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

Anterior cerebral artery (ACA)

Middle cerebral artery (MCA)

Posterior cerebral artery (PCA)

Vertebral artery

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2026 Statistics

Key Facts: SCRN Exam

170

Total Items

ABNN SCRN exam page

150 + 20

Scored + Unscored

ABNN SCRN exam page

200

Minimum Passing Score (scaled)

ABNN SCRN exam page

Exam Time

ABNN SCRN exam page

$300/$400

Member / Nonmember Fee

ABNN SCRN exam page

67%

2024 Pass Rate

ABNN 2026 Candidate Handbook

1 year

Required Stroke Care Experience

ABNN SCRN eligibility

3 years

Recertification Cycle

ABNN SCRN FAQ

ABNN's SCRN exam consists of 170 multiple-choice questions (150 scored + 20 unscored pretest) delivered over 3 hours. The exam uses scaled scoring with a minimum passing score of 200. The five content domains are: Anatomy/Physiology/Pathophysiology (16%), Hyperacute Care (25%), Acute Care (25%), Preventative Care (19%), and Postacute Care (15%). ABNN requires 1 year of stroke care experience for eligibility.

Sample SCRN Practice Questions

Try these sample questions to test your SCRN exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 200+ question experience with AI tutoring.

1Which artery supplies the lateral aspect of the frontal, temporal, and parietal lobes, making it the most common site for ischemic stroke?

A.Anterior cerebral artery (ACA)

B.Middle cerebral artery (MCA)

C.Posterior cerebral artery (PCA)

D.Vertebral artery

Explanation: The middle cerebral artery (MCA) is the largest branch of the internal carotid artery and supplies the lateral surfaces of the frontal, temporal, and parietal lobes. Because of its size and the territory it perfuses, it is the most common site for ischemic stroke, accounting for approximately 70-80% of all ischemic strokes.

2A patient presents with contralateral hemiplegia affecting the leg more than the arm, along with urinary incontinence and abulia. Which artery is most likely occluded?

A.Middle cerebral artery

B.Posterior cerebral artery

C.Anterior cerebral artery

D.Basilar artery

Explanation: Anterior cerebral artery (ACA) strokes classically present with contralateral leg weakness greater than arm weakness, as the ACA supplies the medial frontal and parietal lobes where the leg motor cortex is located. Other signs include urinary incontinence, abulia (lack of initiative), and executive dysfunction.

3Which type of hemorrhagic stroke involves bleeding directly into the brain parenchyma?

A.Subarachnoid hemorrhage

B.Epidural hematoma

C.Intracerebral hemorrhage

D.Subdural hematoma

Explanation: Intracerebral hemorrhage (ICH) involves bleeding directly into the brain parenchyma. It accounts for approximately 10-15% of all strokes. Common causes include hypertension, cerebral amyloid angiopathy, and vascular malformations.

4The penumbra in acute ischemic stroke refers to:

A.The area of irreversibly damaged brain tissue

B.The ischemic but potentially salvageable tissue surrounding the infarct core

C.The hemorrhagic transformation of ischemic stroke

D.The edematous tissue causing mass effect

Explanation: The ischemic penumbra is the area of moderately ischemic brain tissue surrounding the irreversibly damaged infarct core. This tissue is at risk of infarction but remains viable for a limited time, making it the target for acute reperfusion therapies such as thrombolysis and thrombectomy.

5Which of the following is a classic presentation of Wallenberg syndrome (lateral medullary syndrome)?

A.Ipsilateral facial numbness with contralateral body numbness

B.Contralateral facial and body numbness

C.Bilateral facial weakness

D.Isolated motor deficits

Explanation: Wallenberg syndrome (lateral medullary syndrome), typically caused by posterior inferior cerebellar artery (PICA) occlusion, presents with crossed sensory findings: ipsilateral facial numbness (due to involvement of the spinal trigeminal nucleus) with contralateral body numbness (due to involvement of the spinothalamic tract).

6Neuroplasticity following stroke refers to:

A.Permanent brain damage from ischemic injury

B.The brain's ability to reorganize and form new neural connections

C.Inflammatory response after cerebral infarction

D.Cellular death in the penumbral region

Explanation: Neuroplasticity is the brain's ability to reorganize neural pathways and form new connections in response to learning, experience, or injury. After stroke, neuroplasticity underlies functional recovery as the brain compensates for damaged areas through recruitment of alternative pathways.

7Which vascular territory supplies the occipital lobe and medial temporal lobe?

A.Anterior cerebral artery

B.Middle cerebral artery

C.Posterior cerebral artery

D.Anterior communicating artery

Explanation: The posterior cerebral artery (PCA) supplies the occipital lobe, medial temporal lobe, thalamus, and midbrain. PCA strokes often result in visual field defects (homonymous hemianopia), memory impairment, and altered consciousness.

