ABNN SCRN Stroke Certified Registered Nurse

Which artery supplies the lateral aspect of the frontal, temporal, and parietal lobes, making it the most common site for ischemic stroke?

• AAnterior cerebral artery (ACA)
• BMiddle cerebral artery (MCA)
• CPosterior cerebral artery (PCA)
• DVertebral artery

A patient presents with contralateral hemiplegia affecting the leg more than the arm, along with urinary incontinence and abulia. Which artery is most likely occluded?

• AMiddle cerebral artery
• BPosterior cerebral artery
• CAnterior cerebral artery
• DBasilar artery

Which type of hemorrhagic stroke involves bleeding directly into the brain parenchyma?

• ASubarachnoid hemorrhage
• BEpidural hematoma
• CIntracerebral hemorrhage
• DSubdural hematoma

The penumbra in acute ischemic stroke refers to:

• AThe area of irreversibly damaged brain tissue
• BThe ischemic but potentially salvageable tissue surrounding the infarct core
• CThe hemorrhagic transformation of ischemic stroke
• DThe edematous tissue causing mass effect

Which of the following is a classic presentation of Wallenberg syndrome (lateral medullary syndrome)?

• AIpsilateral facial numbness with contralateral body numbness
• BContralateral facial and body numbness
• CBilateral facial weakness
• DIsolated motor deficits

Neuroplasticity following stroke refers to:

• APermanent brain damage from ischemic injury
• BThe brain's ability to reorganize and form new neural connections
• CInflammatory response after cerebral infarction
• DCellular death in the penumbral region

Which vascular territory supplies the occipital lobe and medial temporal lobe?

• AAnterior cerebral artery
• BMiddle cerebral artery
• CPosterior cerebral artery
• DAnterior communicating artery

A stroke mimic that commonly presents with acute focal neurological deficits and is often indistinguishable from stroke on initial presentation is:

• AMigraine with aura
• BComplex partial seizure with postictal paralysis (Todd's paralysis)
• CMultiple sclerosis exacerbation
• DAll of the above

The most common cause of spontaneous (non-traumatic) intracerebral hemorrhage is:

• AArteriovenous malformation
• BChronic hypertension
• CCerebral amyloid angiopathy
• DAnticoagulant therapy

The primary mechanism of injury in ischemic stroke is:

• ADirect mechanical compression of brain tissue
• BLack of oxygen and glucose delivery leading to cellular energy failure
• CToxic effects of blood breakdown products
• DDirect trauma to the vascular wall

Which of the following stroke syndromes is characterized by ipsilateral cranial nerve deficits and contralateral body weakness?

• AAnterior cerebral artery syndrome
• BMiddle cerebral artery syndrome
• CBrainstem stroke (crossed signs)
• DPosterior cerebral artery syndrome

The circle of Willis serves which primary function?

• ADrains venous blood from the brain
• BProvides collateral circulation between cerebral arteries
• CProduces cerebrospinal fluid
• DRegulates blood-brain barrier permeability

Locked-in syndrome is typically caused by:

• ABilateral hemispheric infarction
• BBilateral pontine lesion, usually basilar artery occlusion
• CCerebellar hemorrhage
• DThalamic stroke

Which condition is most likely to be mistaken for acute ischemic stroke but requires completely different management?

• AHypoglycemia
• BMigraine with aura
• CSeizure with Todd's paralysis
• DAll require different management considerations

Cerebral perfusion pressure (CPP) is calculated as:

• AMean arterial pressure (MAP) minus intracranial pressure (ICP)
• BSystolic blood pressure minus diastolic blood pressure
• CMAP plus ICP
• DCentral venous pressure minus ICP

The recommended door-to-needle time for IV thrombolytic administration is:

• AWithin 30 minutes of hospital arrival
• BWithin 60 minutes of hospital arrival
• CWithin 90 minutes of hospital arrival
• DWithin 120 minutes of hospital arrival

The time window for IV alteplase administration in eligible patients is up to:

• A3 hours from symptom onset
• B4.5 hours from symptom onset or last known well
• C6 hours from symptom onset
• D24 hours from symptom onset

Which of the following is an absolute contraindication to IV thrombolytic therapy?

• AAge over 80 years
• BActive internal bleeding
• CHistory of diabetes
• DPrevious TIA more than 6 months ago

The National Institutes of Health Stroke Scale (NIHSS) is used to:

• ADetermine eligibility for thrombolytic therapy
• BQuantify neurological deficit severity and guide treatment decisions
• CPredict long-term functional outcome
• DDiagnose the type of stroke

For mechanical thrombectomy in large vessel occlusion, the recommended door-to-puncture time is:

• AWithin 60 minutes of hospital arrival
• BWithin 90 minutes of hospital arrival
• CWithin 120 minutes of hospital arrival
• DWithin 24 hours of symptom onset

The maximum time window for mechanical thrombectomy in selected patients with large vessel occlusion is up to:

• A6 hours from symptom onset
• B16-24 hours from last known well with appropriate imaging criteria
• C8 hours from symptom onset
• D12 hours from symptom onset

A patient presents with stroke symptoms and blood pressure of 190/110 mmHg. What is the appropriate nursing action before considering thrombolytic therapy?

• AProceed with thrombolytic therapy immediately
• BLower blood pressure to <185/110 mmHg before treatment
• CLower blood pressure to <140/90 mmHg before treatment
• DIncrease blood pressure to improve perfusion