Free SCRN Exam Questions That Helps Candidates Pass

Comprehensive and Detailed Explanation:

The correct answer is A because atrial fibrillation causes blood stasis within the atria, predisposing patients to the formation of cardioembolic thrombi that can travel to cerebral vessels. Direct oral anticoagulants (DOACs) such as rivaroxaban inhibit specific clotting factors, providing superior protection against cardioembolic strokes compared to antiplatelet agents like aspirin, which target platelet aggregation rather than stasis-induced clots. Option B is incorrect because DOACs do not lower blood pressure. Option C is incorrect because anticoagulants prevent new clot formation rather than dissolving existing atherosclerotic plaque. Option D is incorrect because aspirin is a cornerstoneantiplatelet therapy for non-cardioembolic vascular disease. SCRN nurses educate patients on the specific rationale for anticoagulation to promote long-term adherence.

Comprehensive and Detailed Explanation:

The correct answer is A because a history of gastrointestinal ulceration is classified as a relative contraindication (exclusion criterion) for intravenous alteplase within guidelines. However, a remote, healed ulcer without active bleeding over several years carries a lower risk of hemorrhage, meaning the multidisciplinary team can proceed with thrombolysis if the neurological deficit is severe and disabling, weighing the benefit against potential bleeding risks. Option B is incorrect because remote healed ulcers are relative, not absolute, contraindications. Option C is incorrect because surgical intervention is completely unnecessary. Option D is incorrect because gastrointestinal bleeding history must always be carefully screened during hyperacute evaluations. SCRN nurses master complex screening criteria to ensure patient safety during rapid hyperacute evaluations.

Comprehensive and Detailed Explanation:

The correct answer is A because patients with right hemispheric strokes frequently experience left unilateral spatial neglect, causing them to ignore items, people, and safety hazards on their left side. Combined with impaired judgment and impulsivity, this places the patient at extremely high risk for trauma and falls. Effective post-acute transition planning requires comprehensive caregiver education on environmental modifications—such as placing necessary items within the right visual field, arranging rooms to minimize obstacles, and teaching scanning techniques. Option B is incorrect because unilateral spatial neglect can be a chronic, long-term deficit requiring persistent adaptation rather than guaranteed spontaneous resolution. Option C is incorrect because physical restraints are dangerous, increase agitation, and do not substitute for comprehensive safety supervision and environmental structuring. Option D is incorrect because outpatient or home-health continuation of physical, occupational, and speech therapy is vital to maintain functional gains and foster ongoing neurological recovery. Stroke nurses play a pivotal role in bridging acute stabilization with long-term functional independence through targeted discharge education.

Comprehensive and Detailed Explanation:

The correct answer is B because in wake-up strokes where symptom onset time is unknown, advanced magnetic resonance imaging utilizing DWI-FLAIR mismatch helps estimate stroke age. Diffusion-weighted imaging (DWI) shows acute ischemic injury within minutes, whereas fluid-attenuated inversion recovery (FLAIR) signal changes take several hours (typically >4.5 hours) to appear. A lesion visible on DWI with no corresponding hyperintensity on FLAIR indicates that the stroke likely occurred within the past 4.5 hours, qualifying the patient for intravenous alteplase administration. Option A is incorrect because a negative FLAIR means tissue is relatively fresh, not dead for 24 hours. Option C is incorrect because it reflects acute ischemia. Option D is incorrect because it expands treatment eligibility. SCRN nurses must understand advanced neuroimaging protocols to advocate for eligible patients.

Comprehensive and Detailed Explanation:

The correct answer is A because the internal capsule contains densely packed descending motor fibers (corticospinal tract) and ascending sensory radiations. The lenticulostriate arteries—small penetrating branches arising directly from the middle cerebral artery stem—supply the internal capsule and basal ganglia. Occlusion of the MCA stem compromises blood flow through these lenticulostriate vessels, resulting in ischemia of the internal capsule and producing profound contralateral hemisensory and motor deficits. Option B is incorrect because the cerebellar tonsils are located in the posterior fossa and can herniate through the foramen magnum during increased ICP. Option C is incorrect because the medulla oblongata is supplied by vertebrobasilar branches. Option D is incorrect because the olfactory bulb governs cranial nerve I smell sensation. Recognizing deep vascular anatomy helps SCRN nurses correlate clinical findings with microvascular pathology.