CNRN exam questions with verified answers.

CNRN exam 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" "Battle's sign - Correct answer ecchymosis over the temporal bones--develops typically 12-24hrs following the basal skull fracture" "advised to avoid glucose-containing IVF in pts with TBI b/c it can contribute to... - Correct answer neurotoxic acidosis" "characteristic finding on EEG in a patient experiencing "staring spells" - Correct answer irregular 2.5Hz or less spike-wave pattern" "the MOST common reason people with MS stop working is... - Correct answer cognitive impairment affects 60% of people with MS" "what is a disadvantage to gamma-knife tx for malignant brain tumors? - Correct answer it's unable to detect malig cells that may have infiltrated into surrounding normal tissues" "the few/main type of primary malignant brain tumor responsive to chemo is what? - Correct answer oligodendryglioma" "the incidence of medulloblastoma increases or decreases with age? - Correct answer decreases, unlike most other malig and benign tumors that increase with age" "why should pts taking methotrexate avoid ASA and NSAIDs? - Correct answer they increase serum concentration levels of methotrexate, increasing its 1/2 life, and therefore risking toxicity" "neurofibromatosis is inherited how? - Correct answer autosomal dominant fashion, but as many as 1/3 are spontaneous mutations" "which tumor will most likely present bitemporal hemianopia? - Correct answer pituitary adenoma" "chemotherapy for primary spinal cord tumors is consider to be? - Correct answer experimental" "what is the most common route for metas malignant tumors of other organs to spread to the CNS? - Correct answer via blood circulation" "complications in childbirth attribute to what % of cerebral palsy cases in the 1980's? - Correct answer less than 10%" "what is the primary/first line treatment for spasticity in pts with cerebral palsy? - Correct answer physical therapy" "elevated maternal serum alpha-fetoprotein is a marker for what? - Correct answer spina bifida" "the most common location for a CNS hemangioblastoma is where? - Correct answer the posterior fossa" "what is Von-Hippel Lindau disease? - Correct answer autosomal recessive d/o characterized by multiple benign hemangiomas of the CNS." "what is the only fully established risk factor for meningomas? - Correct answer radiation exposure" "what is attributed to the greatest improvement in survival rates of pts with metastatic brain CA? - Correct answer RADIOSURGERY" "untreated syringomyelia can expect what type of progression? - Correct answer slow progression with slow accumulation of neurological deficits" "impaired language function (aphagia) out of proportion to other cognitive deficits is characterized by? - Correct answer frontotemporal dementias" "impaired recent memory out of proportion to remote memory is characterized by? - Correct answer Alzheimer's disease" "what is the best strategy to ensue that a patient with middle stages of Alzheimer's dz can carry out complex instructions? - Correct answer both verbal and nonverbal cues simultaneously" "pt's with _____have a predisposition to generalized sz... - Correct answer Stage 3 Alzheimer's dz" "pt's presenting with impaired memory, broad-based magnetic gait, and urinary incontinence display what d/o? what treatment is indicated? - Correct answer NPH...normal pressure hydrocephalus...treatment is VP shunt" "dementia with a temporal step-wise clinical progression is most likely d/t what? - Correct answer multi-infarct dementia" "what is the single greatest risk factor for the development of pseudotumor cerebri - Correct answer obesity" "The inheritance of ALD is mostly r/t what? - Correct answer X linked recessive gene" "Pts with ALD lack what? - Correct answer Enzyme that breaks down VLCFAs" "What is the most common neurological manifestation of HIV dz? - Correct answer Peripheral neuropathy" "Pts rec'g the following therapies (INH, RIF, EMB, PZA) for HIV should receive supplements of what? - Correct answer Vitamin B6 (pyridoxine)" "RLS can affect people of what age group? - Correct answer Any age" "the inheritance of ALD is nearly always.... - Correct answer X-linked recessive" "patients with adrenoleukodystrophy ALD lack: - Correct answer an enzyme that breaks down very long chain fatty acids" "the most common neurologic manifestation of HIV disease - Correct answer peripheral neuropathy" "the best pharmacologic approach to symptoms of RLS is usually - Correct answer cyclic deployment of various classes of medications" "the GREATEST risk factor for progressive multifocal leukoencephalopathy is what? - Correct answer AIDS" "the MOST common natural history of degenerative disc disease w/o radiculopathy in the lumbar spine is: - Correct answer gradual improvement over time" "patients with multiple system atrophy become overheated and are at significant risk for heat stroke because: - Correct answer they fail to sweat" "back and leg pain associated with lumbar spinal stenosis is usually improved how? - Correct answer improves somewhat with walking uphill" "untreated hydrocephalus in newborns: - Correct answer has a 50-60% death rate overall" "the general term for a document that gives directions concerning a person's health care in the event that he/she can no longer make decisions for him/herself is called... - Correct answer advance directive" "triptans should not be used to abort migraine headaches in patients who: - Correct answer have HTN or other risk factors for heart attack or stroke" "the most effective strategy to date for limiting cognitive impairment in patients with multiple sclerosis is: - Correct answer early intervention with disease-modifying agents" "sympathetic blockade can reduce pain associated with: - Correct answer postherpetic neuralgia" "if a person has one parent with Huntington's disease, his chance of also having Huntington's