexia?
A. Full bladder
B. Low blood glucose
C. Mild hunger
D. Increased room temperature
Answer: A. Full bladder
Rationale: Bladder distention is one of the most common triggers of autonomic
dysreflexia. Bowel distention, skin irritation, and other noxious stimuli can also
trigger it.
7. Which respiratory problem is especially concerning in a client with a high
cervical spinal cord injury?
A. Impaired ventilation
B. Increased appetite
C. Constipation
D. Hyperactive bowel sounds
Answer: A. Impaired ventilation
Rationale: High cervical injuries can impair diaphragmatic and intercostal
muscle function, potentially causing respiratory failure.
8. Which spinal cord level is primarily associated with diaphragm function?
A. C1–C4
B. T1–T4
C. T10–T12
D. L1–L4
Answer: A. C1–C4
Rationale: The phrenic nerves arise primarily from C3–C5, with C3–C4 being
especially important for diaphragmatic function.
, 9. A client with spinal cord injury has paralysis of both legs but normal arm
movement. How should this condition be documented?
A. Quadriplegia
B. Tetraplegia
C. Paraplegia
D. Hemiplegia
Answer: C. Paraplegia
Rationale: Paraplegia refers to paralysis primarily affecting the lower
extremities, whereas tetraplegia involves all four extremities.
10.Which finding suggests spinal shock?
A. Immediate severe muscle spasticity
B. Flaccid paralysis and absent reflexes below the injury
C. Severe hypertension and bradycardia
D. Increased deep tendon reflexes
Answer: B. Flaccid paralysis and absent reflexes below the injury
Rationale: Spinal shock is characterized initially by temporary loss of motor
activity, sensation, and reflexes below the level of injury.
11.Which intervention is appropriate for preventing pressure injuries in a client
with spinal cord injury?
A. Repositioning and pressure redistribution
B. Massaging reddened areas
C. Restricting protein intake
D. Keeping the client in one position
Answer: A. Repositioning and pressure redistribution
Rationale: Immobility and impaired sensation increase pressure-injury risk,
making regular repositioning and pressure redistribution essential.
12.Which assessment is particularly important when evaluating a client with
spinal cord injury?
Nursing 354 Spinal Cord Injury Exam
Questions And Correct Answers (Verified
Answers) Plus Rationales 2026 Q&A
Instant Download Pdf
___________________________________________________________________
1. A client with an acute spinal cord injury arrives in the emergency
department. Which nursing action is the priority?
A. Assess bowel sounds
B. Maintain spinal immobilization
C. Offer oral fluids
D. Encourage active range-of-motion exercises
Answer: B. Maintain spinal immobilization
Rationale: Maintaining spinal alignment and preventing further movement are
priorities because spinal instability can cause additional neurological injury.
2. Which finding is most concerning for a cervical spinal cord injury?
A. Lower-extremity weakness only
B. Tingling in both feet
C. Respiratory difficulty with upper-extremity weakness
D. Mild low-back pain
Answer: C. Respiratory difficulty with upper-extremity weakness
,Rationale: Cervical spinal cord injuries can impair the diaphragm and accessory
respiratory muscles, making respiratory compromise an immediate concern.
3. Which assessment finding is most consistent with neurogenic shock after
spinal cord injury?
A. Hypertension and tachycardia
B. Hypotension and bradycardia
C. Fever and tachycardia
D. Hypertension and bradycardia
Answer: B. Hypotension and bradycardia
Rationale: Neurogenic shock results from loss of sympathetic vascular tone and
may produce hypotension, bradycardia, and warm skin.
4. A client with a thoracic spinal cord injury suddenly develops severe
hypertension, headache, and sweating. Which complication should the
nurse suspect?
A. Hypovolemic shock
B. Neurogenic shock
C. Autonomic dysreflexia
D. Septic shock
Answer: C. Autonomic dysreflexia
Rationale: Autonomic dysreflexia is a medical emergency associated with spinal
cord injuries above the T6 level and commonly causes sudden severe
hypertension, headache, and sweating.
5. What is the nurse's first action when autonomic dysreflexia is suspected?
A. Place the client flat
B. Sit the client upright
C. Administer a sedative
D. Encourage oral fluids
Answer: B. Sit the client upright
,Rationale: Sitting the client upright helps lower blood pressure while the nurse
rapidly searches for and removes the triggering stimulus.
6. Which stimulus is a common cause of autonomic dysreflexia?
A. Full bladder
B. Low blood glucose
C. Mild hunger
D. Increased room temperature
Answer: A. Full bladder
Rationale: Bladder distention is one of the most common triggers of autonomic
dysreflexia. Bowel distention, skin irritation, and other noxious stimuli can also
trigger it.
7. Which respiratory problem is especially concerning in a client with a high
cervical spinal cord injury?
A. Impaired ventilation
B. Increased appetite
C. Constipation
D. Hyperactive bowel sounds
Answer: A. Impaired ventilation
Rationale: High cervical injuries can impair diaphragmatic and intercostal
muscle function, potentially causing respiratory failure.
8. Which spinal cord level is primarily associated with diaphragm function?
A. C1–C4
B. T1–T4
C. T10–T12
D. L1–L4
Answer: A. C1–C4
Rationale: The phrenic nerves arise primarily from C3–C5, with C3–C4 being
especially important for diaphragmatic function.
, 9. A client with spinal cord injury has paralysis of both legs but normal arm
movement. How should this condition be documented?
A. Quadriplegia
B. Tetraplegia
C. Paraplegia
D. Hemiplegia
Answer: C. Paraplegia
Rationale: Paraplegia refers to paralysis primarily affecting the lower
extremities, whereas tetraplegia involves all four extremities.
10.Which finding suggests spinal shock?
A. Immediate severe muscle spasticity
B. Flaccid paralysis and absent reflexes below the injury
C. Severe hypertension and bradycardia
D. Increased deep tendon reflexes
Answer: B. Flaccid paralysis and absent reflexes below the injury
Rationale: Spinal shock is characterized initially by temporary loss of motor
activity, sensation, and reflexes below the level of injury.
11.Which intervention is appropriate for preventing pressure injuries in a client
with spinal cord injury?
A. Repositioning and pressure redistribution
B. Massaging reddened areas
C. Restricting protein intake
D. Keeping the client in one position
Answer: A. Repositioning and pressure redistribution
Rationale: Immobility and impaired sensation increase pressure-injury risk,
making regular repositioning and pressure redistribution essential.
12.Which assessment is particularly important when evaluating a client with
spinal cord injury?
