SCRN Exam
15 min after starting up tPA, the nurse notes new onset bleeding. Whichof the subsequent
findings could maximum likely prompt discontinuation of fibrolytic remedy? -
ANS-Hemoptysis
1st cranial nerve at the brain stem (midbrain) - ANS-CN3
3 pieces of brainstem-Midbrain, PONS, Medulla - ANS-RAS=Awakeness
Motor-Anterior
Semsory=Posterior
30% of stroke sufferers can have a - ANS-Seizure
five P's of Circulatory Checks - ANS-P-Pain
P-Paresthesia
P-Paralysis
P-Pulse
P-Pallor (Paleness)
7 D's of stroke care - ANS-Detection-Facial droop, arm weakness
Dispatch-Ambulance receives PT
Delivery-Pt deliver to ER
Door-Pt arrives
Data-CT test
Decision-Should tPA take delivery of
Drug-what drug
A 30 yr antique girl with Sickle Cell sickness is being visible for stroke prevention diagnostic
testing. The important diagnostic test to assume is.... - ANS-Transcranial doppler
A 35 year antique pt is getting better from a Vertebral artery dissection. Collaboration
interventions in the extreme section of care consciousness on: - ANS-Nutrition and
Communication
A 53 year vintage provides with stroke like symptoms and a blood pressure of 260/a hundred
and forty. He has a records of heavy drinking and meth use. What is suspected? -
ANS-Basal ganglia hemorrhage
A CT Scan with out contrast can screen what in the presence of headache? -
ANS-Blood/Hemorrhage
Blood is WHITE
Ischemia/edema does now not show up for 12-24 hours
Brain parenchyma is grey
,A hyperacute ischemic stroke pt fails to fulfill inclusion criteria for fibrinolytic remedy. Which
of the subsequent techniques is taken into consideration the suitable intervention? -
ANS-Hospital admission and supportive care simplest
A hypotensive stroke pt has concomitant coronary heart failure. Which of the subsequent
retailers is most in all likelihood indicated? - ANS-Dobutamine
A nonverbal pt changed into remaining seen behaving usually 4 hrs previous to coming to
the stroke medical institution. Physical and radiographicfindings advise an ischemic stroke.
In absence of contraindictions, what's next step? - ANS-A. Mechanical clot extraction
A nurse explains to circle of relatives individuals that the number one distinction among a
venous and an arterial thrombotic stroke is: Venous - ANS-clots purpose stroke by way of
congestion, arterial clots purpose stroke by hypoperfusion.
A nurse is being concerned for a cerebral aneurysym pt who simply back to the stroke unit
following a diagnositic cerebral angiogram. The pt will become diaphoretic and complains of
groin and lower back ache. What is it? - ANS-Femoral artery
disecction(bradycardia,hypotension, hemorrhagic shock as well)
Most headaches occur within 12 hours of technique
A nurse is teaching a pt who underwent a cerebral angiogram. Which announcement
requires similarly teaching? - ANS-"I will put the pinnacle of the bed up no more than 60
ranges."
You can NOT hyperextend the leg, or flex the leg!
A psot-stroke pt has been taking every day atorvastatin for several weeks. Which lab take a
look at is maximum regarding? - ANS-CK: 22,000
A pt has a huge thrombus in the proximal left center cerebal artery (MCA). TPA become
given 2 hours in the past, and the pt has proven a few improvements, however symptom
resolution is incomplete. Next step? - ANS-A. Mechanical embolectomy
If pthas a large thrombus, tPA may 'nibble' around the edges, however fail to dissolve the
whole clot. Nexy step might be angiogram via femoral web page and endovascular clot
extraction the use of a mechanical tool.
A pt has visual field deficits and impaired lateral gaze. These findings advocate harm to
which brain structure? - ANS-Midbrain
A pt is admitted to the hospital for an acute ischemic stroke. Continuous cardiac tracking is
recommended - ANS-in the course of the first 24 hrs following a stroke
A pt is being discharged domestic after admission for a TIA. What are his possibilities of
having a stroke after he gets domestic? - ANS-17% of pts will revel in a stroke within 3
months, risk is highest in the first week.
