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

IV alteplase is FDA-approved within 3 hours of ischemic stroke onset, with AHA/ASA extending to 4.5 hours for select patients.

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

Active intracranial hemorrhage on CT is an absolute contraindication to IV tPA due to the risk of worsening hemorrhage.

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

Post-tPA guidelines require maintaining BP below 180/105 mmHg to reduce the risk of hemorrhagic transformation.

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

Middle cerebral artery (MCA) occlusion produces contralateral hemiplegia, hemisensory loss, hemianopia, and aphasia if the dominant hemisphere is affected.

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

4-factor prothrombin complex concentrate (4F-PCC) provides rapid, complete reversal of warfarin anticoagulation in hemorrhagic emergencies.

CNRN Test Practice Test

CNRN Test Practice Test

CNRN Neurovascular Disorders and Stroke Nursing