CNRN Practice Exam Questions With Correct
Answers
Which of the following tumor types will have a higher incidence in pediatric
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populations and have a decreased incidence with age?
| | | | | | |
A. Glioblastoma
|
B. Pilocytic astrocytoma
| |
C. Central nervous system lymphoma
| | | |
D. Metastatic brain tumor - CORRECT ANSWER✔✔-B
| | | | | |
Rationale: Both pilocytic astrocytoma and medulloblastoma brain tumors are
| | | | | | | | |
more commonly found in the younger population. The incidence of these tumors
| | | | | | | | | | | |
will decrease with age. Glioblastomas are more frequently found in young adults.
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CNS lymphoma and metastasis will have an increased incidence with age.
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A patient presents with progressive neurological deficits and has a recent history
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of transient neurological attack. This patient is most likely experiencing which of
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the following types of stroke?
| | | |
A. Thrombotic stroke
| |
B. Embolic stroke
| |
C. Subarachnoid hemorrhage
| |
D. Vasospasms - CORRECT ANSWER✔✔-A
| | | |
Rationale: Thrombotic strokes frequently present as a worsening neurological
| | | | | | | | |
status over a short period of time. Patients may have experienced episodes of
| | | | | | | | | | | | |
transient ischemic attacks (TIAs) before the onset of the ischemic strokes. Embolic
| | | | | | | | | | |
,strokes tend to have a more sudden onset without progression in symptoms.
| | | | | | | | | | | | |
Subarachnoid hemorrhages (SAHs) are a sudden onset of headache without the
| | | | | | | | | | |
history of transient neurological deficits. Vasospasms are associated with SAH,
| | | | | | | | | |
and symptoms occur most commonly between 7 and 10 days after the SAH.
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Which of the following best describes a coup injury?
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A. Injury occurs at the point of impact.
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B. Injury occurs on the contralateral side of impact.
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C. It is an acceleration injury.
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D. It is a deceleration injury. - CORRECT ANSWER✔✔-A
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Rationale: A coup injury occurs at the point of impact, and a contracoup injury
| | | | | | | | | | | | | |
occurs on the contralateral side. The mechanism of injury for acceleration injuries
| | | | | | | | | | |
is commonly defined as a moving object hitting a stationary head, whereas a
| | | | | | | | | | | | | |
deceleration injury involves a moving head hitting a stationary object.
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A patient is admitted to the ICU with persistent epileptic seizures lasting beyond
| | | | | | | | | | | | |
90 minutes. Which of the following best describes the seizure activity?
| | | | | | | | | |
A. Epileptic seizure
| |
B. Epilepsy
|
C. Refractory seizure
| |
D. Nonepileptic seizure - CORRECT ANSWER✔✔-C
| | | | |
Rationale: An epileptic seizure, which persists for greater than 90 minutes despite
| | | | | | | | | | |
administration of anticonvulsants is called a refractory seizure. An epileptic
| | | | | | | | | | |
seizure indicates the presence of EEG wave changes during the seizure activity.
| | | | | | | | | | | |
Epilepsy refers to repetitive seizures without a reversible cause such as
| | | | | | | | | | |
hyponatremia. Nonepileptic seizure is the presence of seizure activity without the
| | | | | | | | | |
EEG changes.
| |
,Which of the following would be the best technique to use to assess for
| | | | | | | | | | | | | |
cerebrospinal fluid in bloody drainage from the nose following a traumatic brain
| | | | | | | | | | | |
injury?
A. Glucose test
| |
B. Halo test
| |
C. Send to lab for hemoglobin level
| | | | | |
D. Litmus test - CORRECT ANSWER✔✔-B
| | | | |
Rationale: Halo test (a positive result produces a yellow ring) is more accurate
| | | | | | | | | | | | |
than a glucose test, especially with the presence of bloody drainage. A glucose
| | | | | | | | | | | | |
test has been used to distinguish between sinus drainage and cerebrospinal fluid
| | | | | | | | | | | |
(CSF) because CSF has glucose but sinus drainage does not. But in this scenario,
| | | | | | | | | | | | | |
the drainage was "bloody," and blood has glucose. Bloody drainage may give a
| | | | | | | | | | | | |
false positive with a glucose test. Testing for hemoglobin in the drainage does not
| | | | | | | | | | | | |
|determine the presence of CSF. Litmus test is used to test a pH of a fluid and is
| | | | | | | | | | | | | | | | | |
not used to distinguish CSF from nasal drainage.
| | | | | | |
Which of the following is the most common cause of an embolic stroke?
| | | | | | | | | | | |
A. Atrial septal defect
| | |
B. Atrial fibrillation
| |
C. Calcified lesion
| |
D. Angioplasty - CORRECT ANSWER✔✔-B
| | | |
Rationale: Atrial fibrillation (AF) is the most common cause of an embolic stroke.
