CNRN Neuroscience Registered Nurse Certification 5

Question 1

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

Accepted Answer

Gait disturbance, urinary incontinence, and cognitive decline

Answer

NPH is characterized by the Hakim triad: gait disturbance (magnetic gait), urinary incontinence, and dementia, occurring in the absence of elevated CSF opening pressure.

Question 2

Which of the following best describes the primary mechanism of secondary brain injury following TBI?

Accepted Answer

Ischemia from disrupted autoregulation, excitotoxicity, and inflammatory cascade

Answer

Secondary brain injury occurs hours to days after TBI through ischemia, glutamate excitotoxicity, calcium influx, mitochondrial dysfunction, and neuroinflammation — all potentially modifiable targets.

Question 3

A patient with multiple sclerosis reports worsening of symptoms each time she showers. This phenomenon is known as:

Accepted Answer

Uhthoff's phenomenon

Answer

Uhthoff's phenomenon is a temporary worsening of MS symptoms with increased body temperature (heat, fever, exercise), caused by heat-induced conduction failure in demyelinated axons.

Question 4

The nurse is caring for a patient after a ventriculostomy (EVD) placement. Which action correctly manages the drainage system?

Accepted Answer

Level the air-fluid interface of the drip chamber to the specified reference point (usually tragus of the ear) before opening the drain

Answer

The EVD reference point (typically the foramen of Monro, approximated by the tragus) must be leveled before opening drainage to ensure accurate pressure measurement and appropriate drainage rate.

Question 5

A patient is admitted with suspected ischemic stroke. CT head is negative. The next most appropriate diagnostic study to detect early infarction is:

Accepted Answer

MRI brain with DWI sequence

Answer

DWI-MRI detects acute ischemic changes within minutes of onset with far greater sensitivity than CT, making it the gold standard for early stroke diagnosis.

CNRN Test Practice Test

CNRN Test Practice Test

CNRN Neuroscience Registered Nurse Certification 5