Stroke Practice Test

Approximately what percentage of strokes are ischemic in nature, and thus eligible for fibrinolytic therapy if the patient qualifies?

Question 1/10

The first critical decision point in the suspected stroke algorithm is?

Question 2/10

Consideration of fibrinolytic therapy

General assessment and stabilization of the patient

Performance and assessment of a non-contrast CT to differentiate between hemorrhagic and ischemic stroke

Review of risks and benefits of fibrinolytic therapy with patient and/or family

Which of the following would exclude the use of fibrinolytic therapy in a patient confirmed to have had an ischemic stroke?

Question 3/10

Elevated blood pressure (systolic >160 or diastolic >90 mmHg)

Current use of an anticoagulant

Head trauma within the previous 3 months

Seizure at the onset of stroke

Exclusion criteria for fibrinolytic therapy include:

Significant head trauma or prior stroke in the previous 3 months
Symptoms suggest subarachnoid hemorrhage
Arterial puncture at noncompressible site in previous 7 days
History of previous intracranial hemorrhage
Elevated blood pressure (systolic greater than 185 mm Hg or diastolic greater than 110 mm Hg)
Active internal bleeding
Acute bleeding diathesis
Blood glucose concentration less than 50 mg/dL (2.7 mmol/L)
CT demonstrates multilobar infarction (hypodensity greater than 1/3 cerebral hemisphere)

AHA Advanced Cardiovascular Life Support Provider Manual, p. 86

Next question

Signs of possible stroke may include:

Question 4/10

Sudden severe headache with no known cause

Sudden trouble walking

Trouble speaking or understanding

All of these

The signs and symptoms of a stroke may be subtle. They include:

Sudden weakness or numbness of the face, arm, or leg, especially on one side of the body
Sudden confusion
Trouble speaking or understanding
Sudden trouble seeing in one or both eyes
Sudden trouble walking
Dizziness or loss of balance and coordination
Sudden severe headache with no known cause

AHA Advanced Cardiovascular Life Support Provider Manual, p. 78-80

Next question

If the patient woke from sleep with symptoms of stroke, when is time zero?

Question 5/10

The time the patient woke up

The time the patient went to sleep

When the patient was last seen to be acting normal

Determined by if the patient has any health problems that could be contributing factors

Out-of-hospital acute stroke care focuses on:

Question 6/10

Initiation of the stroke pathway and patient admission to a stroke unit if available

Ability to rapidly determine patient eligibility for fibrinolytic therapy

Consideration of new treatment options

Rapid transport to a facility capable of providing acute stroke care

The 8 D’s of Stroke Care include:

Question 7/10

Dispatch, Delivery, Death

Door, Data, Defibrillation

Detection, Dispatch, Dopamine

Detection, Decision, Drug

The 8 D’s of Stroke Care are:

Detection: Rapid recognition of stroke symptoms
Dispatch: Early activation and dispatch of EMS by 911
Delivery: Rapid EMS identification, management and transport
Door: Appropriate triage to stroke center
Data: Rapid triage, evaluation, and management within the ED
Decision: Stroke expertise and therapy selection
Drug/Device: Fibrinolytic or endovascular therapy
Disposition: Rapid admission to the stroke unit of critical care unit

AHA Advanced Cardiovascular Life Support Provider Manual, p. 75

Next question

Fibrinolytic therapy should be initiated within how many hours of syptom onset?

Question 8/10

The Cincinnati Prehospital Stroke Scale identifies stroke based on which of the following three findings?

Question 9/10

Abnormal speech, abnormal gait and facial droop

Arm drift, abnormal gait and abnormal speech

One-sided weakness, facial droop and arm drift

Facial droop, arm drift and abnormal speech

Time zero is:

Question 10/10

The time when the patient was last known to be normal

The time when the patient enters the ED (emergency department)

The time when EMS is dispatched to see the patient

The time when the patient is first assessed by the stroke team

Stroke Practice Test

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