CNRN Neurosurgical Nursing and Postoperative Care 2

Question 1

A patient undergoes clipping of an intracranial aneurysm. The most serious immediate postoperative complication the CNRN nurse monitors for is:

Accepted Answer

Cerebral vasospasm and delayed cerebral ischemia

Answer

Wound infection

Answer

Urinary retention

Answer

Pneumonia

Question 2

The nurse is monitoring a patient post-craniotomy and notes the Jackson-Pratt drain output is 300 mL of bright red blood over 1 hour. The priority action is to:

Accepted Answer

Immediately notify the neurosurgeon

Answer

Document and reassess in 30 minutes

Answer

Empty the drain bulb and continue monitoring

Answer

Apply a pressure dressing over the drain site

Question 3

A patient with normal pressure hydrocephalus (NPH) classically presents with which triad of symptoms?

Accepted Answer

Gait disturbance, urinary incontinence, and dementia (Hakim's triad)

Answer

Headache, papilledema, diplopia

Answer

Seizures, focal weakness, and confusion

Answer

Rigidity, tremor, and bradykinesia

Question 4

After a patient returns from carotid endarterectomy (CEA), which neurological assessment finding requires immediate notification of the surgeon?

Accepted Answer

New facial droop or arm weakness on the operative side

Answer

Mild throat soreness

Answer

Mild headache

Answer

Hoarse voice

Question 5

Which post-operative position is recommended after infratentorial (posterior fossa) craniotomy to minimize cerebellar and brainstem edema?

Accepted Answer

Head of bed elevated 30–45 degrees, head midline

Answer

Flat with no pillow

Answer

Lateral decubitus position

Answer

Trendelenburg position

Question 6

The nurse caring for a patient post-endoscopic third ventriculostomy (ETV) monitors closely for which early sign of procedure failure?

Accepted Answer

Worsening headache, nausea, and decreased level of consciousness

Answer

Hypertension and tachycardia

Answer

Incisional pain

Answer

Mild fever within 24 hours