CNRN Exam Study Guide Correct Questions and Answers
Specific condition of small vessels that can lead to lacunar strokes - Correct Answer- lipohyalinosis
what is the greatest risk factor for lacunar strokes - Correct Answer- hypertension
tiny areas of ischemic necrosis caused by occlusion of small penetrating arteries - Correct Answer-
lacunar strokes
what percentage of ischemic strokes do lacunar strokes account for - Correct Answer- 25%
what are the 5 classic syndromes of lacunar strokes - Correct Answer- pure motor hemiparesis, ataxic
hemiparesis, dysarthria/clumsy hand syndrome, pure sensory stroke, and mixed sensorimotor stroke
what is the only non-pain sensitive tissue in the head/brain - Correct Answer- brain parenchyma
what is the biggest insurmountable obstacle to effective pharmacological treatments for patients with
cluster headaches - Correct Answer- cigarette smoking
subdural hematomas most commonly result from what? - Correct Answer- venous bleeding from the
tearing of briding veins
how is the diagnosis of DAI confirmed - Correct Answer- clinical diagnosis, definitively dx requires
microscopice examination of the brain tissue.
what are classic signs of autonomic dysfunction syndrome and what's the most common intervention -
Correct Answer- hypertension, tachycardia, tachypnea, and fever---iv morphine
what is the MOST common source of infection leading to brain abcesses? - Correct Answer-
hematogenous spread from distant infected sites, such as PNA, lung abscess, or bacterial endocarditis
,what group of people have the greatest risk of ICH? - Correct Answer- patients with unruptured
intracerebral AVM's
what is the most important diagnostic test for the pt having a dull headache, superimposed ice pick
sensations on the scalp, jaw claudication, and elevated ESR? - Correct Answer- temporal artery biopsy--
r/o giant cell arteritis
what is a potential complication of a CSF leak in basal skull fx's? - Correct Answer- the trapping of
portions of the frontal meninges b/w the fx edges with a persistent CSF leak requiring surgical
intervention
what is the best way to accomplish external draining of CSF via an EVD? - Correct Answer- drain a few
drops/minute and close the drain after 5min or less
what is the Tinel's sign - Correct Answer- most frequently associated with carpel tunnel, gently tap or
percuss over the injured nerve to elicit a sensation of tingling or "pins and needles" in the nerve
distribution area.
what is the Phalen's sign? - Correct Answer- maneuver to diagnose carpel tunnel--hands forced dorsal
sides together and wrists flexed to 90deg; positive test causes burning, tingling, or numb sensation over
the thumb, index, middle and ring fingers.
what is the most common cause of Erb's palsy? - Correct Answer- dystocia or abnormal or difficult
childbirth or labor
what are the most common sign's of erb's palsy? - Correct Answer- loss of sensation in the arm and
paralysis and atrophy of the deltoid, biceps, and brachialis muscles.
how is the management of the GI system in a SCI pt intiated in the ED? - Correct Answer- by inserting a
NGT d/t the high risk of gastric immotility resulting in distention and an ileus.
what is the most common cause of a radial nerve injury - Correct Answer- humerus fracture
, best treatment options for a woman in 3rd trimester of pregnancy with + Tinel's and Phalen's sign is what?
- Correct Answer- wrist splints and rehab modalities
best way to prevent the development of peroneal nerve palsy in a recently immobilized pt is what? -
Correct Answer- avoiding pressure to the back of the knees during period when pt is immobilized
in a recently immbolized pt, they begin to complain of burning on the top of the foot and have unilateral
foot drop. what is this - Correct Answer- peroneal nerve palsy
what is the major difference b/w subdural hematoma and subdural hygroma - Correct Answer- subdural
hematoma is blood, and subdural hygroma is CSF
ideal treatment for low serum Na level is what? - Correct Answer- slow normalization w/ 3% saline and
lasix to prevent central pontine myelinolysis
what is a common alternative approach to preventing the s/s of carpel tunnel syndrome? - Correct
Answer- yoga
pain upon straight leg raising
in a multi trauma patient may indicate what? - Correct Answer- herniated nucleus pulposus
severe sharp pain with passive hip flexion may indicated what? - Correct Answer- hip fracture
one MOST important discharge education piece to include to parents taking home a baby with Erb's palsy
is what? - Correct Answer- PROM exercises for the affected arm
trauma pts being dc'd home following frontal bone fractures need education to avoid... - Correct Answer-
Food poisoning
anosmia - Correct Answer- the inability to perceive odor or a lack of functioning olfaction
Specific condition of small vessels that can lead to lacunar strokes - Correct Answer- lipohyalinosis
what is the greatest risk factor for lacunar strokes - Correct Answer- hypertension
tiny areas of ischemic necrosis caused by occlusion of small penetrating arteries - Correct Answer-
lacunar strokes
what percentage of ischemic strokes do lacunar strokes account for - Correct Answer- 25%
what are the 5 classic syndromes of lacunar strokes - Correct Answer- pure motor hemiparesis, ataxic
hemiparesis, dysarthria/clumsy hand syndrome, pure sensory stroke, and mixed sensorimotor stroke
what is the only non-pain sensitive tissue in the head/brain - Correct Answer- brain parenchyma
what is the biggest insurmountable obstacle to effective pharmacological treatments for patients with
cluster headaches - Correct Answer- cigarette smoking
subdural hematomas most commonly result from what? - Correct Answer- venous bleeding from the
tearing of briding veins
how is the diagnosis of DAI confirmed - Correct Answer- clinical diagnosis, definitively dx requires
microscopice examination of the brain tissue.
