SCRN Hyperacute Care 4

Question 1

A patient with acute ischemic stroke has a blood glucose of 42 mg/dL. What is the nurse's immediate intervention?

Accepted Answer

Administer IV dextrose (D50) and recheck glucose

Answer

Hypoglycemia (≤60 mg/dL) can mimic stroke and must be corrected immediately with IV dextrose before stroke workup proceeds.

Question 2

Which symptom pattern is most consistent with a posterior circulation (vertebrobasilar) stroke?

Accepted Answer

Vertigo, diplopia, and ataxia

Answer

Posterior circulation strokes commonly present with vertigo, diplopia, dysphagia, and cerebellar ataxia due to brainstem and cerebellar involvement.

Question 3

During hyperacute stroke care, the head of the bed is typically positioned flat (0°) for which reason?

Accepted Answer

To maximize cerebral perfusion pressure in the ischemic penumbra

Answer

Flat positioning improves cerebral perfusion to the ischemic penumbra, though it is contraindicated if the patient has elevated ICP or aspiration risk.

Question 4

What is the correct dose of IV alteplase (tPA) for acute ischemic stroke in adults?

Accepted Answer

0.9 mg/kg IV (max 90 mg), 10% bolus then 90% over 60 minutes

Answer

The standard dose is 0.9 mg/kg (max 90 mg) with 10% given as an IV bolus and the remaining 90% infused over 60 minutes.

Question 5

A patient who received IV tPA 2 hours ago requires urgent surgery for an unrelated emergency. What is the primary concern?

Accepted Answer

Increased bleeding risk due to active fibrinolytic effect

Answer

IV tPA has an active fibrinolytic effect for several hours, significantly increasing surgical bleeding risk and generally requiring delay of elective or semi-urgent procedures.

(SCRN) Stroke Certified Registered Nurse Practice Test

(SCRN) Stroke Certified Registered Nurse Practice Test

SCRN Hyperacute Care 4