, NURS 5463 TEST 5 PRACTICE QUESTIONS
Adult Gerontology Acute Care
University of Texas at Arlington (UTA)
100-Question Original Practice Examination
2026/2027 Edition
Acute Ischemic and Hemorrhagic Stroke
1. A 69-year-old suddenly develops aphasia and right arm weakness 45 minutes ago. What is the immediate
priority?
A) Activate the acute stroke pathway and obtain emergent brain imaging
B) Schedule outpatient MRI next week
C) Treat as peripheral neuropathy
D) Give oral fluids and observe
Correct Answer: A) Activate the acute stroke pathway and obtain emergent brain imaging
Rationale: Acute focal neurologic deficits within a potential reperfusion window require immediate stroke
evaluation. Rapid imaging distinguishes ischemic from hemorrhagic stroke and guides thrombolysis or
thrombectomy decisions.
2. Which imaging study is typically obtained first in suspected acute stroke?
A) Noncontrast head CT
B) Carotid ultrasound only
C) Lumbar spine MRI
D) CT abdomen
Correct Answer: A) Noncontrast head CT
Rationale: Noncontrast CT is fast and detects intracranial hemorrhage, which must be excluded before
thrombolytic therapy. Vascular imaging may follow when large-vessel occlusion is suspected.
3. Why must blood glucose be checked early in acute stroke evaluation?
A) Glucose determines the NIHSS score
B) Hyperglycemia proves intracranial hemorrhage
C) Hypoglycemia can mimic focal neurologic deficits
D) Insulin immediately reverses ischemia
Correct Answer: C) Hypoglycemia can mimic focal neurologic deficits
Rationale: Severe hypoglycemia can cause confusion, weakness, or focal deficits and must be recognized quickly
because treatment is immediate and potentially curative.
4. Which blood-pressure issue can make a patient temporarily ineligible for IV thrombolysis?
A) Normal pulse pressure
NURS 5463 Test 5 Practice Questions | 2026/2027 Edition | Page 1
, B) Mild isolated systolic elevation
C) Severe hypertension above the treatment threshold
D) Blood pressure of 130/80 mm Hg
Correct Answer: C) Severe hypertension above the treatment threshold
Rationale: Excessively high blood pressure increases hemorrhagic risk with thrombolysis. It may need controlled
reduction before treatment if the patient is otherwise eligible.
5. A patient on a direct oral anticoagulant took the last dose this morning and now has an acute ischemic stroke.
What is the main thrombolysis concern?
A) Carotid spasm
B) Increased intracranial bleeding risk
C) Loss of platelet production
D) Reduced glucose delivery
Correct Answer: B) Increased intracranial bleeding risk
Rationale: Recent therapeutic anticoagulant exposure may increase the risk of intracranial hemorrhage with
fibrinolysis. Eligibility depends on agent, timing, kidney function, and relevant testing.
6. Which patient is most likely to benefit from mechanical thrombectomy?
A) One with tension headache
B) One with isolated peripheral neuropathy
C) One with chronic dementia and no acute deficit
D) One with a proximal large-vessel occlusion and salvageable brain tissue
Correct Answer: D) One with a proximal large-vessel occlusion and salvageable brain tissue
Rationale: Mechanical thrombectomy targets large-vessel occlusions and can restore perfusion in selected
patients based on time, imaging, functional status, and anatomy.
7. A patient has dense right hemiplegia and aphasia. Which vascular territory is most likely involved?
A) Right posterior cerebral artery
B) Left vertebral artery only
C) Right cerebellar artery
D) Left middle cerebral artery
Correct Answer: D) Left middle cerebral artery
Rationale: The dominant left MCA territory supplies language networks and motor regions controlling the face and
upper limb, making aphasia with right-sided weakness a classic pattern.
