Hyperacute Care: SCRN Exam Review |
Questions, Answers & Explanations |
2026/2027
Contraindications for TPA? - correct answer-1) active bleeding, intracranial
hemorrhage
2) INR >1.7
3) recent surgery
4) Platelet <100,000
5) uncontrolled HTN BP >185/110 6)major surgeries
7) direct oral anticoagulants within 48 hrs without normal coagulants testing
How soon can you give TPA? - correct answer-tPA can be given 4.5 hrs from last
known well
How soon can someone get endovascular thrombectomy? - correct answer-this
may benefit select patients with large vessel occlusions up to 24 hrs based on
perfusion imaging
door to needle time? - correct answer-<45 mins
Before tPA what should the bp be? - correct answer-BP should be less than or
equal to 185/110
, NIHSS Stroke Scale (11 domains of neurological function)
What does it include?
Scoring? - correct answer-Score Guide Treatment
The higher the number in each category- the greater deficit
Mild: 0-4 : High chances of recovery. Might not qualify for tpa
Moderate: 5-15: Good candidate for IV tPA if within window
Severe: 16-20: Increased risk of poor outcomes; consider endovascular therapy if
you suspect a large vessel occlusion
Very severe: >20: poor prognosis
1) Level of Conciousness
ie 0: alert
1: Not alert but arousable
2: Requires repeated stilmulation
3: Reflecx only but unresponsive
2)Best Gaze
3) Visual Field
4) Facial Palsy
5 and 6) Motor arm R and L
7) and 8) Motor Leg R and L
9) Limb ataxia
Questions, Answers & Explanations |
2026/2027
Contraindications for TPA? - correct answer-1) active bleeding, intracranial
hemorrhage
2) INR >1.7
3) recent surgery
4) Platelet <100,000
5) uncontrolled HTN BP >185/110 6)major surgeries
7) direct oral anticoagulants within 48 hrs without normal coagulants testing
How soon can you give TPA? - correct answer-tPA can be given 4.5 hrs from last
known well
How soon can someone get endovascular thrombectomy? - correct answer-this
may benefit select patients with large vessel occlusions up to 24 hrs based on
perfusion imaging
door to needle time? - correct answer-<45 mins
Before tPA what should the bp be? - correct answer-BP should be less than or
equal to 185/110
, NIHSS Stroke Scale (11 domains of neurological function)
What does it include?
Scoring? - correct answer-Score Guide Treatment
The higher the number in each category- the greater deficit
Mild: 0-4 : High chances of recovery. Might not qualify for tpa
Moderate: 5-15: Good candidate for IV tPA if within window
Severe: 16-20: Increased risk of poor outcomes; consider endovascular therapy if
you suspect a large vessel occlusion
Very severe: >20: poor prognosis
1) Level of Conciousness
ie 0: alert
1: Not alert but arousable
2: Requires repeated stilmulation
3: Reflecx only but unresponsive
2)Best Gaze
3) Visual Field
4) Facial Palsy
5 and 6) Motor arm R and L
7) and 8) Motor Leg R and L
9) Limb ataxia
