CNRN Neuroscience Registered Nurse Certification 2

Question 1

A patient with a subarachnoid hemorrhage suddenly develops severe vasospasm on day 4. Which medication is the first-line prophylactic agent?

Accepted Answer

Nimodipine

Answer

Nimodipine (oral calcium channel blocker) is the standard prophylactic agent for cerebral vasospasm after subarachnoid hemorrhage, given for 21 days.

Question 2

When monitoring intracranial pressure (ICP), which waveform component indicates reduced cerebral compliance?

Accepted Answer

Elevated P2 wave exceeding P1

Answer

An elevated P2 (tidal) wave that exceeds P1 (percussion) indicates reduced intracranial compliance and impending ICP crisis.

Question 3

A patient post-craniotomy reports sudden-onset severe headache and vomiting 6 hours after surgery. The nurse's priority action is to:

Accepted Answer

Notify the neurosurgeon immediately

Answer

Sudden severe headache and vomiting post-craniotomy suggest intracranial hemorrhage; immediate neurosurgeon notification precedes any other intervention.

Question 4

Which finding on a lumbar puncture (LP) is most consistent with bacterial meningitis?

Accepted Answer

CSF glucose <40 mg/dL with elevated protein and cloudy appearance

Answer

Bacterial meningitis classically presents with low CSF glucose (<40 mg/dL or <60% serum), elevated protein, PMN pleocytosis, and turbid appearance.

Question 5

A patient with Guillain-Barré syndrome has a forced vital capacity (FVC) of 15 mL/kg. The nurse anticipates:

Accepted Answer

Elective intubation for airway protection

Answer

FVC <20 mL/kg (or <1L) in GBS indicates impending respiratory failure and is the threshold for elective intubation before crisis occurs.

CNRN Test Practice Test

CNRN Test Practice Test

CNRN Neuroscience Registered Nurse Certification 2