,A pt is put up carotid revascularization provides with a blood stress of one hundred
eighty/90, an ipsilateral HA, and contralateral deficits. Which of the following is maximum
likely occuring? - ANS-Reperfusion Syndrome
A pt provides with PURE MOTOR hemiparesis and no detectable signs and symptoms of
visual, sensory, or speech loss. Which of the subsequent is most probable associated with
these symptoms? - ANS-Small vessel disease
A pt provides with sudden onset of dizziness, nausea, vomiting and unsteady gait. Which of
the subsequent stroke syndromes is consistent with these signs and symptoms? -
ANS-ISCHEMIC stroke within the cerebellum
A pt who had a MCA ischemic stroke has been within the ICU for four days. The nurse notes
the pt needs progressive stimulation to arouse the pt. What isthe maximum probably cause
of this neurologic change? - ANS-Cerebral edema
A pt who had a subarachnoid hemorrhage has a low urine output, a sodium level of 124, and
accelerated confusion. Which of the following is maximum likely related to those symptoms?
- ANS-SIADH
A pt who has undergone an interventional method is now complaining of swelling and pain to
the groin. Upon evaluation, a pulsatile mass that has a BRUIT is observed. Which is the
maximum likely cause? - ANS-Pseudoaneurysm
A pt who recieved tPA inside the ER 8 hrs ago has a BP of 200/a hundred and ten no matter
repeated IV Labetalol doses. Next step? - ANS-initiate a continuous nicardipine infusion
A pt with a 3cm by using 2cm posterior fossa hematoma is admitted to am extensive care
unit. The pt reveals decorticate posturing and SBP >220. The nurse anticipates: -
ANS-Craniotomy to take away the hemorrhage
A pt with a records of venous thromboembolism experienced a spontaneous intracerebral
hemorrhage (ICH). On hospital arrival, PT-INR four.2. Which of the subsequent agents does
the nurse count on administering to mormalize PT-INR rapidly? - ANS-Prothrombin complex
pay attention PCC
A pt with a huge ischemic stroke has big cerebral edema. Which of the following saline
concentrations is CONTRAINDICTATED for incresed intracranial stress remedy?
0.9%-isotonic
3%-hypertonic
7.Five%-hypertonic
23.Four%-hypertonic - ANS-zero.9%-isotonic
A pt with a probable MCA stroke will first get a non-more advantageous CT experiment to
identify: - ANS-Presence of cerebral edema
, A pt with cerebral edema and refractory ICP as measured by way of EVD is displaying signs
and symptoms of mind stem comprimise notwithstanding recieving maximal hypertonic fluid
remedy. What intervention should the nurse count on next? - ANS-Decompressive therapy
A pt with HX of CHF and O2 sat of 88% offers with stroke signs. How should this be dealt
with? - ANS-Nasal Canula
A pt with improved vasogenic edema is ordered Mannitol 25mg IV every 3 hrs. What are the
nursing considerations when administering this medicine? - ANS-Serum osmolarity, CPP
dreams, and fluid stability
A pt's NIHSS rating coorelates with: - ANS-The size of the infarct
A stroke pt underwent endarectomy for carotid artery stenosis. Which of the following
medications might be a crucial part of the pt's domestic medicinal drug regimen? -
ANS-Aspirin
A ventricular catheter allows for _____ drainage - ANS-CSF
Pt with ICP
ABCD - ANS-Higher the score=you are going to stroke in 2 days
ABCD rating - ANS-Age, Blood Pressure, Clinical Features, Duration of Symptoms and
Diabetes
Age > 60 = 1 Point
Blood Pressure >one hundred forty/>90 = 1 Point
Clinical Features - Unilateral Weakness - 2 Points, Speech Disturbances - 1 Point
Neuro Sx > 60 Mins = 2 Points
10 Mins to 60 Mins = 1 Point
DM = 1 Point
Score 0 to 3: Low Stroke Risk-may not be wished except afib
Score four to 5: Moderate Risk-clinic obs justified in most situations
Score 6 to 7: High Risk-health center statement worthwhile
Above the necklace-Anterior Circulation= - ANS-Unilateral deficits
ACA controls frontal lobe - ANS-LEG and Judgement
After an ischemic stroke, which of the following factors is UNRELATED to penumbral size? -
ANS-CSF production
Alberta Stroke Program Early CT ASPECT Score= - ANS-Assesses early MCA on CT
