Practice Test Geeks(ASC) Advanced Stroke Coordinator Certification Practice Test
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Neurological Assessment & Monitoring Flashcards

7 cards from real ASC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Neurological Assessment & Monitoring flashcards as text

  1. Which intracranial pressure (ICP) waveform component, when elevated above the P1 amplitude, signals compromised cerebral compliance in a stroke patient?

    Answer: P2 (tidal wave)

    When P2 exceeds P1 amplitude, it indicates reduced intracranial compliance and impaired autoregulation, signaling early herniation risk.

  2. A patient with large hemispheric infarction is being monitored for malignant edema. The Stroke Coordinator should anticipate peak cerebral swelling at:

    Answer: 48–72 hours post-stroke

    Cytotoxic edema following large ischemic stroke peaks at 48–72 hours and is the window of highest herniation risk.

  3. A right-handed patient presents with inability to name objects but intact repetition and comprehension. This pattern best localizes to:

    Answer: Anomic aphasia, often with angular gyrus involvement

    Anomic aphasia (isolated naming deficit with intact repetition and comprehension) most commonly involves the angular gyrus or temporal-parietal junction.

  4. When using transcranial Doppler (TCD) to monitor for vasospasm after subarachnoid hemorrhage, a mean flow velocity above which threshold in the MCA indicates severe vasospasm?

    Answer: 200 cm/s

    MCA mean flow velocity >200 cm/s on TCD is classified as severe vasospasm and correlates with high risk of delayed cerebral ischemia.

  5. The Lindegaard ratio in TCD monitoring is calculated to differentiate vasospasm from hyperemia. A ratio above what value confirms vasospasm rather than systemic hyperemia?

    Answer: 3

    A Lindegaard ratio (MCA velocity / extracranial ICA velocity) >3 indicates true vasospasm rather than hyperdynamic flow from systemic causes.

  6. A stroke patient in the ICU has cerebral perfusion pressure (CPP) of 48 mmHg with ICP of 22 mmHg. The MAP is:

    Answer: 70 mmHg

    CPP = MAP − ICP; therefore MAP = CPP + ICP = 48 + 22 = 70 mmHg.

  7. Which pupillometry parameter measured by quantitative pupillometry (NPi) best predicts early neurological deterioration in neurocritical care?

    Answer: Neurological Pupil index (NPi) below 3

    An NPi <3 on automated infrared pupillometry has been validated as an early and sensitive predictor of neurological deterioration and herniation.