Answer to Question 1
ANS: C
The described symptoms indicate autonomic hyperreflexia and are due to a distended bladder or rectum. The described symptoms are not due to the accumulation of free radicals, pain stimula-tion, or an abnormal vagal response.
Answer to Question 2
ANS: C
The patient is experiencing autonomic hyperreflexia, which is manifested by paroxysmal hyper-tension (up to 300 mm Hg, systolic), a pounding headache, blurred vision, sweating above the level of the lesion with flushing of the skin, nasal congestion, nausea, piloerection caused by pi-lomotor spasm, and bradycardia (30-40 beats/min). The patient in extreme spinal shock experi-ences paralysis and flaccidity in muscles, absence of sensation, loss of bladder and rectal control, transient drop in blood pressure, and poor venous circulation. The patient may experience acute anxiety, but the symptoms of elevated blood pressure with severe headache are due to autonomic hyperreflexia.
It is autonomic hyperreflexia, not parasympathetic areflexia, that produces paroxysmal hyperten-sion (up to 300 mm Hg, systolic), a pounding headache, blurred vision, sweating above the level of the lesion with flushing of the skin, nasal congestion, nausea, piloerection caused by pilomotor spasm, and bradycardia (30-40 beats/min).
The general survey includes assessing every patient for signs of distress.
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Each patient is greeted by the receptionist.
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