Autonomic Dysreflexia: NCLEX Nursing Emergency Quiz

1. A patient with autonomic dysreflexia is catheterized. The catheter is patent but the patient remains hypertensive. What should you do next?

Assume the dysreflexia is resolved and monitor

Irrigate the catheter gently with sterile saline

Assess for other triggers such as bowel impaction or skin irritation

Immediately administer antihypertensive medication

Submit

3. Which spinal cord injury patient is at LOWEST risk for developing autonomic dysreflexia?

Complete injury at T4

Incomplete injury at T10

Complete injury at L2

Incomplete injury at T5

4. True or False: A patient experiencing autonomic dysreflexia should be placed in a supine position to reduce intracranial pressure.

True

False

Submit

6. Which preventive measure is most effective in reducing the incidence of autonomic dysreflexia?

Regular prophylactic antihypertensive medication

Consistent bladder and bowel management programs

Daily skin inspection and pressure relief

Maintaining cool room temperature

7. The bradycardia sometimes seen during autonomic dysreflexia results from what mechanism?

Direct vagal stimulation from high blood pressure

Baroreceptor reflex causing parasympathetic response

Decreased myocardial contractility

Atrioventricular block from sympathetic overload

8. A patient with T5 spinal cord injury and autonomic dysreflexia has a blood pressure of 220/115 mmHg. The bladder is empty and no other triggers are found. What is the most appropriate next step?

Continue monitoring; symptoms may resolve spontaneously

Contact the physician for antihypertensive medication

Perform a rectal examination to rule out bowel impaction

Increase oxygen delivery and prepare for possible seizure

9. Which clinical finding during autonomic dysreflexia is caused by vasodilation above the lesion level?

Pale, cold skin below the injury

Red, flushed face and neck

Piloerection (goosebumps)

Increased perspiration below the injury

10. True or False: Patients with complete spinal cord injuries below T6 cannot develop autonomic dysreflexia.

True

False

11. Autonomic dysreflexia most commonly occurs in patients with spinal cord injuries at what level or above?

T6 (thoracic 6) or above

T10 (thoracic 10) or above

L1 (lumbar 1) or above

S1 (sacral 1) or above

12. After identifying and removing a trigger for autonomic dysreflexia, how long should you monitor the patient before considering the episode resolved?

5 minutes

15 minutes

30 minutes

1 hour

13. Which medication is most commonly used to treat acute hypertension during an autonomic dysreflexia episode?

Enalapril (ACE inhibitor)

Nifedipine (calcium channel blocker)

Metoprolol (beta-blocker)

Furosemide (diuretic)

14. True or False: Autonomic dysreflexia can cause a stroke if not treated promptly.

True

False

15. A patient with T7 spinal cord injury reports a severe headache and you notice profuse diaphoresis and facial flushing. Blood pressure is 210/110 mmHg. What is your priority nursing action?

Call the physician immediately for medication orders

Place patient supine to reduce cerebral blood flow

Sit patient upright and assess for triggering causes

Administer oxygen and monitor cardiac rhythm

16. The pathophysiology of autonomic dysreflexia involves a massive sympathetic response below the injury level due to loss of what?

Parasympathetic control

Descending inhibitory control from the brain

Peripheral nerve function

Reflex arc integrity

17. Which of the following is NOT a common trigger for autonomic dysreflexia?

Bowel impaction or constipation

Urinary tract infection

Low room temperature

Pressure ulcers or skin irritation

18. What is the immediate first action when autonomic dysreflexia is suspected?

Administer antihypertensive medication

Sit the patient upright to 90 degrees

Check and empty the bladder

Loosen constrictive clothing and check for triggers

19. A distended bladder is the triggering cause in approximately what percentage of autonomic dysreflexia cases?

25%

40%

60%

80%

20. Which symptom is the earliest and most reliable sign of autonomic dysreflexia?

Severe hypertension

Flushed face and neck

Diaphoresis above the injury level

Pounding headache

Dysreflexia Quiz: Can You Act Fast?

1. A patient with autonomic dysreflexia is catheterized. The catheter is patent but the patient remains hypertensive. What should you do next?

2.

What first name or nickname would you like us to use?

2. When educating a patient with spinal cord injury about autonomic dysreflexia prevention, you should emphasize the importance of ____ management to prevent bladder distension.

3. Which spinal cord injury patient is at LOWEST risk for developing autonomic dysreflexia?

4. True or False: A patient experiencing autonomic dysreflexia should be placed in a supine position to reduce intracranial pressure.

5. A patient reports goosebumps and sudden sweating above a T8 spinal cord injury. Blood pressure is 198/102 mmHg. This presentation is most consistent with ____ dysreflexia.

6. Which preventive measure is most effective in reducing the incidence of autonomic dysreflexia?

7. The bradycardia sometimes seen during autonomic dysreflexia results from what mechanism?

8. A patient with T5 spinal cord injury and autonomic dysreflexia has a blood pressure of 220/115 mmHg. The bladder is empty and no other triggers are found. What is the most appropriate next step?

9. Which clinical finding during autonomic dysreflexia is caused by vasodilation above the lesion level?

10. True or False: Patients with complete spinal cord injuries below T6 cannot develop autonomic dysreflexia.

11. Autonomic dysreflexia most commonly occurs in patients with spinal cord injuries at what level or above?

12. After identifying and removing a trigger for autonomic dysreflexia, how long should you monitor the patient before considering the episode resolved?

13. Which medication is most commonly used to treat acute hypertension during an autonomic dysreflexia episode?

14. True or False: Autonomic dysreflexia can cause a stroke if not treated promptly.

15. A patient with T7 spinal cord injury reports a severe headache and you notice profuse diaphoresis and facial flushing. Blood pressure is 210/110 mmHg. What is your priority nursing action?

16. The pathophysiology of autonomic dysreflexia involves a massive sympathetic response below the injury level due to loss of what?

17. Which of the following is NOT a common trigger for autonomic dysreflexia?

18. What is the immediate first action when autonomic dysreflexia is suspected?

19. A distended bladder is the triggering cause in approximately what percentage of autonomic dysreflexia cases?

20. Which symptom is the earliest and most reliable sign of autonomic dysreflexia?