Free SCRN Exam Questions That Helps Candidates Pass

Comprehensive and Detailed Explanation:

The correct answer is A because a rapid drop in consciousness, ipsilateral pupillary dilation with sluggish reactivity due to third nerve compression, and decerebrate or decorticate posturing are hallmark signs of uncal (transtentorial) brain herniation. This catastrophic emergency stems from malignant cerebral edema and uncontrolled intracranial pressure following a large hemispheric stroke. Option B is incorrect because positional vertigo causes brief spinning without altered consciousness or pupillary changes. Option C is incorrect because postural hypotension causes brief dizziness, not progressive coma and herniation. Option D is incorrect because dementia is chronic and progressive over years, not acute and fatal over hours. SCRN nurses maintain rigorous neurological surveillance to detect herniation early.

Comprehensive and Detailed Explanation:

The correct answer is B because standard clinical guidelines for intravenous alteplase administration in acute ischemic stroke specify a baseline platelet count threshold of 100,000/mcL. A platelet count of 85,000/mcL represents a relative or absolute contraindication depending on institutional protocols and bleeding risk, meaning IV alteplase should generally be withheld to avoid catastrophic systemic and intracranial hemorrhage. However, if the patient has a large vessel occlusion, mechanical endovascular thrombectomy (EVT) can still be safely and effectively performed without the systemic bleeding risks associated with thrombolytic drugs. Option A is incorrect because 85,000/mcL is below the standard safety threshold of 100,000/mcL. Option C is incorrect because modifying or doubling thrombolytic dosing is never appropriate and vastly increases mortality. Option D is incorrect because delaying time-sensitive hyperacute workflows to transfuse platelets for thrombolytic eligibility is not recommended. SCRN nurses must master screening criteria, contraindications, and alternative reperfusion pathways to ensure patient safety during hyperacute evaluations.

Comprehensive and Detailed Explanation:

The correct answer is A because stringent blood pressure control is vital for preventing recurrent stroke. Current secondary prevention guidelines recommend a blood pressure target of below 140/90 mmHg for stroke survivors, with tighter control (below 130/80 mmHg) recommended for high-risk patients with comorbidities such as diabetes mellitus or lacunar stroke, provided treatment is well-tolerated. Option B is incorrect because high blood pressure accelerates microvascular damage. Option C is incorrect because unmanaged hypertension drastically increases recurrence risk. Option D is incorrect because extreme hypotension causes cerebral hypoperfusion. SCRN nurses educate patients on lifestyle modification, sodium restriction, and medication adherence.

Comprehensive and Detailed Explanation:

The correct answer is A because for patients with non-cardioembolic ischemic stroke or transient ischemic attack, clinical guidelines recommend long-term antiplatelet therapy rather than oral anticoagulation to reduce recurrent stroke risk. Approved antiplatelet options include aspirin, clopidogrel, or the combination of extended-release dipyridamole and aspirin. Option B is incorrect because continuous intravenous heparin is an acute inpatient therapy, not a safe long-term outpatient secondary prevention strategy. Option C is incorrect because high INR targets greatly increase bleeding complications without providing added ischemic benefit for non-cardioembolic disease. Option D is incorrect because routine NSAIDs increase cardiovascular and gastrointestinal bleeding risks and are not recommended for stroke prevention. SCRN nurses educate patients on medication options, adherence, and monitoring for adverse bruising or bleeding.

Comprehensive and Detailed Explanation:

The correct answer is A because new-onset atrial fibrillation with rapid ventricular response (RVR) is a frequent cardiac complication following acute ischemic stroke, often precipitated by neurocardiac axis stimulation. When the patient is hemodynamically stable, the primary management objective is ventricular rate control using agents such as intravenous metoprolol, diltiazem, or amiodarone, alongside continuous cardiac telemetry and frequent neurological monitoring. Option B is incorrect because unsynchronized defibrillation is strictly reserved for pulseless ventricular tachycardia or ventricular fibrillation, not stable atrial fibrillation with RVR. Option C is incorrect because rapid potassium administration without laboratory verification of hypokalemia is dangerous and must be infused cautiously. Option D is incorrect because neurological assessments must never be interrupted or omitted. SCRN nurses maintain vigilant cardiorespiratory monitoring to catch and treat paroxysmal arrhythmias quickly.