Critical Care Registered Nurse (CCRN) Practice Exam

After a spinal cord injury, what is associated with possible urinary retention?

1. Return of reflexes

2. Increased sensation

3. Loss of automatic response

4. Improved circulation

The correct answer is: Loss of automatic response

Urinary retention following a spinal cord injury is often associated with the loss of automatic response. In this context, the automatic response refers to the involuntary actions of the bladder that help facilitate urination. When the spinal cord is injured, particularly in the areas that control bladder function, these reflexes may be disrupted. Injuries at or above the sacral level can lead to detrusor muscle dysfunction. Normally, the bladder contracts reflexively when it fills, sending signals to the brain that it’s time to void. However, with a loss of automatic response due to spinal cord injury, this reflex pathway is impaired, leading to a decreased ability to void urine naturally and, consequently, urinary retention. The return of reflexes or increased sensation might suggest some degree of recovery, but those phenomena do not necessarily facilitate bladder function. Improved circulation, while beneficial for overall health, does not directly relate to bladder control or urinary function in the context of spinal cord injuries. Thus, the most relevant aspect explaining the urinary retention is indeed through the lens of the loss of automatic response.