CNRN Certification Exam
CNRN Nursing Certification Exam – 100% Correct
Questions and Answers | Graded A+
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.
1
,CNRN Certification Exam
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
2
,CNRN Certification Exam
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
3
, CNRN Certification Exam
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
B. Diencephalic seizure
C. Paroxysmal sympathetic hyperactivity
D. Cerebral salt wasting syndrome - Correct Answer- C
Rationale: Traumatic brain injury (TBI) patients can experience "sympathetic storms" called
paroxysmal sympathetic hyperactivity. The symptoms include fever, tachycardia, hypertension,
profuse sweating, agitation, and increase respiratory rate. The "storm" is thought to be due to
intermittent stimulation of the sympathoexcitatory centers located in upper brainstem and
diencephalon. Diencephalic seizure is an incorrect term for the symptoms because the EEG is
negative. Neurogenic fevers can occur following TBI but is not associated with the other
symptoms of hypertension and tachycardia. Cerebral salt wasting syndrome (CSWS) is the loss
of sodium through the kidneys and results in hypovolemic hyponatremia.
In severe cases of cerebral palsy, there may be a delay in growth and development. Which of the
following conditions can occur in these cases?
A. Coagulopathy
B. Immunocompromise
C. Failure to thrive
D. Locked-in syndrome - Correct Answer- C
Rationale: Failure to thrive is a complication of moderate to severe cerebral palsy (CP). It can
result in malnutrition and death. CP is not associated with immunocompromise or
coagulopathies. CP involves abnormal motor movements associated with spasticity or flaccidity,
but does not develop locked-in syndrome.
Which of the following best describes the penumbra in an ischemic stroke?
4
CNRN Nursing Certification Exam – 100% Correct
Questions and Answers | Graded A+
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.
1
,CNRN Certification Exam
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
2
,CNRN Certification Exam
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
3
, CNRN Certification Exam
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
B. Diencephalic seizure
C. Paroxysmal sympathetic hyperactivity
D. Cerebral salt wasting syndrome - Correct Answer- C
Rationale: Traumatic brain injury (TBI) patients can experience "sympathetic storms" called
paroxysmal sympathetic hyperactivity. The symptoms include fever, tachycardia, hypertension,
profuse sweating, agitation, and increase respiratory rate. The "storm" is thought to be due to
intermittent stimulation of the sympathoexcitatory centers located in upper brainstem and
diencephalon. Diencephalic seizure is an incorrect term for the symptoms because the EEG is
negative. Neurogenic fevers can occur following TBI but is not associated with the other
symptoms of hypertension and tachycardia. Cerebral salt wasting syndrome (CSWS) is the loss
of sodium through the kidneys and results in hypovolemic hyponatremia.
In severe cases of cerebral palsy, there may be a delay in growth and development. Which of the
following conditions can occur in these cases?
A. Coagulopathy
B. Immunocompromise
C. Failure to thrive
D. Locked-in syndrome - Correct Answer- C
Rationale: Failure to thrive is a complication of moderate to severe cerebral palsy (CP). It can
result in malnutrition and death. CP is not associated with immunocompromise or
coagulopathies. CP involves abnormal motor movements associated with spasticity or flaccidity,
but does not develop locked-in syndrome.
Which of the following best describes the penumbra in an ischemic stroke?
4
