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

Beta-2 transferrin is the most specific test for CSF; the halo (ring) sign on filter paper — a clear ring around a bloody center — also suggests CSF.

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

Diabetes insipidus after pituitary surgery results from ADH deficiency, causing large volumes of dilute urine and hypernatremia.

Question 3

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

Accepted Answer

Desmopressin (DDAVP)

Answer

Desmopressin (DDAVP) is a synthetic analog of ADH used to treat central diabetes insipidus by reducing urine output.

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

A postural headache (worse upright, better supine) with a bulge under the wound after spinal surgery suggests a CSF leak and pseudomeningocele formation.

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

Fever, headache, and nuchal rigidity in a VP shunt patient suggests shunt infection/meningitis, a neurosurgical emergency requiring immediate notification.

CNRN Test Practice Test

CNRN Test Practice Test

CNRN Neurosurgical Nursing and Postoperative Care