what are classic signs of autonomic dysfunction syndrome and what's the most common intervention -
Correct Answer- hypertension, tachycardia, tachypnea, and fever---iv morphine
what is the MOST common source of infection leading to brain abcesses? - Correct Answer-
hematogenous spread from distant infected sites, such as PNA, lung abscess, or bacterial endocarditis
,what group of people have the greatest risk of ICH? - Correct Answer- patients with unruptured
intracerebral AVM's
what is the most important diagnostic test for the pt having a dull headache, superimposed ice pick
sensations on the scalp, jaw claudication, and elevated ESR? - Correct Answer- temporal artery biopsy--
r/o giant cell arteritis
what is a potential complication of a CSF leak in basal skull fx's? - Correct Answer- the trapping of
portions of the frontal meninges b/w the fx edges with a persistent CSF leak requiring surgical
intervention
what is the best way to accomplish external draining of CSF via an EVD? - Correct Answer- drain a few
drops/minute and close the drain after 5min or less
what is the Tinel's sign - Correct Answer- most frequently associated with carpel tunnel, gently tap or
percuss over the injured nerve to elicit a sensation of tingling or "pins and needles" in the nerve
distribution area.
what is the Phalen's sign? - Correct Answer- maneuver to diagnose carpel tunnel--hands forced dorsal
sides together and wrists flexed to 90deg; positive test causes burning, tingling, or numb sensation over
the thumb, index, middle and ring fingers.
what is the most common cause of Erb's palsy? - Correct Answer- dystocia or abnormal or difficult
childbirth or labor
what are the most common sign's of erb's palsy? - Correct Answer- loss of sensation in the arm and
paralysis and atrophy of the deltoid, biceps, and brachialis muscles.
how is the management of the GI system in a SCI pt intiated in the ED? - Correct Answer- by inserting a
NGT d/t the high risk of gastric immotility resulting in distention and an ileus.
what is the most common cause of a radial nerve injury - Correct Answer- humerus fracture
, best treatment options for a woman in 3rd trimester of pregnancy with + Tinel's and Phalen's sign is what?
- Correct Answer- wrist splints and rehab modalities
best way to prevent the development of peroneal nerve palsy in a recently immobilized pt is what? -
Correct Answer- avoiding pressure to the back of the knees during period when pt is immobilized
in a recently immbolized pt, they begin to complain of burning on the top of the foot and have unilateral
foot drop. what is this - Correct Answer- peroneal nerve palsy
what is the major difference b/w subdural hematoma and subdural hygroma - Correct Answer- subdural
hematoma is blood, and subdural hygroma is CSF
ideal treatment for low serum Na level is what? - Correct Answer- slow normalization w/ 3% saline and
lasix to prevent central pontine myelinolysis
what is a common alternative approach to preventing the s/s of carpel tunnel syndrome? - Correct
Answer- yoga
pain upon straight leg raising
in a multi trauma patient may indicate what? - Correct Answer- herniated nucleus pulposus
severe sharp pain with passive hip flexion may indicated what? - Correct Answer- hip fracture
one MOST important discharge education piece to include to parents taking home a baby with Erb's palsy
is what? - Correct Answer- PROM exercises for the affected arm
trauma pts being dc'd home following frontal bone fractures need education to avoid... - Correct Answer-
Food poisoning
anosmia - Correct Answer- the inability to perceive odor or a lack of functioning olfaction
