American Red Cross ACLS Stroke
Management Examination Questions
And Correct Answers (Verified
Answers) Plus Rationales 2026 Q&A |
Instant Download Pdf
1. A patient suddenly develops facial drooping, right arm weakness,
and difficulty speaking. What is the most appropriate initial action?
A. Give oral aspirin immediately
B. Place the patient in a sitting position and observe
C. Activate the stroke response and rapidly assess for acute stroke
D. Administer a sedative to reduce agitation
Answer: C. Activate the stroke response and rapidly assess for acute
stroke
Rationale: Sudden focal neurologic deficits such as facial droop,
unilateral weakness, and speech difficulty are classic warning signs of
acute stroke. Rapid recognition and activation of the stroke system are
essential because time-sensitive evaluation and treatment can reduce
disability. Aspirin or other medications should not be given before the
stroke type and hemorrhage status have been evaluated.
2. Which finding is most characteristic of an acute ischemic stroke?
A. Sudden unilateral weakness or numbness
B. Gradual bilateral leg weakness over several weeks
C. Chronic headache occurring every morning
D. Long-standing tremor without other neurologic changes
,Answer: A. Sudden unilateral weakness or numbness
Rationale: Acute ischemic stroke commonly presents with sudden focal
neurologic deficits, including unilateral weakness or sensory loss,
facial asymmetry, visual changes, aphasia, or neglect. The abrupt
onset is particularly important because stroke treatment is highly time
dependent.
3. Which question is especially important when evaluating a patient
with suspected acute stroke?
A. What did the patient eat for breakfast?
B. When was the patient last known to be at their neurologic
baseline?
C. Has the patient ever had seasonal allergies?
D. What is the patient's favorite medication?
Answer: B. When was the patient last known to be at their
neurologic baseline?
Rationale: The last-known-well time is critical in acute stroke
assessment because eligibility for time-dependent reperfusion
therapies depends partly on when the patient was last known to be
normal. The history should establish the precise or best-known time
the patient was last neurologically normal.
4. A patient with suspected stroke has a finger-stick glucose of 38
mg/dL and altered speech. What should be addressed promptly?
A. Hypertension
B. Fever
C. Mild dehydration
D. Hypoglycemia
Answer: D. Hypoglycemia
,Rationale: Hypoglycemia can produce neurologic abnormalities that
mimic stroke, including confusion, weakness, and speech
disturbances. Blood glucose should be checked promptly in patients
with suspected stroke, and significant hypoglycemia should be treated
according to protocol. Persistent deficits after glucose correction may
still require full stroke evaluation.
5. Which component of the neurologic assessment is particularly
useful for identifying aphasia?
A. Checking peripheral pulses
B. Assessing ankle reflexes only
C. Asking the patient to name objects and follow verbal commands
D. Measuring abdominal circumference
Answer: C. Asking the patient to name objects and follow verbal
commands
Rationale: Aphasia involves impaired language production or
comprehension. Asking the patient to name common objects, repeat
phrases, and follow commands can help identify language impairment.
A patient may have preserved consciousness but still have significant
aphasia.
6. Which symptom is more suggestive of a posterior circulation
stroke?
A. Isolated chronic knee pain
B. Sudden vertigo with ataxia or other brainstem findings
C. Long-standing constipation
D. Mild bilateral hand dryness
Answer: B. Sudden vertigo with ataxia or other brainstem findings
, Rationale: Posterior circulation strokes may involve the brainstem or
cerebellum and can present with vertigo, severe imbalance, ataxia,
diplopia, dysarthria, visual abnormalities, or altered consciousness.
These presentations can be less obvious than classic facial-arm-speech
findings and require careful neurologic assessment.
7. Why should a patient with suspected stroke be transported rapidly
to an appropriate stroke-capable facility?
A. Time-sensitive evaluation and treatment may improve neurologic
outcomes
B. Stroke symptoms always resolve during transportation
C. Transport prevents all complications
D. It eliminates the need for brain imaging
Answer: A. Time-sensitive evaluation and treatment may improve
neurologic outcomes
Rationale: Stroke management is highly time dependent. Rapid
transport facilitates brain imaging, vascular assessment when
indicated, determination of eligibility for reperfusion therapy, and
management of complications. Delays can reduce the opportunity for
beneficial treatment.
8. Which assessment is most useful for determining whether a patient
has a potentially disabling focal neurologic deficit?
