SCRN EXAM REVIEW (2025–2026) ACTUAL
QUESTIONS AND 100% VERIFIED ANSWERS
GRADED A+
1. Occlusion of the left middle cerebral artery (MCA) typically produces:
A. Left hemiplegia and neglect
B. Right hemiplegia and expressive aphasia
C. Bilateral weakness
D. Ataxia and diplopia
✅ Answer: B
Rationale: The left MCA supplies Broca’s and Wernicke’s areas—damage causes
right hemiplegia + aphasia.
2. The posterior cerebral artery (PCA) supplies which region?
A. Frontal lobes
B. Temporal and occipital lobes
C. Parietal lobes
D. Basal ganglia
✅ Answer: B
Rationale: PCA perfuses occipital (visual cortex) and inferior temporal
regions—damage → visual field loss.
,3. The Circle of Willis provides:
A. Primary blood supply to the spinal cord
B. Collateral circulation between major cerebral arteries
C. Drainage of venous sinuses
D. Arterial supply to meninges only
✅ Answer: B
Rationale: The Circle of Willis allows for collateral flow in case of arterial
occlusion.
4. A patient presents with right facial droop, right arm weakness, and slurred
speech. The most likely lesion site is:
A. Left MCA
B. Right ACA
C. Left PCA
D. Brainstem
✅ Answer: A
Rationale: Left MCA affects face/arm > leg and speech centers (dominant
hemisphere).
5. In ischemic stroke, tissue in the ischemic penumbra is:
A. Dead and non-recoverable
B. Viable but at risk
C. Normal
D. Edematous but perfused normally
,✅ Answer: B
Rationale: The penumbra is salvageable tissue with decreased perfusion but
preserved membrane function.
6. The NIH Stroke Scale (NIHSS) primarily assesses:
A. Intracranial pressure
B. Stroke risk factors
C. Neurologic deficits severity
D. Vital signs
✅ Answer: C
Rationale: NIHSS quantifies neurological impairment—used to determine stroke
severity and guide treatment.
7. For a patient eligible for IV tPA, treatment must begin within:
A. 2 hours of onset
B. 3 hours (may extend to 4.5 for select patients)
C. 6 hours
D. 12 hours
✅ Answer: B
Rationale: IV alteplase is approved for ≤3 hours; up to 4.5 hours in certain
populations per AHA/ASA.
, 8. A stroke patient suddenly develops a severe headache, vomiting, and rapid
decline in consciousness. This suggests:
A. Embolic infarct
B. Hemorrhagic transformation
C. Lacunar infarct
D. TIA
✅ Answer: B
Rationale: Hemorrhagic transformation or ICH causes acute headache and
deterioration due to increased ICP.
9. Which imaging study best differentiates ischemic from hemorrhagic stroke
on arrival?
A. MRI DWI
B. CT without contrast
C. CTA
D. PET scan
✅ Answer: B
Rationale: Non-contrast CT rapidly identifies bleeding before fibrinolytic
therapy.
10. A right hemisphere stroke most commonly results in:
A. Language deficits
B. Left visual and spatial neglect
C. Expressive aphasia
QUESTIONS AND 100% VERIFIED ANSWERS
GRADED A+
1. Occlusion of the left middle cerebral artery (MCA) typically produces:
A. Left hemiplegia and neglect
B. Right hemiplegia and expressive aphasia
C. Bilateral weakness
D. Ataxia and diplopia
✅ Answer: B
Rationale: The left MCA supplies Broca’s and Wernicke’s areas—damage causes
right hemiplegia + aphasia.
2. The posterior cerebral artery (PCA) supplies which region?
A. Frontal lobes
B. Temporal and occipital lobes
C. Parietal lobes
D. Basal ganglia
✅ Answer: B
Rationale: PCA perfuses occipital (visual cortex) and inferior temporal
regions—damage → visual field loss.
,3. The Circle of Willis provides:
A. Primary blood supply to the spinal cord
B. Collateral circulation between major cerebral arteries
C. Drainage of venous sinuses
D. Arterial supply to meninges only
✅ Answer: B
Rationale: The Circle of Willis allows for collateral flow in case of arterial
occlusion.
4. A patient presents with right facial droop, right arm weakness, and slurred
speech. The most likely lesion site is:
A. Left MCA
B. Right ACA
C. Left PCA
D. Brainstem
✅ Answer: A
Rationale: Left MCA affects face/arm > leg and speech centers (dominant
hemisphere).
5. In ischemic stroke, tissue in the ischemic penumbra is:
A. Dead and non-recoverable
B. Viable but at risk
C. Normal
D. Edematous but perfused normally
,✅ Answer: B
Rationale: The penumbra is salvageable tissue with decreased perfusion but
preserved membrane function.
6. The NIH Stroke Scale (NIHSS) primarily assesses:
A. Intracranial pressure
B. Stroke risk factors
C. Neurologic deficits severity
D. Vital signs
✅ Answer: C
Rationale: NIHSS quantifies neurological impairment—used to determine stroke
severity and guide treatment.
7. For a patient eligible for IV tPA, treatment must begin within:
A. 2 hours of onset
B. 3 hours (may extend to 4.5 for select patients)
C. 6 hours
D. 12 hours
✅ Answer: B
Rationale: IV alteplase is approved for ≤3 hours; up to 4.5 hours in certain
populations per AHA/ASA.
, 8. A stroke patient suddenly develops a severe headache, vomiting, and rapid
decline in consciousness. This suggests:
A. Embolic infarct
B. Hemorrhagic transformation
C. Lacunar infarct
D. TIA
✅ Answer: B
Rationale: Hemorrhagic transformation or ICH causes acute headache and
deterioration due to increased ICP.
9. Which imaging study best differentiates ischemic from hemorrhagic stroke
on arrival?
A. MRI DWI
B. CT without contrast
C. CTA
D. PET scan
✅ Answer: B
Rationale: Non-contrast CT rapidly identifies bleeding before fibrinolytic
therapy.
10. A right hemisphere stroke most commonly results in:
A. Language deficits
B. Left visual and spatial neglect
C. Expressive aphasia
