CNRN Neurosurgical Nursing and Postoperative Care

Question 1

After a craniotomy, the nurse assesses the patient and finds clear fluid draining from the nose. To determine if this is CSF, the nurse should:

Accepted Answer

Test for beta-2 transferrin and check for a halo sign on filter paper

Answer

Send fluid for glucose level only

Answer

Perform a dipstick urinalysis on the fluid

Answer

Observe the color and odor of the fluid

Question 2

A patient who had a transsphenoidal hypophysectomy for pituitary adenoma develops polyuria (output 500 mL/hour) and hypernatremia. The nurse suspects:

Accepted Answer

Diabetes insipidus (DI)

Answer

Syndrome of inappropriate ADH (SIADH)

Answer

Cerebral salt-wasting syndrome

Answer

Postoperative fluid mobilization

Question 3

Which medication is used to treat central diabetes insipidus after pituitary surgery?

Accepted Answer

Desmopressin (DDAVP)

Answer

Fludrocortisone

Answer

Furosemide

Answer

Hydrocortisone

Question 4

After lumbar spinal fusion surgery, the nurse assesses the surgical site and notes a bulge under the wound. The patient reports headache when upright that resolves when lying flat. The nurse suspects:

Accepted Answer

CSF leak with pseudomeningocele

Answer

Wound infection

Answer

Seroma formation

Answer

Surgical hematoma

Question 5

A patient with a ventriculoperitoneal (VP) shunt develops fever, headache, and stiff neck. The priority nursing intervention is to:

Accepted Answer

Notify the neurosurgeon immediately for suspected shunt infection

Answer

Pump the shunt reservoir to assess function

Answer

Administer acetaminophen and reassess in 2 hours

Answer

Perform a CT head immediately without notifying the surgeon

Question 6

The nurse is monitoring a patient's external ventricular drain (EVD). The drain is set to drain at 10 cmH₂O. The nurse should position the drip chamber reference point at:

Accepted Answer

The level of the tragus of the ear (foramen of Monro)

Answer

The level of the patient's chin

Answer

The level of the patient's shoulder

Answer

The level of the patient's mid-sternum