CNRN Neurovascular Disorders and Stroke Nursing

Question 1

Which time window is the FDA-approved limit for IV alteplase (tPA) administration in eligible ischemic stroke patients?

Accepted Answer

Within 3 hours of symptom onset (up to 4.5 hours per extended guidelines)

Answer

Within 2 hours of symptom onset

Answer

Within 6 hours of symptom onset

Answer

Within 12 hours of symptom onset

Question 2

The nurse is preparing a patient for IV tPA. Which finding is an absolute contraindication?

Accepted Answer

Active intracranial hemorrhage on CT

Answer

Blood glucose of 60 mg/dL

Answer

BP of 175/95 mmHg

Answer

Age greater than 80

Question 3

A patient with ischemic stroke is being monitored post-tPA. The nurse notes the patient's BP is 195/110 mmHg. The priority action is to:

Accepted Answer

Administer antihypertensive to keep BP below 180/105 mmHg

Answer

Continue monitoring per routine schedule

Answer

Stop the tPA infusion immediately

Answer

Place the patient in Trendelenburg position

Question 4

Which artery occlusion typically produces the syndrome of contralateral hemiplegia, hemisensory loss, homonymous hemianopia, and aphasia (dominant hemisphere)?

Accepted Answer

Middle cerebral artery

Answer

Posterior cerebral artery

Answer

Anterior cerebral artery

Answer

Basilar artery

Question 5

The nurse is caring for a patient with a hemorrhagic stroke on anticoagulation. Which medication is used to reverse warfarin toxicity emergently?

Accepted Answer

4-factor prothrombin complex concentrate (4F-PCC)

Answer

Protamine sulfate

Answer

Vitamin K only

Answer

Fresh frozen plasma alone

Question 6

Which neurological deficit is most characteristic of a cerebellar stroke?

Accepted Answer

Ipsilateral limb ataxia and gait instability

Answer

Expressive aphasia

Answer

Contralateral hemiplegia

Answer

Neglect syndrome