CNRN Practice Samples questions
with verified answers
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. - correct answer ✔✔ 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
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. - correct
answer ✔✔ 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
,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. - correct answer ✔✔ 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.
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. - correct answer ✔✔ 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
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. - correct answer ✔✔ 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
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. - correct answer ✔✔ 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
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. - correct answer ✔✔ 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
, 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. - correct answer ✔✔ Which of
the following electrolyte abnormalities is LESS likely to result in a seizure?
A. Hyponatremia
B. Hyperkalemia
C. Hypocalcemia
D. Hypomagnesemia
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. - correct answer ✔✔
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
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
with verified answers
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. - correct answer ✔✔ 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
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. - correct
answer ✔✔ 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
,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. - correct answer ✔✔ 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.
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. - correct answer ✔✔ 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
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. - correct answer ✔✔ 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
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. - correct answer ✔✔ 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
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. - correct answer ✔✔ 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
, 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. - correct answer ✔✔ Which of
the following electrolyte abnormalities is LESS likely to result in a seizure?
A. Hyponatremia
B. Hyperkalemia
C. Hypocalcemia
D. Hypomagnesemia
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. - correct answer ✔✔
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
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
