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Stroke Practice Questions
**(Asterisks***** indicate correct response)
1. A person presenting with a left lower extremity weakness most likely involves which vascular territory? a. the anterior cerebral **artery***** b. the middle cerebral artery c. the posterior cerebral artery d. the basilar artery 2. The right hemisphere is most commonly the dominant hemisphere responsible for communication. a. true b. **false***** 3. The complication of diabetes insipidus after a stroke is due to injury of which of the following? a. the **hypothalamus***** b. the thalamus c. the substantia nigra d. the midbrain 4. Which of the following types of stroke is most likely to develop hydrocephalus? a. a lacunar stroke b. a subarachnoid **hemorrhage***** c. a cardioembolic stroke
d. a thrombotic stroke
5. Where is the most common area in the brain for obstruction of the CSF flow to occur, resulting in non ‐ communicating hydrocephalus? a. lateral ventricles b. foramen of Monro c. arachnoid villi d. aqueduct of **Sylvius***** 6. The gag and swallow reflexes are commonly assessed prior to administering oral fluids following a stroke. Where do the cranial nerves originate that control the gag and swallow reflexes? a. the cerebral cortex b. the midbrain c. the pons d. the **medulla***** 7. Based upon the core measures, patients in atrial fibrillation (AF) should have which of the following ordered by the time of discharge? a. anticoagulation **therapy***** b. antiplatelet therapy c. a beta antagonist d. a calcium channel blocker 8. Which of the following is a nonmodifiable risk of a stroke? a. hypertension b. dyslipidemia
a. Treat if greater than 250 mg/dl b. Between 140 ‐ 180 **mg/dl***** c. Maintain less than 130 mg/dl d. Between 80 ‐ 120 mg/dl
13. Which of the following types of strokes is an ischemic stroke caused by chronic hypertension? a. a Moyamoya stroke b. a cerebral venous thrombosis stroke c. a watershed stroke d. a lacunar **stroke***** 14. Which of the following is the most common cause of an intracerebral hemorrhage (ICH)? a. anticoagulation therapy b. **hypertension***** c. aneurysm rupture d. an arteriovenous malformation (AVM) rupture 15. Which of the following is a difference between a comprehensive and a primary stroke center? a. MRI/MRA capabilities b. neurocritical care **units***** c. contracts with acute stroke ready hospitals (ASRHs) d. low key quality stroke care measurement are tracked
16. Which of the following systems are most likely to use telemedicine and teleradiology to assist with their care of stroke patients? a. acute stroke ready hospitals (ASRHs) b. primary stroke centers (PSC) c. comprehensive stroke centers **(CSC)***** d. nonprofit hospitals 17. Which of the following is a false statement? a. Subluxation of the shoulder is a result of paralyzed muscles not able to support the joint. b. The patient should be moved up in bed using the arms to **pull.***** c. Shoulder subluxation causes shoulder pain. d. Do not position patient on the side of the affected shoulder. 18. When positioning a stroke patient, which of the following is a true statement? a. Allow the patient to lean toward the preferred side b. Good positioning is important to prevent contractures and **swelling.***** c. Never position the patient on his or her affected side d. Families should not be allowed to assist in positioning the patient. 19. Which of the following interventions may improve memory following a stroke? a. Use of picture and communication boards b. Use of memory **books***** c. Encourage the patient to read and repeat information
c. Discharging patients on statin **medication***** d. GI prophylaxis
24. Which of the following are tools used by the EMS providers to assess for a potential stroke? a. the Cincinnati **Scale***** b. the Glasgow Coma Scale c. the NIH Stroke Scale d. the Framingham Scale 25. An ischemic stroke patient weighting 100 kg should receive a total of 90 mg of IV rtPA. a. **true***** b. false 26. Currently which of the following mechanical devices has the highest recommendations? a. MERCI retrieval b. Penumbra device c. EKOS catheter d. TREVO **stent***** 27. Which of the recommended treatment after a diagnosis of heparin ‐ induced thrombocytopenia (HIT)? a. Stop heparin and administer warfarin (Coumadin) b. Stop heparin and administer a direct thrombin inhibitor c. Stop heparin and evaluate the need for anticoagulation **therapy***** d. Change anticoagulation therapy from unfractionated heparin to low molecular weight heparin (LMWH)
28. An aspirin is a recommended within 24 ‐ 48 hours of an ischemic stroke. How long is the antiplatelet effect of an aspirin? a. 3 hours b. 12 hours c. 24 hours d. 7 **days***** 29. Purple toe syndrome is a complication of which medication commonly administered after stroke? a. heparin b. clopidogrel (Plavix) c. aspirin d. warfarin **(Coumadin)***** 30. Which of the following medications may be used to decrease cerebral edema and treat an increased intracranial pressure? a. Hypertonic **saline***** b. Transexamic acid (TXA) c. Aminocaproic Acid (Amicar) d. lacosamide (Vimpat) 31. Which of the following best defines secondary stroke prevention? a. The patient has not had a previous stroke. b. The patient has had a cardiovascular event, but not a stroke.
a. 10 minutes b. 25 **minutes***** c. 45 minutes d. 60 minutes
36. Perfusion CT and MRI may be considered for a selecti on of patients for acute perfusion beyond time window for IV fibrinolysis. a. **true***** b. false 37. Which of the following is an advantage of a standard MRI? a. You can identify ischemic stroke within 30 minutes. b. You can differentiate reversible from irreversible injury. c. You can avoid ionizing **radiation.***** d. You can identify a hemorrhagic stroke. 38. A noncontract CT scan will not demonstrate an ischemic stroke early, but which of the following signs may indicate a large vessel obstruction on CT scan? a. a hyperdense vessel **sign***** b. a hydrocephalus c. an effacement of cisterns d. a transtentorial shift 39. When a stroke patient is positioned on their back which of the following is recommended for the affected leg?
a. Keep leg crossed over the unaffected leg. b. Keep legs apart to encourage hips to turn out c. Place a pillow on affected buttock to relax the **leg***** d. Keep knee bent and foot on the bed.
40. Which of the following is a recommended intervention to assist the post stroke patient in preventing incontinence? a. Limit fluid intake b. Encourage use of bedpan instead of ambulating to the bathroom c. Provide regular toileting to promote **continence***** d. Place indwelling urinary catheter 41. A patient present to the ED with the “worst headache of their life.” It is associated with focal neurological deficits. What is the most likely cause of the headache? a. a thrombotic stroke b. a cardioembolic stroke c. an intracerebral hemorrhage d. a subarachnoid **hemorrhage***** 42. A patient presents with a hemorrhagic stroke due to anticoagulation therapy with a vitamin K antagonist. His INR is 3.2. Which of the following is appropriate for initial reversal of the bleeding disorder? a. Administer protamine sulfate b. Administer FFP and vitamin **K***** c. Initiate hemodialysis d. Administer recombinant Factor VIIa (Novo ‐ Seven)