8A stroke mimic that commonly presents with acute focal neurological deficits and is often indistinguishable from stroke on initial presentation is:

A.Migraine with aura

B.Complex partial seizure with postictal paralysis (Todd's paralysis)

C.Multiple sclerosis exacerbation

D.All of the above

Explanation: All of the listed conditions are common stroke mimics. Migraine with aura can present with transient hemiparesis or aphasia. Todd's paralysis (postictal paralysis) can mimic stroke. MS exacerbations can cause acute focal deficits. Rapid imaging and clinical assessment are necessary to differentiate.

9The most common cause of spontaneous (non-traumatic) intracerebral hemorrhage is:

A.Arteriovenous malformation

B.Chronic hypertension

C.Cerebral amyloid angiopathy

D.Anticoagulant therapy

Explanation: Chronic hypertension is the most common cause of spontaneous intracerebral hemorrhage, accounting for approximately 50-70% of cases. Hypertension causes lipohyalinosis and microaneurysm formation in small penetrating arteries, particularly in the basal ganglia, thalamus, pons, and cerebellum.

10The primary mechanism of injury in ischemic stroke is:

A.Direct mechanical compression of brain tissue

B.Lack of oxygen and glucose delivery leading to cellular energy failure

C.Toxic effects of blood breakdown products

D.Direct trauma to the vascular wall

Explanation: The primary mechanism of injury in ischemic stroke is loss of blood flow leading to inadequate oxygen and glucose delivery. This causes cellular energy failure, resulting in ion pump dysfunction, calcium influx, excitotoxicity, and ultimately cell death if perfusion is not restored.

About the SCRN Exam

SCRN is ABNN's specialty certification for nurses providing care to stroke patients across the continuum. The exam tests knowledge of cerebrovascular anatomy and pathophysiology, hyperacute stroke care including thrombolytics and thrombectomy, acute stroke management, secondary prevention, and postacute rehabilitation.

Questions

170 scored questions

Time Limit

3 hours

Passing Score

Scaled score 200 (minimum passing)

Exam Fee

$300 AANN members / $400 non-members (ABNN (American Board of Neuroscience Nursing))

SCRN Exam Content Outline

16%

Anatomy/Physiology/Pathophysiology

Cerebrovascular anatomy, brain structure and function, ischemic and hemorrhagic stroke types, stroke syndromes, stroke mimics, neuroplasticity, and ischemic penumbra

25%

Hyperacute Care

Stroke recognition and triage, NIHSS assessment, IV thrombolytic therapy, mechanical thrombectomy, door-to-needle times, eligibility criteria, and complications management

25%

Acute Care

Neurological monitoring, blood pressure management, ICP management, cerebral edema, seizure management, anticoagulation, nutrition support, DVT prophylaxis, and stroke complications

19%

Preventative Care

Secondary prevention strategies, antiplatelet and anticoagulation therapy, statin therapy, lifestyle modifications, patient education, stroke screening, and atrial fibrillation management

15%

Postacute Care

Rehabilitation principles, functional assessment, discharge planning, care transitions, caregiver support, long-term recovery, and community resources

How to Pass the SCRN Exam

What You Need to Know

Passing score: Scaled score 200 (minimum passing)
Exam length: 170 questions
Time limit: 3 hours
Exam fee: $300 AANN members / $400 non-members

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

SCRN Study Tips from Top Performers

1Study by the ABNN domain weighting - prioritize Hyperacute Care and Acute Care (25% each) as the largest sections

2Master the NIHSS assessment - understanding stroke severity scoring is critical for hyperacute care decisions

3Know thrombolytic therapy inside and out - eligibility criteria, contraindications, blood pressure management, and complication recognition

4Understand mechanical thrombectomy candidate selection and time windows including extended window criteria

5Practice stroke syndrome localization - knowing vascular territories helps answer both anatomy and clinical management questions

6Review secondary prevention guidelines - antiplatelet vs anticoagulation, statin therapy, and lifestyle modifications

7Study stroke mimics and how to differentiate them from true stroke

Frequently Asked Questions

How many questions are on the SCRN exam?

ABNN lists 170 total items: 150 scored items and 20 unscored pretest items. You have 3 hours to complete the exam.

What score do I need to pass SCRN?

ABNN uses scaled scoring with a minimum passing score of 200. The exact number of correct answers needed varies based on exam form difficulty.

How long is the SCRN exam?

ABNN lists a 3-hour testing appointment for SCRN.

How much does SCRN cost?

ABNN's current SCRN fees are $300 for AANN members and $400 for non-members.

Who can take the SCRN exam?

ABNN requires active unrestricted RN licensure with a minimum of 1 year of stroke care experience. Stroke care includes direct care of stroke patients in settings such as emergency department, stroke unit, neuro ICU, rehabilitation, or stroke clinic.

How often do I renew SCRN?

ABNN certifications follow a 3-year recertification cycle. You can recertify by continuing education hours or by retaking the exam.

What content does the SCRN exam cover?

The 2021-2022 SCRN Content Outline includes 5 domains: Anatomy/Physiology/Pathophysiology (16%), Hyperacute Care (25%), Acute Care (25%), Preventative Care (19%), and Postacute Care (15%).