APRN ACCNS-AG
Final Test Review
(Questions & Solutions)
2025
1
,1. A 72-year-old male presents with acute ischemic stroke. The CNS APN
must determine eligibility for thrombolytic therapy. Which time frame
from symptom onset is critical for thrombolytic administration?
A) Within 12 hours
B) Within 3 hours
C) Within 6 hours
D) Within 24 hours
ANS: B) Within 3 hours
Rationale: Intravenous tissue plasminogen activator (tPA) is most
effective if administered within 3 hours of ischemic stroke onset,
improving outcomes by restoring perfusion.
2. In managing an older adult with acute traumatic brain injury (TBI),
what ICP (intracranial pressure) threshold typically necessitates
intervention?
A) >15 mmHg
B) >20 mmHg
C) >25 mmHg
D) >30 mmHg
ANS: B) >20 mmHg
Rationale: ICP >20 mmHg is considered elevated and usually requires
intervention to prevent secondary brain injury.
3. In a patient post severe stroke, which nursing intervention best
promotes neurological recovery during the acute phase?
A) Early mobilization within 24-48 hours
B) Strict bed rest until 7 days post-stroke
C) High-dose corticosteroids administration
D) Complete sensory deprivation
ANS: A) Early mobilization within 24-48 hours
2
, Rationale: Early mobilization improves functional outcomes and reduces
complications like deep vein thrombosis and pneumonia.
4. You suspect a geriatric patient shows symptoms consistent with
normal pressure hydrocephalus (NPH). Which clinical triad is
characteristic?
A) Headache, nausea, and vomiting
B) Gait disturbance, dementia, urinary incontinence
C) Seizures, visual changes, ataxia
D) Fever, neck stiffness, photophobia
ANS: B) Gait disturbance, dementia, urinary incontinence
Rationale: The classic triad of NPH includes gait disturbance, cognitive
impairment, and urinary incontinence.
5. A 68-year-old with subarachnoid hemorrhage develops hyponatremia.
The CNS APN recognizes this is most likely due to:
A) Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
B) Diabetes insipidus
C) Hyperaldosteronism
D) Acute renal failure
ANS: A) SIADH
Rationale: SIADH is common after CNS injury including subarachnoid
hemorrhage, causing retention of water and hyponatremia.
6. Which diagnostic procedure is most definitive for differentiating
Alzheimer’s disease from vascular dementia in an acute care setting?
A) MRI with diffusion-weighted imaging
B) Electroencephalogram (EEG)
C) Lumbar puncture with CSF analysis
D) PET scan amyloid imaging
ANS: A) MRI with diffusion-weighted imaging
Rationale: MRI can identify ischemic lesions characteristic of vascular
3
Final Test Review
(Questions & Solutions)
2025
1
,1. A 72-year-old male presents with acute ischemic stroke. The CNS APN
must determine eligibility for thrombolytic therapy. Which time frame
from symptom onset is critical for thrombolytic administration?
A) Within 12 hours
B) Within 3 hours
C) Within 6 hours
D) Within 24 hours
ANS: B) Within 3 hours
Rationale: Intravenous tissue plasminogen activator (tPA) is most
effective if administered within 3 hours of ischemic stroke onset,
improving outcomes by restoring perfusion.
2. In managing an older adult with acute traumatic brain injury (TBI),
what ICP (intracranial pressure) threshold typically necessitates
intervention?
A) >15 mmHg
B) >20 mmHg
C) >25 mmHg
D) >30 mmHg
ANS: B) >20 mmHg
Rationale: ICP >20 mmHg is considered elevated and usually requires
intervention to prevent secondary brain injury.
3. In a patient post severe stroke, which nursing intervention best
promotes neurological recovery during the acute phase?
A) Early mobilization within 24-48 hours
B) Strict bed rest until 7 days post-stroke
C) High-dose corticosteroids administration
D) Complete sensory deprivation
ANS: A) Early mobilization within 24-48 hours
2
, Rationale: Early mobilization improves functional outcomes and reduces
complications like deep vein thrombosis and pneumonia.
4. You suspect a geriatric patient shows symptoms consistent with
normal pressure hydrocephalus (NPH). Which clinical triad is
characteristic?
A) Headache, nausea, and vomiting
B) Gait disturbance, dementia, urinary incontinence
C) Seizures, visual changes, ataxia
D) Fever, neck stiffness, photophobia
ANS: B) Gait disturbance, dementia, urinary incontinence
Rationale: The classic triad of NPH includes gait disturbance, cognitive
impairment, and urinary incontinence.
5. A 68-year-old with subarachnoid hemorrhage develops hyponatremia.
The CNS APN recognizes this is most likely due to:
A) Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
B) Diabetes insipidus
C) Hyperaldosteronism
D) Acute renal failure
ANS: A) SIADH
Rationale: SIADH is common after CNS injury including subarachnoid
hemorrhage, causing retention of water and hyponatremia.
6. Which diagnostic procedure is most definitive for differentiating
Alzheimer’s disease from vascular dementia in an acute care setting?
A) MRI with diffusion-weighted imaging
B) Electroencephalogram (EEG)
C) Lumbar puncture with CSF analysis
D) PET scan amyloid imaging
ANS: A) MRI with diffusion-weighted imaging
Rationale: MRI can identify ischemic lesions characteristic of vascular
3
