Discuss NCLEX NCLEX-RN Exam Topic 1 Question 2

When evaluating a client with symptoms of shock, it is important for the nurse to differentiate between neurogenic and hypovolemic shock. The symptoms of neurogenic shock differ from hypovolemic shock in that:

AIn neurogenic shock, the skin is warm and dry

BIn hypovolemic shock, there is a bradycardia

CIn hypovolemic shock, capillary refill is less than 2 seconds

DIn neurogenic shock, there is delayed capillary refill

Suggested Answer: A

(A) Neurogenic shock is caused by injury to the cervical region, which leads to loss of sympathetic control. This loss leads to vasodilation of the vascular beds, bradycardia resulting from the lack of sympathetic balance to parasympathetic stimuli from the vagus nerve, and the loss of the ability to sweat below the level of injury. In neurogenic shock, the client is hypotensive but bradycardiac with warm, dry skin. (B) In hypovolemic shock, the client ishypotensive and tachycardiac with cool skin. (C) In hypovolemic shock, the capillary refill would be>5 seconds. (D) In neurogenic shock, there is no capillary delay, the vascular beds are dilated, and peripheral flow is good.

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31 comments · newest first

Ressie 10 months ago

Wait, are we sure about the capillary refill times?

Barb 10 months ago

I thought hypovolemic shock would show bradycardia too?

Shannan 10 months ago

Hypovolemic shock usually has cool, clammy skin.

Ben 10 months ago

Definitely agree, neurogenic shock is tricky!

Elfriede 11 months ago

Neurogenic shock has warm, dry skin for sure.

Cletus 11 months ago

I vaguely remember that neurogenic shock has a different skin presentation, but I can't remember if it's warm and dry or something else.

Nichelle 11 months ago

I feel like capillary refill is a key indicator, but I can't recall if it's delayed in neurogenic shock or hypovolemic shock.

Dortha 11 months ago

I think I practiced a question where hypovolemic shock had tachycardia, not bradycardia, but I might be mixing it up.

Benedict 12 months ago

I remember that in neurogenic shock, the skin can be warm and dry due to vasodilation, but I'm not completely sure about the specifics.

Blondell 12 months ago

Ugh, I'm really struggling with this question. The symptoms just seem so similar, and I'm not sure I fully understand the distinction between the two types of shock. I'll have to review my notes and try to find a way to remember the differences.

Tequila 12 months ago

Okay, I've got this. The key difference is that in neurogenic shock, the skin is warm and dry, while in hypovolemic shock, the skin is cool and clammy. I'm confident I can get this right.

Judy 1 year ago

Hmm, I'm a bit unsure about this one. The symptoms of the two types of shock seem pretty similar, so I'll need to think it through carefully. Maybe I can use the process of elimination to narrow it down.

Eric 1 year ago

This is a good question to test our understanding of the differences between neurogenic and hypovolemic shock. I'll need to carefully review the symptoms for each type to determine the correct answer.

Yolando 1 year ago

D has to be the right answer. Neurogenic shock causes delayed capillary refill, while hypovolemic shock has a warm, dry skin.

Laurene 1 year ago

↳ replying to Yolando

Yes, you're right. In hypovolemic shock, the skin is warm and dry.

Delila 1 year ago

↳ replying to Yolando

I think D is the correct answer. Neurogenic shock does cause delayed capillary refill.

Kayleigh 1 year ago

Haha, I bet the answer is C. In hypovolemic shock, capillary refill is less than 2 seconds because the patient is trying to save their life by running a marathon.

Jin 1 year ago

↳ replying to Kayleigh

C) In hypovolemic shock, capillary refill is less than 2 seconds

Cheryl 1 year ago

↳ replying to Kayleigh

B) In hypovolemic shock, there is a bradycardia

Cruz 1 year ago

↳ replying to Kayleigh

A) In neurogenic shock, the skin is warm and dry

Kate 1 year ago

I believe the answer is D) In neurogenic shock, there is delayed capillary refill, as it makes sense with the symptoms.

Georgeanna 1 year ago

I agree with Pamella, because in hypovolemic shock, there is a bradycardia.

Pamella 1 year ago

I think the answer is A) In neurogenic shock, the skin is warm and dry.

Vallie 1 year ago

I'm pretty sure it's B. In hypovolemic shock, there is a bradycardia as the body tries to compensate for the decreased blood volume.

Augustine 1 year ago

↳ replying to Vallie

That makes sense. It's a way for the body to try to maintain blood pressure.

Mitzie 1 year ago

↳ replying to Vallie

I think you're right. The body slows down the heart rate in hypovolemic shock.

Glory 1 year ago

I think the correct answer is D. In neurogenic shock, there is delayed capillary refill due to the loss of sympathetic tone, which leads to vasodilation and poor perfusion.

Maira 1 year ago

↳ replying to Glory

D) In neurogenic shock, there is delayed capillary refill

Cassie 1 year ago

↳ replying to Glory

C) In hypovolemic shock, capillary refill is less than 2 seconds

Ming 1 year ago

↳ replying to Glory

B) In hypovolemic shock, there is a bradycardia

Arlette 1 year ago

↳ replying to Glory

A) In neurogenic shock, the skin is warm and dry

NCLEX-RN Exam - Topic 1 Question 2 Discussion