A young adult male client is admitted to the emergency department (ED) following a motor vehicle collision and the nurse suspects that he has suffered a spinal cord injury (SCI). Which assessment finding, if present, will alert the nurse to suspect spinal shock?

Rationale: A. Dilated pupils: Pupil dilation is typically associated with increased intracranial pressure, hypoxia, or sympathetic stimulation, not spinal shock. It reflects neurological or ocular changes but does not indicate the loss of spinal reflex activity. B. Hypertension: Spinal shock causes loss of sympathetic tone, leading to hypotension rather than hypertension. Elevated blood pressure is more characteristic of autonomic dysreflexia, which occurs later in the course of spinal cord injury, not during the initial shock phase. C. Tachycardia: Spinal shock usually results in bradycardia due to unopposed parasympathetic activity. Tachycardia is inconsistent with the physiological response seen in spinal shock and would more likely indicate pain, anxiety, or hypovolemia. D. Absence of reflexes: The hallmark of spinal shock is the complete but temporary loss of all motor, sensory, and reflex activity below the level of injury. This areflexia occurs because of sudden interruption of neuronal communication and typically resolves as the spinal cord recovers from the acute insult.