The nurse is performing an assessment of a patient with neurogenic shock. Which of the following manifestations does the nurse anticipate?

A. Heart rate of 128 bpm: Tachycardia is commonly associated with hypovolemic or distributive shock due to compensatory sympathetic stimulation. In neurogenic shock, sympathetic outflow is disrupted, so the heart rate often does not increase, making this finding less likely. B. Cool extremities: Cool, clammy extremities are typical in hypovolemic or cardiogenic shock due to peripheral vasoconstriction. Neurogenic shock, however, involves vasodilation from loss of sympathetic tone, so extremities are usually warm rather than cool. C. Heart rate of 48 bpm: Bradycardia is a hallmark of neurogenic shock because disruption of sympathetic pathways below the level of injury prevents normal sympathetic stimulation of the heart. The unopposed parasympathetic (vagal) activity results in a slowed heart rate despite hypotension, distinguishing it from other shock types. D. Moist skin: Moist, diaphoretic skin is characteristic of compensatory shock states like hypovolemic shock, where sympathetic stimulation triggers sweating. In neurogenic shock, vasodilation reduces sympathetic activity, often leaving the skin warm and dry rather than moist.