American Association of Critical-Care Nurses (AACN) Certification Practice Test

In neurogenic shock, which of the following symptoms is NOT typically observed?

1. Hypothermia

2. Hypertension

3. Bradycardia

4. Hypotension

The correct answer is: Hypertension

In neurogenic shock, a condition often resulting from spinal cord injury or significant central nervous system compromise, certain symptoms are characteristic due to the loss of sympathetic tone. One of the hallmark symptoms of neurogenic shock is hypotension, caused by widespread vasodilation and loss of vascular resistance. Bradycardia is another common symptom; the loss of sympathetic nerve activity can lead to decreased heart rate due to unopposed parasympathetic stimulation. Hypothermia can occur due to impaired thermoregulation resulting from the disruption of normal sympathetic pathways, as the body struggles to maintain temperature control. However, hypertension is not typical in neurogenic shock; in fact, patients usually experience hypotension rather than elevated blood pressure. The combination of these symptoms—hypotension, bradycardia, and possibly hypothermia—provides insight into the pathophysiological mechanisms at play. Hypertension does not align with the expected presentation of a patient experiencing neurogenic shock; instead, it would indicate a different underlying issue, such as compensatory responses seen in other forms of shock or stress. Understanding these clinical features helps in the identification and management of neurogenic shock effectively.