SCRN Hyperacute Care 5

Question 1

After IV tPA administration, how frequently should neurological assessments and blood pressure be monitored in the first 2 hours?

Accepted Answer

Every 15 minutes

Answer

During tPA infusion and for the first 2 hours after, neurological checks and BP should be performed every 15 minutes to detect hemorrhagic complications early.

Question 2

Which of the following laboratory values is MOST important to obtain before administering IV tPA in a patient on anticoagulation?

Accepted Answer

INR and aPTT

Answer

INR and aPTT must be checked to rule out therapeutic anticoagulation, as an INR >1.7 is a contraindication to IV tPA.

Question 3

A patient is eligible for mechanical thrombectomy. What is the recommended door-to-puncture time goal at thrombectomy-capable stroke centers?

Accepted Answer

90 minutes or less

Answer

The AHA/ASA recommends a door-to-puncture time of 90 minutes or less for mechanical thrombectomy at capable centers.

Question 4

A hyperacute stroke patient with known DOAC use taken within the last 48 hours presents within the tPA window. What is the appropriate action?

Accepted Answer

IV tPA is generally contraindicated; proceed with thrombectomy if LVO present

Answer

DOACs taken within 48 hours are a contraindication to IV tPA; mechanical thrombectomy remains an option if LVO is confirmed on imaging.

Question 5

Which sign on non-contrast CT is associated with a proximal MCA occlusion in hyperacute ischemic stroke?

Accepted Answer

Hyperdense MCA sign

Answer

The hyperdense MCA sign represents acute thrombus within the middle cerebral artery and indicates proximal occlusion requiring emergent intervention.

(SCRN) Stroke Certified Registered Nurse Practice Test

(SCRN) Stroke Certified Registered Nurse Practice Test

SCRN Hyperacute Care 5