is: - Correct answer 50%" "antibiotic treatment for neurosyphillis should consist of: - Correct answer IV aqueous crystalline PCN-G q4h x 10-14 days" "when a woman giving birth is known to have MS.... - Correct answer she should be given the same options for interventions for pain control for all other women" "the BEST method for preventing subacute sclerosing pan encephalitis (SSPE) is? - Correct answer measles vaccinations" "patients with idiopathic intracranial HTN should be followed with - Correct answer quantitative visual field examination" "it is common for a pt with narcolepsy experiencing an episode to: - Correct answer awaken feeling refreshed, although not necessarily for long" "careful temperature monitoring following an acute CVA is important b/c - Correct answer hyperthermia increases the risk of infarct extension" "pt's with ALS experience extended survival time and extended time not requiring a tracheostomy when treated with ? - Correct answer Riluzole" "the GREATEST risk factor for multi-infarct dementia is? - Correct answer HTN" "the most sensitive marker for neuromyelitis optical is? - Correct answer serum NMO IgG antibody" "the classic triad of fever, focal abnormalities, and increased ICP are seen in ... - Correct answer brain abscesses" "post polio syndrome can cause - Correct answer sleep apnea" "patient presenting with pure mental neuropathy (numb chin syndrome) is MOST likely to have? - Correct answer metastatic cancer" "a young patient presenting with Bell's palsy should always be evaluated for - Correct answer diabetes" "on EMG examination of a patient with post-polio syndrome, you can expect to see - Correct answer evidence of anterior horn disease with increased amplitude and duration with the evoked potentials and increased % of polyphasic potentials" "a patient with post-polio syndrome most likely had what kind of recovery course from the initial illness - Correct answer normal or good recovery course" "young patients presenting with trigemnal neuralgia should also be evaluated for? - Correct answer multiple sclerosis" "prevention of DVT in the patient hospitalized for GB management is best accomplished how? - Correct answer mini doses of heparin" "the goal of blood pressure management in a patient with aneurysmal SAH awaiting treatment is what? - Correct answer keep BP high enough to prevent vasospasm, but low enough to prevent aneurysmal rebleeding" "a person with a severe throbbing Rt sided headache 3 days post MVA, & transient ipsilateral monocular blindness should be monitored for what? - Correct answer partial Horner's syndrome" "a very common manifestation of carotid dissection r/t neck injury - Correct answer partial Horner's syndrome" "the most appropriate nutritional supplement for a patient with MS and his children - Correct answer Vitamin D" "emphasis is on re-establishing normal movement patterns through having the pt experience the sensations of normal movement - Correct answer Bobath neurodevelopment approach to rehab" "a conscious hemiplegic stroke pt should transfer from chair to bed how? - Correct answer orienting the chair at an angle and the unaffected side closest to the bed" "the most common route by which infective agents enter the CNS is how? - Correct answer hematogenous spread" "what pathogen is most commonly responsible for causing bacterial meningitis in adolescents and young adults? - Correct answer Neisseria meningitides" "effective acute treatment for cluster headaches is what? - Correct answer 100% O2 via a non-rebreathing face mask" "cigarette smoking is an insurmountable obstacle in the pharm tx of which class of headaches? - Correct answer cluster headaches" "treating spasticity in pts with syringomyelia should be balanced so as to not: - Correct answer inadvertently increase weakness" "a tremor that occurs most prominently when the hands are in use is r/t? - Correct answer benign essential tremor" "tremors associated with Parkinson's disease occur primarily when? - Correct answer at rest" "cerebellar tremors primarily are associated when? - Correct answer at the end of a movement" "tremors d/t toxic or metabolic abnorms occur when? - Correct answer both at rest and with motion" "treatment of Parkinson's with Carbidopa, the drug helps how? - Correct answer inhibits the enzyme dopa decarboxylase" "the use of anticholinergic meds to treat Parkinson's helps what? - Correct answer often reduces tremors and drooling" "before deep brain stimulation is used in a Parkinson's pt, they should - Correct answer dc PD meds the night before surgery" "dietary supplement most appropriate for patients with Wilson's disease - Correct answer Zinc acetate" "most prevalent focal dystonia - Correct answer torticollis" "dietary modifications necessary for a pt with hypokalemic periodic paralysis - Correct answer avoid high carb meals" "neuropathic pain follows what pattern typically? - Correct answer worse in the evening" "people with Down syndrome have the GREATEST increased risk of: - Correct answer dementia" "a child with Down syndrome in school is having difficulty learning new material & requiring a great deal of repitition; what test should be considered - Correct answer polysomnography (r/o sleep apnea)" "a baby with Down syndrome is likely to need? - Correct answer assistance breast feeding or bottle feeding with manual support of chin and throat" "assists in preventing opiod tolerance - Correct answer dextromethorphan" "symmetric, bilat distribution of sensory and motor deficits, beginning distally and progressing proximally - Correct answer diabetic peripheral neuropathy" "education on the proper use of crutches can help prevent what type of injury? - Correct answer radial nerve entrapment injury" "MS pts being treated with Tysabri require intensive long-term monitoring why? - Correct answer there is a 1/1000 risk of developing progressive multifocal leukoencephalopathy" "