BCEN BCEN Neurological Emergencies

Question 1

A patient presents with sudden onset of the 'worst headache of their life.' What condition should be suspected first?

Accepted Answer

Subarachnoid hemorrhage

Answer

Sudden severe 'thunderclap' headache is a classic hallmark of subarachnoid hemorrhage until proven otherwise.

Question 2

Which scale is most commonly used in the ED to assess level of consciousness and neurological status?

Accepted Answer

Glasgow Coma Scale

Answer

The Glasgow Coma Scale (GCS) evaluates eye, verbal, and motor responses to provide a standardized neurological assessment in emergency settings.

Question 3

A patient with ischemic stroke arrives within 2 hours of symptom onset. What is the first-line pharmacological intervention if eligible?

Accepted Answer

IV alteplase (tPA)

Answer

IV alteplase (tPA) is the standard fibrinolytic therapy for eligible ischemic stroke patients within the 3–4.5 hour window.

Question 4

Which finding on CT scan is most consistent with an epidural hematoma?

Accepted Answer

Biconvex (lens-shaped) hyperdensity

Answer

An epidural hematoma classically appears as a biconvex (lens-shaped) hyperdensity on CT due to arterial bleeding between the skull and dura.

Question 5

A patient seizing for more than 5 minutes is considered to have status epilepticus. What is the first-line IV treatment?

Accepted Answer

Lorazepam

Answer

Benzodiazepines such as lorazepam are first-line treatment for status epilepticus due to rapid onset and CNS inhibitory action.

(BCEN) Board of Certification of Emergency Nursing Practice Test