1. A patient presents with sudden facial droop, arm weakness, and slurred speech. What is
the priority action?
A. Give oral fluids
B. Obtain immediate CT scan
C. Check blood glucose and activate stroke protocol
D. Administer antihypertensive medication
Correct Answer: C. Check blood glucose and activate stroke protocol
Rationale: Rapid assessment and activation of stroke protocol is essential to preserve brain
tissue.
2. Which tool is commonly used to assess acute stroke severity?
A. APGAR score
B. NIH Stroke Scale
C. Braden Scale
D. Glasgow-Blatchford Score
Correct Answer: B. NIH Stroke Scale
Rationale: NIHSS evaluates neurological deficits in stroke patients.
3. Which symptom is most consistent with left hemispheric stroke?
A. Left-sided neglect
B. Aphasia
C. Bradycardia
D. Hearing loss
Correct Answer: B. Aphasia
Rationale: Left hemisphere controls language in most patients.
4. Which finding is an early sign of increased intracranial pressure (ICP)?
A. Bradycardia, hypertension, irregular respirations
B. Tachycardia and hypotension
,C. Fever and rash
D. Diarrhea
Correct Answer: A. Bradycardia, hypertension, irregular respirations
Rationale: Cushing’s triad indicates rising ICP.
5. A patient with suspected stroke arrives within 2 hours of symptom onset. What is the
priority imaging?
A. MRI of spine
B. Non-contrast CT brain
C. Chest X-ray
D. Abdominal CT
Correct Answer: B. Non-contrast CT brain
Rationale: CT is used to distinguish ischemic vs hemorrhagic stroke.
6. Which condition is an absolute contraindication for tPA?
A. Ischemic stroke within 4.5 hours
B. Active intracranial hemorrhage
C. Hypertension controlled
D. Diabetes mellitus
Correct Answer: B. Active intracranial hemorrhage
Rationale: tPA increases bleeding risk and cannot be used in hemorrhagic stroke.
7. Which neurological sign indicates worsening ICP?
A. Decreasing level of consciousness
B. Improved speech
C. Stable pupils
D. Increased appetite
Correct Answer: A. Decreasing level of consciousness
Rationale: LOC decline is an early sign of brain pressure increase.
, 8. Which pupil finding suggests brain herniation?
A. Equal reactive pupils
B. Fixed and dilated pupil
C. Small reactive pupils
D. Intermittent blinking
Correct Answer: B. Fixed and dilated pupil
Rationale: Herniation compresses cranial nerves affecting pupil response.
9. Which position is best for a patient with elevated ICP?
A. Trendelenburg
B. Supine flat
C. Head elevated 30 degrees
D. Prone position
Correct Answer: C. Head elevated 30 degrees
Rationale: Promotes venous drainage and reduces ICP.
10.Which intervention should be avoided in increased ICP?
A. Clustering nursing care
B. Maintaining oxygenation
C. Hyperventilation (prolonged routine use)
D. Elevating head of bed
Correct Answer: C. Hyperventilation (prolonged routine use)
Rationale: Excessive CO₂ reduction can cause cerebral vasoconstriction and ischemia.
11.Which Glasgow Coma Scale score indicates severe brain injury?
A. 15
B. 13
C. 9
D. 4
the priority action?
A. Give oral fluids
B. Obtain immediate CT scan
C. Check blood glucose and activate stroke protocol
D. Administer antihypertensive medication
Correct Answer: C. Check blood glucose and activate stroke protocol
Rationale: Rapid assessment and activation of stroke protocol is essential to preserve brain
tissue.
2. Which tool is commonly used to assess acute stroke severity?
A. APGAR score
B. NIH Stroke Scale
C. Braden Scale
D. Glasgow-Blatchford Score
Correct Answer: B. NIH Stroke Scale
Rationale: NIHSS evaluates neurological deficits in stroke patients.
3. Which symptom is most consistent with left hemispheric stroke?
A. Left-sided neglect
B. Aphasia
C. Bradycardia
D. Hearing loss
Correct Answer: B. Aphasia
Rationale: Left hemisphere controls language in most patients.
4. Which finding is an early sign of increased intracranial pressure (ICP)?
A. Bradycardia, hypertension, irregular respirations
B. Tachycardia and hypotension
,C. Fever and rash
D. Diarrhea
Correct Answer: A. Bradycardia, hypertension, irregular respirations
Rationale: Cushing’s triad indicates rising ICP.
5. A patient with suspected stroke arrives within 2 hours of symptom onset. What is the
priority imaging?
A. MRI of spine
B. Non-contrast CT brain
C. Chest X-ray
D. Abdominal CT
Correct Answer: B. Non-contrast CT brain
Rationale: CT is used to distinguish ischemic vs hemorrhagic stroke.
6. Which condition is an absolute contraindication for tPA?
A. Ischemic stroke within 4.5 hours
B. Active intracranial hemorrhage
C. Hypertension controlled
D. Diabetes mellitus
Correct Answer: B. Active intracranial hemorrhage
Rationale: tPA increases bleeding risk and cannot be used in hemorrhagic stroke.
7. Which neurological sign indicates worsening ICP?
A. Decreasing level of consciousness
B. Improved speech
C. Stable pupils
D. Increased appetite
Correct Answer: A. Decreasing level of consciousness
Rationale: LOC decline is an early sign of brain pressure increase.
, 8. Which pupil finding suggests brain herniation?
A. Equal reactive pupils
B. Fixed and dilated pupil
C. Small reactive pupils
D. Intermittent blinking
Correct Answer: B. Fixed and dilated pupil
Rationale: Herniation compresses cranial nerves affecting pupil response.
9. Which position is best for a patient with elevated ICP?
A. Trendelenburg
B. Supine flat
C. Head elevated 30 degrees
D. Prone position
Correct Answer: C. Head elevated 30 degrees
Rationale: Promotes venous drainage and reduces ICP.
10.Which intervention should be avoided in increased ICP?
A. Clustering nursing care
B. Maintaining oxygenation
C. Hyperventilation (prolonged routine use)
D. Elevating head of bed
Correct Answer: C. Hyperventilation (prolonged routine use)
Rationale: Excessive CO₂ reduction can cause cerebral vasoconstriction and ischemia.
11.Which Glasgow Coma Scale score indicates severe brain injury?
A. 15
B. 13
C. 9
D. 4
