A patient with massive trauma and possible spinal cord injury is admitted to the emergency department. The nurse suspects that the patient may be experiencing neurogenic shock based on which assessment finding?

A. Cool, clammy skin: Cool, clammy skin is characteristic of hypovolemic or cardiogenic shock due to peripheral vasoconstriction. In neurogenic shock, loss of sympathetic tone causes vasodilation, so the skin is typically warm and dry rather than cool and clammy. B. Hypotension: Hypotension is present in neurogenic shock due to systemic vasodilation and relative hypovolemia. While it is an important finding, it is not specific for neurogenic shock and can be seen in multiple types of shock, making it less definitive as a distinguishing feature. C. Bradycardia: Neurogenic shock involves loss of sympathetic innervation below the level of spinal cord injury, resulting in unopposed parasympathetic stimulation. This leads to bradycardia in combination with hypotension, a hallmark finding that differentiates neurogenic shock from other shock types, which usually cause tachycardia. D. Decreased urinary output: Oliguria may occur in neurogenic shock due to hypotension and reduced renal perfusion. However, it is a secondary effect rather than a primary diagnostic sign. Early recognition relies on the combination of hypotension with bradycardia and vasodilation.