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

Cerebral vasospasm causing delayed cerebral ischemia is the most serious postoperative complication after aneurysm clipping, occurring days 4–14.

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

Sudden large-volume bright red blood output from a post-craniotomy drain indicates active hemorrhage requiring immediate neurosurgical notification.

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

Normal pressure hydrocephalus presents with Hakim's triad: gait apraxia (magnetic gait), urinary incontinence, and cognitive decline (dementia).

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

New focal neurological deficits after CEA suggest stroke from thromboembolism or carotid occlusion, requiring immediate surgical reassessment.

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

Head elevation at 30–45 degrees with midline head positioning promotes venous drainage and reduces posterior fossa edema after infratentorial craniotomy.

CNRN Test Practice Test

CNRN Test Practice Test

CNRN Neurosurgical Nursing and Postoperative Care 2