| | | | | | | | | | | | |
Atrial septic defect (ASD) and calcified lesions can also result in embolic strokes
| | | | | | | | | | | | |
but are significantly less common than AF. A complication of angioplasty can be
| | | | | | | | | | | | |
distal embolization but again is not the most common cause of an embolic stroke.
| | | | | | | | | | | | |
, Cranial nerve (CN) VII (facial nerve) is commonly involved with Bell's palsy. Where
| | | | | | | | | | | |
does this CN originate?
| | | |
A. Pons |
B. Medulla
|
C. Midbrain
|
D. Basal ganglia - CORRECT ANSWER✔✔-A
| | | | |
Rationale: Cranial nerve (CN) V (trigeminal nerve), VI (abducens nerve), VII (facial
| | | | | | | | | | | |
nerve), and VIII (acoustic nerve) originate from the pons. CNs IX (hypoglossal
| | | | | | | | | | | |
nerve), X (vagus), XI (spinal accessory nerve), and XII (hypoglossal nerve) originate
| | | | | | | | | | |
from medulla. CNs III (oculomotor nerve) and IV (glossopharyngeal nerve)
| | | | | | | | | | |
originate from the midbrain. No cranial nerves originate from the basal ganglia.
| | | | | | | | | | |
Which of the following electrolyte abnormalities is LESS likely to result in a
| | | | | | | | | | | | |
seizure?
A. Hyponatremia
|
B. Hyperkalemia
|
C. Hypocalcemia
|
D. Hypomagnesemia - CORRECT ANSWER✔✔-B
| | | |
Rationale: Hyponatremia is one of the most common electrolyte abnormalities
| | | | | | | | | |
that can cause a seizure. Hypocalcemia and hypomagnesemia can also cause
| | | | | | | | | | |
seizures. Potassium is more likely to affect the myocardial electrical system,
| | | | | | | | | | |
resulting in arrhythmias. | |
A patient in the ICU following a severe traumatic brain injury suddenly
| | | | | | | | | | | |
demonstrates profuse sweating, sustained tachycardia, hypertension, and fever.
| | | | | | | |
Which of the following is the most likely cause?
| | | | | | | |
A. Neurogenic fever
| |
Answers
Which of the following tumor types will have a higher incidence in pediatric
| | | | | | | | | | | | |
populations and have a decreased incidence with age?
| | | | | | |
A. Glioblastoma
|
B. Pilocytic astrocytoma
| |
C. Central nervous system lymphoma
| | | |
D. Metastatic brain tumor - CORRECT ANSWER✔✔-B
| | | | | |
Rationale: Both pilocytic astrocytoma and medulloblastoma brain tumors are
| | | | | | | | |
more commonly found in the younger population. The incidence of these tumors
| | | | | | | | | | | |
will decrease with age. Glioblastomas are more frequently found in young adults.
| | | | | | | | | | | |
CNS lymphoma and metastasis will have an increased incidence with age.
| | | | | | | | | |
A patient presents with progressive neurological deficits and has a recent history
| | | | | | | | | | | |
of transient neurological attack. This patient is most likely experiencing which of
| | | | | | | | | | | |
the following types of stroke?
| | | |
A. Thrombotic stroke
| |
B. Embolic stroke
| |
C. Subarachnoid hemorrhage
| |
D. Vasospasms - CORRECT ANSWER✔✔-A
| | | |
Rationale: Thrombotic strokes frequently present as a worsening neurological
| | | | | | | | |
status over a short period of time. Patients may have experienced episodes of
| | | | | | | | | | | | |
transient ischemic attacks (TIAs) before the onset of the ischemic strokes. Embolic
| | | | | | | | | | |
,strokes tend to have a more sudden onset without progression in symptoms.
| | | | | | | | | | | | |
Subarachnoid hemorrhages (SAHs) are a sudden onset of headache without the
| | | | | | | | | | |
history of transient neurological deficits. Vasospasms are associated with SAH,
| | | | | | | | | |
and symptoms occur most commonly between 7 and 10 days after the SAH.
| | | | | | | | | | | |
Which of the following best describes a coup injury?
| | | | | | | |
A. Injury occurs at the point of impact.
| | | | | | |
B. Injury occurs on the contralateral side of impact.
| | | | | | | |
C. It is an acceleration injury.
| | | | |
D. It is a deceleration injury. - CORRECT ANSWER✔✔-A
| | | | | | | |
Rationale: A coup injury occurs at the point of impact, and a contracoup injury
| | | | | | | | | | | | | |
occurs on the contralateral side. The mechanism of injury for acceleration injuries
| | | | | | | | | | |
is commonly defined as a moving object hitting a stationary head, whereas a
| | | | | | | | | | | | | |
deceleration injury involves a moving head hitting a stationary object.