A. Temperature alone
B. Skin color alone
C. Capillary refill alone
D. A structured neurologic assessment such as the NIH Stroke Scale
Answer: D. A structured neurologic assessment such as the NIH
Stroke Scale
Management Examination Questions
And Correct Answers (Verified
Answers) Plus Rationales 2026 Q&A |
Instant Download Pdf
1. A patient suddenly develops facial drooping, right arm weakness,
and difficulty speaking. What is the most appropriate initial action?
A. Give oral aspirin immediately
B. Place the patient in a sitting position and observe
C. Activate the stroke response and rapidly assess for acute stroke
D. Administer a sedative to reduce agitation
Answer: C. Activate the stroke response and rapidly assess for acute
stroke
Rationale: Sudden focal neurologic deficits such as facial droop,
unilateral weakness, and speech difficulty are classic warning signs of
acute stroke. Rapid recognition and activation of the stroke system are
essential because time-sensitive evaluation and treatment can reduce
disability. Aspirin or other medications should not be given before the
stroke type and hemorrhage status have been evaluated.
2. Which finding is most characteristic of an acute ischemic stroke?
A. Sudden unilateral weakness or numbness
B. Gradual bilateral leg weakness over several weeks
C. Chronic headache occurring every morning
D. Long-standing tremor without other neurologic changes
,Answer: A. Sudden unilateral weakness or numbness
Rationale: Acute ischemic stroke commonly presents with sudden focal
neurologic deficits, including unilateral weakness or sensory loss,
facial asymmetry, visual changes, aphasia, or neglect. The abrupt
onset is particularly important because stroke treatment is highly time
dependent.
3. Which question is especially important when evaluating a patient
with suspected acute stroke?
A. What did the patient eat for breakfast?
B. When was the patient last known to be at their neurologic
baseline?
C. Has the patient ever had seasonal allergies?
D. What is the patient's favorite medication?
Answer: B. When was the patient last known to be at their
neurologic baseline?
Rationale: The last-known-well time is critical in acute stroke
assessment because eligibility for time-dependent reperfusion
therapies depends partly on when the patient was last known to be
normal. The history should establish the precise or best-known time
the patient was last neurologically normal.
4. A patient with suspected stroke has a finger-stick glucose of 38
mg/dL and altered speech. What should be addressed promptly?
A. Hypertension
B. Fever
C. Mild dehydration
D. Hypoglycemia
Answer: D. Hypoglycemia
,Rationale: Hypoglycemia can produce neurologic abnormalities that
mimic stroke, including confusion, weakness, and speech
disturbances. Blood glucose should be checked promptly in patients
with suspected stroke, and significant hypoglycemia should be treated
according to protocol. Persistent deficits after glucose correction may
still require full stroke evaluation.
5. Which component of the neurologic assessment is particularly
useful for identifying aphasia?
A. Checking peripheral pulses
B. Assessing ankle reflexes only
C. Asking the patient to name objects and follow verbal commands
D. Measuring abdominal circumference
Answer: C. Asking the patient to name objects and follow verbal
commands
Rationale: Aphasia involves impaired language production or
comprehension. Asking the patient to name common objects, repeat
phrases, and follow commands can help identify language impairment.
A patient may have preserved consciousness but still have significant
aphasia.
6. Which symptom is more suggestive of a posterior circulation
stroke?
A. Isolated chronic knee pain
B. Sudden vertigo with ataxia or other brainstem findings
C. Long-standing constipation
D. Mild bilateral hand dryness
Answer: B. Sudden vertigo with ataxia or other brainstem findings
, Rationale: Posterior circulation strokes may involve the brainstem or
cerebellum and can present with vertigo, severe imbalance, ataxia,
diplopia, dysarthria, visual abnormalities, or altered consciousness.
These presentations can be less obvious than classic facial-arm-speech
findings and require careful neurologic assessment.
7. Why should a patient with suspected stroke be transported rapidly
to an appropriate stroke-capable facility?
A. Time-sensitive evaluation and treatment may improve neurologic
outcomes
B. Stroke symptoms always resolve during transportation
C. Transport prevents all complications
D. It eliminates the need for brain imaging
Answer: A. Time-sensitive evaluation and treatment may improve
neurologic outcomes
Rationale: Stroke management is highly time dependent. Rapid
transport facilitates brain imaging, vascular assessment when
indicated, determination of eligibility for reperfusion therapy, and
management of complications. Delays can reduce the opportunity for
beneficial treatment.
8. Which assessment is most useful for determining whether a patient
has a potentially disabling focal neurologic deficit?
A. Temperature alone
B. Skin color alone
C. Capillary refill alone
D. A structured neurologic assessment such as the NIH Stroke Scale
Answer: D. A structured neurologic assessment such as the NIH
Stroke Scale
