STROKE CERTIFIED REGISTERED NURSE
(SCRN)EXAM NEWEST COMPLETE QUESTIONS AND
CORRECT VERIFIED ANSWERS(DETAILED
ANSWERS)|ALREADY GRADED A+
,SCRN 100-Question Practice Exam
1. A patient presents with acute onset of aphasia and right-sided weakness. A CT scan is negative for
hemorrhage. The symptom onset was 4 hours ago. The patient takes warfarin for atrial fibrillation, and the INR is
2.8. What is the most appropriate next step?
A. Administer IV tPA
B. Consult for mechanical thrombectomy
C. Administer Vitamin K and Prothrombin Complex Concentrate
D. Start an IV heparin infusion
Answer: B. Consult for mechanical thrombectomy
Rationale: IV tPA is contraindicated with an INR >1.7 due to increased risk of hemorrhage. The patient is outside
the 4.5-hour window for IV tPA but within the 24-hour window for mechanical thrombectomy in selected patients
with large vessel occlusion. Vitamin K and PCC are for life-threatening hemorrhage or urgent surgery, not
indicated here without bleeding. Heparin is not an acute reperfusion therapy.
2. A patient post-tPA administration develops sudden onset of severe headache, nausea, and a new fixed,
dilated pupil. What is the priority nursing action?
,A. Administer IV labetalol
B. Immediate CT scan of the head
C. Stop the tPA infusion and notify the provider
D. Administer ondansetron for nausea
Answer: C. Stop the tPA infusion and notify the provider
Rationale: These symptoms suggest intracerebral hemorrhage. The immediate first step is to stop any ongoing
thrombolytic infusion to prevent further bleeding, then obtain an emergent CT scan and notify the provider.
3. Which of the following is a modifiable risk factor for ischemic stroke?
A. Age
B. Family history of stroke
C. Hypertension
D. Male sex
Answer: C. Hypertension
, Rationale: Hypertension is the single most important modifiable risk factor for stroke. Age, family history, and sex
are non-modifiable risk factors.
4. A patient with an acute ischemic stroke is scheduled for mechanical thrombectomy. The NIHSS was 18 on
arrival. Which vital sign parameter is most critical to manage in the post-procedure period to prevent reperfusion
injury?
A. Heart rate < 60 bpm
B. Blood pressure control as per provider orders
C. Temperature > 37.5°C
D. Respiratory rate > 20
Answer: B. Blood pressure control as per provider orders
Rationale: After successful recanalization, the cerebral vasculature may be fragile and at risk for hyperperfusion
injury and hemorrhage. Strict blood pressure control is paramount to prevent this complication.
(SCRN)EXAM NEWEST COMPLETE QUESTIONS AND
CORRECT VERIFIED ANSWERS(DETAILED
ANSWERS)|ALREADY GRADED A+
,SCRN 100-Question Practice Exam
1. A patient presents with acute onset of aphasia and right-sided weakness. A CT scan is negative for
hemorrhage. The symptom onset was 4 hours ago. The patient takes warfarin for atrial fibrillation, and the INR is
2.8. What is the most appropriate next step?
A. Administer IV tPA
B. Consult for mechanical thrombectomy
C. Administer Vitamin K and Prothrombin Complex Concentrate
D. Start an IV heparin infusion
Answer: B. Consult for mechanical thrombectomy
Rationale: IV tPA is contraindicated with an INR >1.7 due to increased risk of hemorrhage. The patient is outside
the 4.5-hour window for IV tPA but within the 24-hour window for mechanical thrombectomy in selected patients
with large vessel occlusion. Vitamin K and PCC are for life-threatening hemorrhage or urgent surgery, not
indicated here without bleeding. Heparin is not an acute reperfusion therapy.
2. A patient post-tPA administration develops sudden onset of severe headache, nausea, and a new fixed,
dilated pupil. What is the priority nursing action?
,A. Administer IV labetalol
B. Immediate CT scan of the head
C. Stop the tPA infusion and notify the provider
D. Administer ondansetron for nausea
Answer: C. Stop the tPA infusion and notify the provider
Rationale: These symptoms suggest intracerebral hemorrhage. The immediate first step is to stop any ongoing
thrombolytic infusion to prevent further bleeding, then obtain an emergent CT scan and notify the provider.
3. Which of the following is a modifiable risk factor for ischemic stroke?
A. Age
B. Family history of stroke
C. Hypertension
D. Male sex
Answer: C. Hypertension
, Rationale: Hypertension is the single most important modifiable risk factor for stroke. Age, family history, and sex
are non-modifiable risk factors.
4. A patient with an acute ischemic stroke is scheduled for mechanical thrombectomy. The NIHSS was 18 on
arrival. Which vital sign parameter is most critical to manage in the post-procedure period to prevent reperfusion
injury?
A. Heart rate < 60 bpm
B. Blood pressure control as per provider orders
C. Temperature > 37.5°C
D. Respiratory rate > 20
Answer: B. Blood pressure control as per provider orders
Rationale: After successful recanalization, the cerebral vasculature may be fragile and at risk for hyperperfusion
injury and hemorrhage. Strict blood pressure control is paramount to prevent this complication.