Scan-everyone receives 10 points
Subtract 1 factor for every ischemic location on CT test
15 min after starting up tPA, the nurse notes new onset bleeding. Whichof the subsequent
findings could maximum likely prompt discontinuation of fibrolytic remedy? -
ANS-Hemoptysis
1st cranial nerve at the brain stem (midbrain) - ANS-CN3
3 pieces of brainstem-Midbrain, PONS, Medulla - ANS-RAS=Awakeness
Motor-Anterior
Semsory=Posterior
30% of stroke sufferers can have a - ANS-Seizure
five P's of Circulatory Checks - ANS-P-Pain
P-Paresthesia
P-Paralysis
P-Pulse
P-Pallor (Paleness)
7 D's of stroke care - ANS-Detection-Facial droop, arm weakness
Dispatch-Ambulance receives PT
Delivery-Pt deliver to ER
Door-Pt arrives
Data-CT test
Decision-Should tPA take delivery of
Drug-what drug
A 30 yr antique girl with Sickle Cell sickness is being visible for stroke prevention diagnostic
testing. The important diagnostic test to assume is.... - ANS-Transcranial doppler
A 35 year antique pt is getting better from a Vertebral artery dissection. Collaboration
interventions in the extreme section of care consciousness on: - ANS-Nutrition and
Communication
A 53 year vintage provides with stroke like symptoms and a blood pressure of 260/a hundred
and forty. He has a records of heavy drinking and meth use. What is suspected? -
ANS-Basal ganglia hemorrhage
A CT Scan with out contrast can screen what in the presence of headache? -
ANS-Blood/Hemorrhage
Blood is WHITE
Ischemia/edema does now not show up for 12-24 hours
Brain parenchyma is grey
,A hyperacute ischemic stroke pt fails to fulfill inclusion criteria for fibrinolytic remedy. Which
of the subsequent techniques is taken into consideration the suitable intervention? -
ANS-Hospital admission and supportive care simplest
A hypotensive stroke pt has concomitant coronary heart failure. Which of the subsequent
retailers is most in all likelihood indicated? - ANS-Dobutamine
A nonverbal pt changed into remaining seen behaving usually 4 hrs previous to coming to
the stroke medical institution. Physical and radiographicfindings advise an ischemic stroke.
In absence of contraindictions, what's next step? - ANS-A. Mechanical clot extraction
A nurse explains to circle of relatives individuals that the number one distinction among a
venous and an arterial thrombotic stroke is: Venous - ANS-clots purpose stroke by way of
congestion, arterial clots purpose stroke by hypoperfusion.
A nurse is being concerned for a cerebral aneurysym pt who simply back to the stroke unit
following a diagnositic cerebral angiogram. The pt will become diaphoretic and complains of
groin and lower back ache. What is it? - ANS-Femoral artery
disecction(bradycardia,hypotension, hemorrhagic shock as well)
Most headaches occur within 12 hours of technique
A nurse is teaching a pt who underwent a cerebral angiogram. Which announcement
requires similarly teaching? - ANS-"I will put the pinnacle of the bed up no more than 60
ranges."
You can NOT hyperextend the leg, or flex the leg!
A psot-stroke pt has been taking every day atorvastatin for several weeks. Which lab take a
look at is maximum regarding? - ANS-CK: 22,000
A pt has a huge thrombus in the proximal left center cerebal artery (MCA). TPA become
given 2 hours in the past, and the pt has proven a few improvements, however symptom
resolution is incomplete. Next step? - ANS-A. Mechanical embolectomy
If pthas a large thrombus, tPA may 'nibble' around the edges, however fail to dissolve the
whole clot. Nexy step might be angiogram via femoral web page and endovascular clot
extraction the use of a mechanical tool.
A pt has visual field deficits and impaired lateral gaze. These findings advocate harm to
which brain structure? - ANS-Midbrain
A pt is admitted to the hospital for an acute ischemic stroke. Continuous cardiac tracking is
recommended - ANS-in the course of the first 24 hrs following a stroke
A pt is being discharged domestic after admission for a TIA. What are his possibilities of
having a stroke after he gets domestic? - ANS-17% of pts will revel in a stroke within 3
months, risk is highest in the first week.
