CNRN Practice Exam Questions
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 - VERIFIED ANSB
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 - VERIFIED ANSA
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
trANSWERient 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. - VERIFIED ANSA
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 - VERIFIED ANSC
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 - VERIFIED ANSB
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 - VERIFIED ANSB
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 - VERIFIED ANSA
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 - VERIFIED ANSB
, 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 - VERIFIED ANSC
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 - VERIFIED ANSC
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?
A. Irreversibly damaged tissue
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 - VERIFIED ANSB
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 - VERIFIED ANSA
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
trANSWERient 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. - VERIFIED ANSA
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 - VERIFIED ANSC
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 - VERIFIED ANSB
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 - VERIFIED ANSB
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 - VERIFIED ANSA
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 - VERIFIED ANSB
, 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 - VERIFIED ANSC
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 - VERIFIED ANSC
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?
A. Irreversibly damaged tissue