8. Left-sided neglect after stroke most strongly suggests injury to the:
A) Spinal cord
B) Right parietal cortex
NURS 5463 Test 5 Practice Questions | 2026/2027 Edition | Page 2
Adult Gerontology Acute Care
University of Texas at Arlington (UTA)
100-Question Original Practice Examination
2026/2027 Edition
Acute Ischemic and Hemorrhagic Stroke
1. A 69-year-old suddenly develops aphasia and right arm weakness 45 minutes ago. What is the immediate
priority?
A) Activate the acute stroke pathway and obtain emergent brain imaging
B) Schedule outpatient MRI next week
C) Treat as peripheral neuropathy
D) Give oral fluids and observe
Correct Answer: A) Activate the acute stroke pathway and obtain emergent brain imaging
Rationale: Acute focal neurologic deficits within a potential reperfusion window require immediate stroke
evaluation. Rapid imaging distinguishes ischemic from hemorrhagic stroke and guides thrombolysis or
thrombectomy decisions.
2. Which imaging study is typically obtained first in suspected acute stroke?
A) Noncontrast head CT
B) Carotid ultrasound only
C) Lumbar spine MRI
D) CT abdomen
Correct Answer: A) Noncontrast head CT
Rationale: Noncontrast CT is fast and detects intracranial hemorrhage, which must be excluded before
thrombolytic therapy. Vascular imaging may follow when large-vessel occlusion is suspected.
3. Why must blood glucose be checked early in acute stroke evaluation?
A) Glucose determines the NIHSS score
B) Hyperglycemia proves intracranial hemorrhage
C) Hypoglycemia can mimic focal neurologic deficits
D) Insulin immediately reverses ischemia
Correct Answer: C) Hypoglycemia can mimic focal neurologic deficits
Rationale: Severe hypoglycemia can cause confusion, weakness, or focal deficits and must be recognized quickly
because treatment is immediate and potentially curative.
4. Which blood-pressure issue can make a patient temporarily ineligible for IV thrombolysis?
A) Normal pulse pressure
NURS 5463 Test 5 Practice Questions | 2026/2027 Edition | Page 1
, B) Mild isolated systolic elevation
C) Severe hypertension above the treatment threshold
D) Blood pressure of 130/80 mm Hg
Correct Answer: C) Severe hypertension above the treatment threshold
Rationale: Excessively high blood pressure increases hemorrhagic risk with thrombolysis. It may need controlled
reduction before treatment if the patient is otherwise eligible.
5. A patient on a direct oral anticoagulant took the last dose this morning and now has an acute ischemic stroke.
What is the main thrombolysis concern?
A) Carotid spasm
B) Increased intracranial bleeding risk
C) Loss of platelet production
D) Reduced glucose delivery
Correct Answer: B) Increased intracranial bleeding risk
Rationale: Recent therapeutic anticoagulant exposure may increase the risk of intracranial hemorrhage with
fibrinolysis. Eligibility depends on agent, timing, kidney function, and relevant testing.
6. Which patient is most likely to benefit from mechanical thrombectomy?
A) One with tension headache
B) One with isolated peripheral neuropathy
C) One with chronic dementia and no acute deficit
D) One with a proximal large-vessel occlusion and salvageable brain tissue
Correct Answer: D) One with a proximal large-vessel occlusion and salvageable brain tissue
Rationale: Mechanical thrombectomy targets large-vessel occlusions and can restore perfusion in selected
patients based on time, imaging, functional status, and anatomy.
7. A patient has dense right hemiplegia and aphasia. Which vascular territory is most likely involved?
A) Right posterior cerebral artery
B) Left vertebral artery only
C) Right cerebellar artery
D) Left middle cerebral artery
Correct Answer: D) Left middle cerebral artery
Rationale: The dominant left MCA territory supplies language networks and motor regions controlling the face and
upper limb, making aphasia with right-sided weakness a classic pattern.
8. Left-sided neglect after stroke most strongly suggests injury to the:
A) Spinal cord
B) Right parietal cortex
NURS 5463 Test 5 Practice Questions | 2026/2027 Edition | Page 2