,A pt is put up carotid revascularization provides with a blood stress of one hundred
eighty/90, an ipsilateral HA, and contralateral deficits. Which of the following is maximum
likely occuring? - ANS-Reperfusion Syndrome
A pt provides with PURE MOTOR hemiparesis and no detectable signs and symptoms of
visual, sensory, or speech loss. Which of the subsequent is most probable associated with
these symptoms? - ANS-Small vessel disease
A pt provides with sudden onset of dizziness, nausea, vomiting and unsteady gait. Which of
the subsequent stroke syndromes is consistent with these signs and symptoms? -
ANS-ISCHEMIC stroke within the cerebellum
A pt who had a MCA ischemic stroke has been within the ICU for four days. The nurse notes
the pt needs progressive stimulation to arouse the pt. What isthe maximum probably cause
of this neurologic change? - ANS-Cerebral edema
A pt who had a subarachnoid hemorrhage has a low urine output, a sodium level of 124, and
accelerated confusion. Which of the following is maximum likely related to those symptoms?
- ANS-SIADH
A pt who has undergone an interventional method is now complaining of swelling and pain to
the groin. Upon evaluation, a pulsatile mass that has a BRUIT is observed. Which is the
maximum likely cause? - ANS-Pseudoaneurysm
A pt who recieved tPA inside the ER 8 hrs ago has a BP of 200/a hundred and ten no matter
repeated IV Labetalol doses. Next step? - ANS-initiate a continuous nicardipine infusion
A pt with a 3cm by using 2cm posterior fossa hematoma is admitted to am extensive care
unit. The pt reveals decorticate posturing and SBP >220. The nurse anticipates: -
ANS-Craniotomy to take away the hemorrhage
A pt with a records of venous thromboembolism experienced a spontaneous intracerebral
hemorrhage (ICH). On hospital arrival, PT-INR four.2. Which of the subsequent agents does
the nurse count on administering to mormalize PT-INR rapidly? - ANS-Prothrombin complex
pay attention PCC
A pt with a huge ischemic stroke has big cerebral edema. Which of the following saline
concentrations is CONTRAINDICTATED for incresed intracranial stress remedy?
0.9%-isotonic
3%-hypertonic
7.Five%-hypertonic
23.Four%-hypertonic - ANS-zero.9%-isotonic
A pt with a probable MCA stroke will first get a non-more advantageous CT experiment to
identify: - ANS-Presence of cerebral edema
, A pt with cerebral edema and refractory ICP as measured by way of EVD is displaying signs
and symptoms of mind stem comprimise notwithstanding recieving maximal hypertonic fluid
remedy. What intervention should the nurse count on next? - ANS-Decompressive therapy
A pt with HX of CHF and O2 sat of 88% offers with stroke signs. How should this be dealt
with? - ANS-Nasal Canula
A pt with improved vasogenic edema is ordered Mannitol 25mg IV every 3 hrs. What are the
nursing considerations when administering this medicine? - ANS-Serum osmolarity, CPP
dreams, and fluid stability
A pt's NIHSS rating coorelates with: - ANS-The size of the infarct
A stroke pt underwent endarectomy for carotid artery stenosis. Which of the following
medications might be a crucial part of the pt's domestic medicinal drug regimen? -
ANS-Aspirin
A ventricular catheter allows for _____ drainage - ANS-CSF
Pt with ICP
ABCD - ANS-Higher the score=you are going to stroke in 2 days
ABCD rating - ANS-Age, Blood Pressure, Clinical Features, Duration of Symptoms and
Diabetes
Age > 60 = 1 Point
Blood Pressure >one hundred forty/>90 = 1 Point
Clinical Features - Unilateral Weakness - 2 Points, Speech Disturbances - 1 Point
Neuro Sx > 60 Mins = 2 Points
10 Mins to 60 Mins = 1 Point
DM = 1 Point
Score 0 to 3: Low Stroke Risk-may not be wished except afib
Score four to 5: Moderate Risk-clinic obs justified in most situations
Score 6 to 7: High Risk-health center statement worthwhile
Above the necklace-Anterior Circulation= - ANS-Unilateral deficits
ACA controls frontal lobe - ANS-LEG and Judgement
After an ischemic stroke, which of the following factors is UNRELATED to penumbral size? -
ANS-CSF production
Alberta Stroke Program Early CT ASPECT Score= - ANS-Assesses early MCA on CT
Scan-everyone receives 10 points
Subtract 1 factor for every ischemic location on CT test
