ASC Telestroke & Remote Care 3

Question 1

What regulatory body provides certification standards that directly influence telestroke program quality benchmarks in the United States?

Accepted Answer

The Joint Commission (TJC)

Answer

The Joint Commission's Primary and Comprehensive Stroke Center certification standards set quality benchmarks that telestroke programs must support.

Question 2

A patient with wake-up stroke presents at a spoke hospital. The telestroke neurologist wants to assess eligibility for late-window tPA using MRI DWI-FLAIR mismatch. What does this mismatch indicate?

Accepted Answer

The ischemic core is older than the surrounding penumbra, suggesting stroke onset within approximately 4.5 hours

Answer

DWI-FLAIR mismatch (DWI positive, FLAIR negative) suggests the stroke occurred within approximately 4.5 hours, supporting tPA eligibility in wake-up stroke.

Question 3

Which of the following best describes the concept of 'telestroke as a hub-and-spoke model'?

Accepted Answer

A comprehensive stroke center provides remote neurological expertise to multiple smaller facilities

Answer

In the hub-and-spoke model, a comprehensive stroke center (hub) extends expertise to community hospitals (spokes) via telemedicine.

Question 4

When documenting a telestroke encounter, which element is MOST critical to include for medicolegal and quality assurance purposes?

Accepted Answer

Time stamps for consult initiation, NIHSS completion, imaging review, and treatment decision

Answer

Accurate time stamps allow assessment of treatment delays, support regulatory compliance, and provide medicolegal documentation.

Question 5

A spoke hospital asks whether their telestroke neurologist can prescribe controlled substances for stroke-related pain remotely. Under the Ryan Haight Act, what is required?

Accepted Answer

An in-person medical evaluation is required before prescribing controlled substances via telemedicine, with limited exceptions

Answer

The Ryan Haight Act generally requires an in-person evaluation before prescribing controlled substances via telemedicine, though emergency exceptions exist.

(ASC) Advanced Stroke Coordinator Certification Practice Test

(ASC) Advanced Stroke Coordinator Certification Practice Test

ASC Telestroke & Remote Care 3