SCRN Pharmacological Management 2

Question 1

A stroke patient on warfarin has an INR of 3.2 and presents with acute ischemic stroke. Which reversal agent is recommended?

Accepted Answer

4-factor prothrombin complex concentrate (PCC)

Answer

4-factor PCC rapidly reverses warfarin anticoagulation and is preferred over FFP alone due to faster onset and lower volume requirements.

Question 2

Which medication is specifically used to reverse dabigatran (a direct thrombin inhibitor) in acute hemorrhagic stroke?

Accepted Answer

Idarucizumab (Praxbind)

Answer

Idarucizumab is a specific reversal agent for dabigatran, binding it with high affinity and rapidly neutralizing its anticoagulant effect.

Question 3

A patient with hemorrhagic stroke has been taking apixaban. Which reversal agent should the nurse anticipate administering?

Accepted Answer

Andexanet alfa

Answer

Andexanet alfa reverses factor Xa inhibitors such as apixaban and rivaroxaban by binding and sequestering the drug.

Question 4

Nimodipine is administered after subarachnoid hemorrhage primarily to prevent which complication?

Accepted Answer

Cerebral vasospasm

Answer

Nimodipine, a calcium channel blocker, is administered for 21 days after SAH to reduce the incidence and severity of cerebral vasospasm.

Question 5

A stroke patient develops symptomatic cerebral edema. Which osmotic agent is commonly used to reduce intracranial pressure?

Accepted Answer

Mannitol

Answer

Mannitol is an osmotic diuretic that creates an osmotic gradient to draw water from cerebral tissue, effectively reducing ICP.

(SCRN) Stroke Certified Registered Nurse Practice Test