Acute Stroke

Take the Test

Taking the test does not commit you to registering or paying, but you must register and pay to get your Certificate of Completion. Your Certificate will be delivered online immediately upon completing the registration process. There is no charge for free courses and online certificate delivery.

You must score 70% or better to pass this course. Select one answer for each question by clicking the circle at the left of your choice. To change your selection, click a different circle. Do not skip any questions.

Test Question

1. Most strokes are caused by:

a. Ruptured aneurysms.
b. Intracerebral hemorrhages.
c. Clots or emboli blocking cerebral arteries.
d. Bleeds into brain tissue.

Test Question

2. Transient ischemic attacks (TIAs):

a. Are frightening to the patient but need not be taken seriously.
b. Are minor strokes that can take weeks to clear up neurologically.
c. Often precede (by days or weeks) a full-blown stroke.
d. Are another name for hemorrhagic strokes.

Test Question

3. The anterior circulation of the brain is:

a. Another name for the anterior communicating cerebral artery.
b. The cerebral blood vessels that are branches of the internal carotids.
c. The cerebral blood vessels that supply the brainstem and cerebellum.
d. The cerebral blood vessels that are branches of the vertebral arteries.

Test Question

4. The first symptoms of an ischemic stroke are caused by:

a. The fact that brain neurons have died.
b. The hypoglycemia that inevitably follows a serious blood clot.
c. A reduction of cerebral blood flow sufficient to stop neurons from signaling.
d. Activation of the fight-or-flight response of the sympathetic nervous system.

Test Question

5. The ischemic penumbra is:

a. The regions in the brain where reduced blood flow was enough to stop neurons from responding but not enough to kill them immediately.
b. The regions in the brain where reduced blood flow quickly killed neurons.
c. The shadowy regions visible in noncontrast CT scans indicating bleeding.
d. The bright regions visible in noncontrast CT scans indicating bleeding.

Test Question

6. Ischemic strokes usually:

a. Produce a severe headache.
b. Produce nausea and vomiting.
c. Cause a loss of consciousness.
d. Are painless.

Test Question

7. Three quick assessments for an acute stroke ask the patient to:

a. Sit, stand, and walk.
b. Smile, talk (repeat a sentence), and hold out or raise both arms.
c. Take a sip of water, cough, and stick out their tongue.
d. Write their name, the date, and their current location.

Test Question

8. First aid by a bystander for a possible stroke begins with:

a. Getting the patient in a safe place, calling 911, and stopping any bleeding.
b. Driving a patient immediately to the closest Emergency Department.
c. Giving the patient coffee and making him walk so he won't loose consciousness.
d. Searching for the nearest doctor immediately.

Test Question

9. EMS operators should:

a. Skip the usual questions if there is a possibility the call concerns a stroke.
b. Memorize the stroke protocol because they will need it at least once a night.
c. Not use the word stroke to avoid upsetting the caller.
d. Include key stroke questions when first eliciting information from a caller.

Test Question

10. When an EMS operator suspects that a call concerns a stroke:

a. The call should be assigned the highest level of emergency care available.
b. The ED nearest the patient should be consulted before a response team is dispatched.
c. The caller should be instructed to drive the patient immediately to the nearest ED.
d. Only an advanced life support team should be sent and, if one is not available, the dispatcher should wait until one is.

Test Question

11. For a potential stroke, one of the most critical pieces of information is:

a. The time at which stroke symptoms first appeared.
b. The family history of stroke and other cardiovascular diseases.
c. The time of the patient's last meal.
d. The patient's history of recent immunizations.

Test Question

12. For a potential stroke, the EMS response team should first:

a. Administer the Cincinnati Prehospital Stroke Scale.
b. Determine whether the patient has had a seizure.
c. Take statements from witnesses.
d. Stabilize the patient's airway, breathing, and circulation.

Test Question

13. A quick way to recognize a likely stroke is The Cincinnati Prehospital Stroke Scale, which:

a. Assesses the patient's level of consciousness.
b. Tests whether the patient can perform three motor tasks normally.
c. Tests the patient's short-term memory.
d. Measures the patient's blood pressure and blood glucose levels.

Test Question

14. Hypoglycemia:

a. Is rare in insulin-dependent diabetics with acute stroke symptoms.
b. Should be ignored, because low blood sugar level helps neurons survive in stroke.
c. Is the body's natural protective reaction to oxygen deprivation of the brain.
d. Can produce symptoms that look like stroke.

Test Question

15. For ischemic strokes, treatment with the clot-dissolving drug rt-PA must begin within:

a. 1 hour of the onset of stroke symptoms.
b. 3 hours of the onset of stroke symptoms.
c. 6 hours of the onset of stroke symptoms.
d. 24 hours of the onset of stroke symptoms.

Test Question

16. The NIH Stroke Scale (NIHSS):

a. Depends on CT scan results and must be done by a radiologist.
b. Uses three criteria to quantify the brain damage that underlies a change in consciousness.
c. Uses three neurologic criteria to determine whether a person has had an acute stroke.
d. Uses fifteen neurologic criteria to quantify the severity of a stroke.

Test Question

17. Besides hemorrhagic stroke, the major causes of coma are:

a. Neuropathies (eg., Bell's palsy) and migraines.
b. Psychiatric illnesses and systemic lupus erythematosus (SLE).
c. Intoxication and head trauma.
d. Pneumonias and COPD.

Test Question

18. The Glasgow Coma Scale quantifies a patient's:

a. Severity of motor deficits after a stroke.
b. Aphasia.
c. Level of consciousness and arousal.
d. Likelihood of developing coma after treatment with anti-seizure medications.

