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

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What is a common feature in patients experiencing Neurogenic shock?

Hyperreflexive muscle activity
Bradycardia
Pinpoint pupils
Lead pipe rigidity

The correct answer is: Bradycardia

Neurogenic shock is characterized by a loss of sympathetic nervous system tone, which leads to a variety of physiological changes. One of the hallmark features of this condition is bradycardia, or a slower than normal heart rate. This occurs because, in neurogenic shock, there is an unopposed vagal (parasympathetic) influence on the heart due to the disruption in sympathetic nerve activity. The lack of sympathetic stimulation results in decreased heart rate and may also lead to hypotension (low blood pressure) due to vasodilation. Other common symptoms associated with neurogenic shock can include hypotension and warm skin, in contrast to other types of shock where the skin might be cold and clammy. Understanding the role of the autonomic nervous system in regulating heart rate helps clarify why bradycardia is a prominent feature in this particular type of shock.