Free SCRN Exam Questions That Helps Candidates Pass

Comprehensive and Detailed Explanation:

The correct answer is A because rigorous blood pressure control is the single most important intervention for preventing recurrent stroke. Current guidelines recommend lowering blood pressure below 140/90 mmHg for all stroke survivors, with tighter targets (such as below 130/80 mmHg) recommended for patients with high-risk comorbidities like diabetes mellitus or lacunar strokes, provided treatment is well-tolerated. Option B is incorrect because stopping antihypertensive agents drastically increases the risk of recurrent ischemic and hemorrhagic events. Option C is incorrect because tighter targets are preferred for high-risk diabetic patients. Option D is incorrect because raising blood pressure with saline is contraindicated in secondary prevention and would worsen hypertension. SCRN nurses educate patients on the vital role of medication adherence, home blood pressure tracking, and salt restriction.

Comprehensive and Detailed Explanation:

The correct answer is A because the patient is well within the 4.5-hour window for intravenous alteplase, has a non-diagnostic head CT for hemorrhage, maintains blood pressure below the 185/110 mmHg threshold, and has a remote surgical history (appendectomy 10 years ago) that poses zero bleeding risk. Given the high NIHSS score, immediate intravenous thrombolysis followed by mechanical thrombectomy evaluation is indicated. Option B is incorrect because delaying treatment wastessalvageable penumbra. Option C is incorrect because dropping blood pressure to hypotensive levels causes cerebral hypoperfusion and enlarges the core infarct. Option D is incorrect because lumbar puncture is unnecessary when CT is negative and the patient is a candidate for reperfusion. SCRN nurses facilitate rapid-response workflows to optimize door-to-needle metrics.

Comprehensive and Detailed Explanation:

The correct answer is A because locked-in syndrome is classically caused by a massive infarction or hemorrhage of the bilateral ventral pons, which disrupts the descending corticospinal and corticobulbar tracts while sparing the ascending reticular activating system in the tegmentum (preserving consciousness) and oculomotor pathways controlling vertical gaze and blinking. Patients cannot move their limbs or speak but remain fully awake and aware. Option B is incorrect because cortical lesions cause aphasia or hemiparesis, not locked-in syndrome. Option C is incorrect because occipital lesions cause cortical blindness. Option D is incorrect because cerebellar vermis lesions cause truncal ataxia. Recognizing locked-in syndrome is an essential competency for SCRN nurses, who must establish alternative communication methods (such as blinking codes) to alleviate terror and ensure compassionate, comprehensive care.

Comprehensive and Detailed Explanation:

The correct answer is B because statin-associated muscle symptoms (SAMS) are a known side effect of high-intensity statin therapy. The nurse should document the symptoms, reassure the patient while evaluating severity, and notify the healthcare provider so that laboratory tests (such as creatine kinase or liver function tests) can be reviewed if necessary. Patients should be explicitly cautioned against stopping high-intensity statins independently, as abrupt cessation markedly increases secondary cardiovascular and cerebrovascular event risks. Option A is incorrect because stopping statins without medical consultation removes essential secondary protection. Option C is incorrect because muscle aches are a documented adverse effect of statins. Option D is incorrect because increasing the dose would exacerbate muscle toxicity. SCRN nurses facilitate long-term secondary prevention by proactively managing medication side effects, promoting adherence, and maintaining open communication with the interprofessional team.

Comprehensive and Detailed Explanation:

The correct answer is A because non-valvular atrial fibrillation is a major cardioembolic risk factor for ischemic stroke, and current clinical guidelines strongly recommend oral anticoagulation—preferably with direct oral anticoagulants (DOACs) like apixaban, rivaroxaban, dabigatran, or edoxaban over vitamin K antagonists—for secondary stroke prevention in these patients. Antiplatelet agents such as aspirin alone are significantly less effective than anticoagulants for preventing cardioembolic events originating from atrial fibrillation. Option B is incorrect because dual antiplatelet therapy (aspirin and clopidogrel) is reserved for short-term use in acute minor stroke or high-risk TIA, or following intracranial stenting, rather than long-term cardioembolic prevention. Option C is incorrect because higher INR targets (3.0–4.0) increase bleeding risks without conferring added ischemic protection unless mechanical heart valves are present. Option D is incorrect because aspirin monotherapy is inadequate for cardioembolic prophylaxis in atrial fibrillation. Understanding risk factor modification and secondary prevention pharmacology is essential for nurses guiding patients toward optimal long-term outcomes and recurrence reduction.