Test Question

19. During the initial ED management of a potential stroke patient:

a. Only a neurologic exam need be done.
b. Only a standardized stroke assessment need be done.
c. Both a neurologic exam and a standardized stroke assessment should be done.
d. Either a neurologic exam or a standardized stroke assessment should be done.

Test Question

20. The key diagnostic exam needed to distinguish between ischemic and hemorrhagic stroke is:

a. A CT or MRI scan.
b. Coagulation studies (platelet counts and prothrombin time).
c. ECG.
d. EEG (electroencephalogram).

Test Question

21. Thrombolytic treatment for acute stroke:

a. Is used for treating hemorrhagic stroke, including intracerebral and subarachnoid hemorrhages.
b. Is an outpatient procedure when done by an experienced neurologist.
c. Is still an experimental procedure awaiting FDA approval.
d. Involves administering recombinant tissue plasminogen activator (rt-PA) intravenously.

Test Question

22. Criteria for administering rt-PA for an acute stroke include:

a. The patient must have a very high NIH Stroke Scale score (>25).
b. The patient must be over the age of 60 years.
c. The patient must have had a chest x-ray and lung function tests.
d. The patient must have a sufficient number of platelets (≥100,000 mm³).

Test Question

23. Criteria excluding a patient from being treated with rt-PA for an acute stroke include:

a. The patient has a history of smoking.
b. A CT or MRI scan suggests intracranial bleeding.
c. The patient's next-of-kin are not available to authorize treatment.
d. The patient's blood pressure is within a normal range.

Test Question

24. After treating an acute ischemic stroke with rt-PA:

a. The risk of intracerebral hemorrhage rises ten-fold, from 0.6% to 6.4%.
b. Most patients can be discharged within 2 to 4 hours.
c. Additional antiplatelet drugs should be administered to keep clots from reforming.
d. It is best to get patients up and walking within an hour to prevent deep vein thrombi.

Test Question

25. Alteplase:

a. Is the generic name of an antihypertensive drug.
b. Is the generic name for rt-PA.
c. Is the brand name of an anti-seizure medicine.
d. Is the brand name of the anti-coagulant warfarin.

Test Question

26. Patients with acute hemorrhagic stroke:

a. Can be treated with rt-PA within 3 hours of onset if they meet other criteria.
b. Should be treated immediately with anticoagulants or antiplatelet drugs.
c. Are at risk of deteriorating quickly, and should be admitted to an ICU.
d. Have, overall, better prognoses than patients with ischemic stroke.

Test Question

27. Most acute stroke patients:

a. Can be discharged after being monitored in an ED for a few hours.
b. Should be transferred to a comprehensive stroke center as soon as possible.
c. Must be managed in a neurologic ICU.
d. Can be managed in a medical unit experienced in stroke care.

Test Question

28. Dysphagia means:

a. Swallowing difficulties.
b. Speaking difficulties.
c. Feelings of unpleasantness in which nothing is enjoyable.
d. Breathing difficulties, such as shortness of breath.

Test Question

29. Regarding blood pressure in acute stroke patients:

a. Hypertension contributes to poor neurologic outcome, but hypotension does not.
b. Both hypertension and hypotension are associated with worse outcomes.
c. Hypotension contributes to poor neurologic outcome, but hypertension does not.
d. Neither hypertension nor hypotension have much affect on the outcome.

Test Question

30. Hyperglycemia:

a. Should not be treated with insulin in acute stroke patients.
b. Is a natural compensatory mechanism that actually improves stroke outcomes.
c. Is rare in acute stroke, because most stroke patients present with hypoglycemia.
d. Is a common finding in patients with acute stroke.

Test Question

31. Primary stroke centers:

a. Are not yet nationally accredited.
b. Have the capability of diagnosing but not necessarily treating acute ischemic strokes.
c. Have the capability of diagnosing and treating acute ischemic strokes.
d. Are currently located within 100 miles of all major United States cities.

Test Question

32. Time targets for the flow of acute stroke patients through a primary stroke center include:

a. From the front door to thrombolytic (rt-PA) treatment should be less than 1 hour.
b. From the front door to thrombolytic (rt-PA) treatment should be less than 3 hours.
c. From the front door to being seen by a physician should be less than 3 minutes.
d. From the front door to being seen by a physician should be less than 3 hours.

Test Question

33. Comprehensive stroke centers:

a. Do not yet have a nationally established accrediting agency.
b. Are hospitals with EDs capable of diagnosing all forms of acute stroke but not of treating ischemic strokes.
c. Are hospitals with EDs capable of diagnosing and treating ischemic strokes but not of managing hemorrhagic strokes.
d. Are currently distributed so that all major United States cities are within 100 miles.

Test Question

34. When patients suspected of an acute stroke are too far from a primary stroke center to be diagnosed and treated within 3 hours:

a. Local teams should treat the patient with extra caution, because conservative management in the local hospital is the only option.
b. Local teams should be taught to administer thrombolytic drugs (rt-PA) as soon as they find the patient.
c. The patient should always be transported quickly to a primary stroke center.
d. Local EDs can sometimes diagnose and begin treatment of acute ischemic strokes with guidance via video link to a primary stroke center.

Test Question

35. If a caller says he is worried that he might be having a stroke, you should:

a. Tell him to hang up and get someone to drive him to the nearest hospital.
b. Tell him to hang up, call 911, and wait for the EMS team.
c. Quiz him quickly about the ability to move various parts of his body.
d. Recommend that he call his doctor for detailed medical advice.

Security | Privacy | Help | Contact