ACLS Acute Stroke Care 3

Question 1

What is the recommended glucose target range in acute ischemic stroke patients to prevent worsening outcomes?

Accepted Answer

140–180 mg/dL

Answer

Hyperglycemia worsens stroke outcomes; AHA/ASA guidelines recommend treating glucose > 180 mg/dL and maintaining levels of 140–180 mg/dL.

Question 2

A patient with acute ischemic stroke has a temperature of 38.6°C. Which intervention is most appropriate?

Accepted Answer

Acetaminophen to reduce fever toward normothermia

Answer

Fever increases cerebral metabolic demand and worsens ischemic injury; antipyretics (e.g., acetaminophen) should be used to achieve normothermia.

Question 3

Which of the following is the MOST sensitive early imaging modality for detecting acute ischemic stroke within the first few hours of onset?

Accepted Answer

Diffusion-weighted MRI (DWI)

Answer

DWI-MRI detects cytotoxic edema within minutes of ischemia onset and is far more sensitive than CT in the hyperacute phase.

Question 4

A patient is eligible for IV tPA. The dose of alteplase for acute ischemic stroke is:

Accepted Answer

0.9 mg/kg IV, max 90 mg

Answer

The standard dose is 0.9 mg/kg (maximum 90 mg), with 10% given as an IV bolus over 1 minute and the remainder over 60 minutes.

Question 5

What oxygen saturation target should be maintained in acute ischemic stroke patients without hypoxia?

Accepted Answer

SpO₂ > 94%; do not give supplemental O₂ if already ≥ 94%

Answer

Supplemental oxygen is indicated only if SpO₂ < 94%; routine hyperoxia provides no benefit and may be harmful.

ACLS Practice Test