SCRN Acute Care 4

Question 1

A patient develops seizures 12 hours after an ischemic stroke. Which nursing intervention takes priority?

Accepted Answer

Administer an antiepileptic drug as ordered and protect the airway

Answer

Seizure management priorities are airway protection and prompt administration of ordered antiepileptics to terminate the seizure and prevent recurrence.

Question 2

A patient with subarachnoid hemorrhage (SAH) from a ruptured aneurysm is at high risk for which serious delayed complication between days 4–14?

Accepted Answer

Cerebral vasospasm causing delayed ischemic neurological deficit (DIND)

Answer

Cerebral vasospasm peaks between days 4 and 14 after SAH and can cause delayed ischemic injury; nimodipine is given prophylactically to reduce this risk.

Question 3

Nimodipine is routinely administered after subarachnoid hemorrhage. Its primary mechanism of benefit is:

Accepted Answer

Reduction of vasospasm-related cerebral ischemia by blocking calcium channels

Answer

Nimodipine is a calcium channel blocker that reduces the severity of neurological deficits from vasospasm-induced ischemia following SAH.

Question 4

A stroke patient on heparin infusion for cardioembolic stroke has a PTT result of 220 seconds (therapeutic range: 60–100 seconds). What is the nurse's priority action?

Accepted Answer

Decrease the heparin rate per the protocol and notify the physician

Answer

A supratherapeutic PTT increases hemorrhagic transformation risk; the heparin rate must be reduced per weight-based protocol and the physician notified.

Question 5

Which clinical finding in an acute stroke patient suggests hemorrhagic transformation of an ischemic infarct?

Accepted Answer

Sudden neurological deterioration, new severe headache, and rising blood pressure

Answer

Hemorrhagic transformation typically presents with abrupt neurological worsening, severe headache, and hypertension as blood extravasates into the infarct zone.

(SCRN) Stroke Certified Registered Nurse Practice Test

(SCRN) Stroke Certified Registered Nurse Practice Test

SCRN Acute Care 4