| | | | | | | | |
A patient is admitted to the ICU with persistent epileptic seizures lasting beyond
| | | | | | | | | | | | |
90 minutes. Which of the following best describes the seizure activity?
| | | | | | | | | |
A. Epileptic seizure
| |
B. Epilepsy
|
C. Refractory seizure
| |
D. Nonepileptic seizure - CORRECT ANSWER✔✔-C
| | | | |
Rationale: An epileptic seizure, which persists for greater than 90 minutes despite
| | | | | | | | | | |
administration of anticonvulsants is called a refractory seizure. An epileptic
| | | | | | | | | | |
seizure indicates the presence of EEG wave changes during the seizure activity.
| | | | | | | | | | | |
Epilepsy refers to repetitive seizures without a reversible cause such as
| | | | | | | | | | |
hyponatremia. Nonepileptic seizure is the presence of seizure activity without the
| | | | | | | | | |
EEG changes.
| |
,Which of the following would be the best technique to use to assess for
| | | | | | | | | | | | | |
cerebrospinal fluid in bloody drainage from the nose following a traumatic brain
| | | | | | | | | | | |
injury?
A. Glucose test
| |
B. Halo test
| |
C. Send to lab for hemoglobin level
| | | | | |
D. Litmus test - CORRECT ANSWER✔✔-B
| | | | |
Rationale: Halo test (a positive result produces a yellow ring) is more accurate
| | | | | | | | | | | | |
than a glucose test, especially with the presence of bloody drainage. A glucose
| | | | | | | | | | | | |
test has been used to distinguish between sinus drainage and cerebrospinal fluid
| | | | | | | | | | | |
(CSF) because CSF has glucose but sinus drainage does not. But in this scenario,
| | | | | | | | | | | | | |
the drainage was "bloody," and blood has glucose. Bloody drainage may give a
| | | | | | | | | | | | |
false positive with a glucose test. Testing for hemoglobin in the drainage does not
| | | | | | | | | | | | |
|determine the presence of CSF. Litmus test is used to test a pH of a fluid and is
| | | | | | | | | | | | | | | | | |
not used to distinguish CSF from nasal drainage.
| | | | | | |
Which of the following is the most common cause of an embolic stroke?
| | | | | | | | | | | |
A. Atrial septal defect
| | |
B. Atrial fibrillation
| |
C. Calcified lesion
| |
D. Angioplasty - CORRECT ANSWER✔✔-B
| | | |
Rationale: Atrial fibrillation (AF) is the most common cause of an embolic stroke.
| | | | | | | | | | | | |
Atrial septic defect (ASD) and calcified lesions can also result in embolic strokes
| | | | | | | | | | | | |
but are significantly less common than AF. A complication of angioplasty can be
| | | | | | | | | | | | |
distal embolization but again is not the most common cause of an embolic stroke.
| | | | | | | | | | | | |
, Cranial nerve (CN) VII (facial nerve) is commonly involved with Bell's palsy. Where
| | | | | | | | | | | |
does this CN originate?
| | | |
A. Pons |
B. Medulla
|
C. Midbrain
|
D. Basal ganglia - CORRECT ANSWER✔✔-A
| | | | |
Rationale: Cranial nerve (CN) V (trigeminal nerve), VI (abducens nerve), VII (facial
| | | | | | | | | | | |
nerve), and VIII (acoustic nerve) originate from the pons. CNs IX (hypoglossal
| | | | | | | | | | | |
nerve), X (vagus), XI (spinal accessory nerve), and XII (hypoglossal nerve) originate
| | | | | | | | | | |
from medulla. CNs III (oculomotor nerve) and IV (glossopharyngeal nerve)
| | | | | | | | | | |
originate from the midbrain. No cranial nerves originate from the basal ganglia.
| | | | | | | | | | |
Which of the following electrolyte abnormalities is LESS likely to result in a
| | | | | | | | | | | | |
seizure?
A. Hyponatremia
|
B. Hyperkalemia
|
C. Hypocalcemia
|
D. Hypomagnesemia - CORRECT ANSWER✔✔-B
| | | |
Rationale: Hyponatremia is one of the most common electrolyte abnormalities
| | | | | | | | | |
that can cause a seizure. Hypocalcemia and hypomagnesemia can also cause
| | | | | | | | | | |
seizures. Potassium is more likely to affect the myocardial electrical system,
| | | | | | | | | | |
resulting in arrhythmias. | |
A patient in the ICU following a severe traumatic brain injury suddenly
| | | | | | | | | | | |
demonstrates profuse sweating, sustained tachycardia, hypertension, and fever.
| | | | | | | |
Which of the following is the most likely cause?
| | | | | | | |
A. Neurogenic fever
| |
