Question

Please answer each question to the best of your ability. You must receive a score of 100% to pass. 1) EMS calls in with a patient en-route with suspected stroke, and requests guidance for treatment of blood pressure of 210/110. What is the recommended treatment? Elevate the head of the stretcher or place patient in reverse Trendelenberg Place one inch of nitro paste on the patient’s chest No intervention at present 2) Which of the following reflect the protocol for activating a code stroke? Patient must have significant stroke symptoms and be within 3 hours of last known well. Patient must be less than 80 and be within 4.5 hours of time last known well. Patient must have persistent stroke symptoms and be within 12 hours of time last known well. 3) Who can activate the code stroke process? ED Physician ED triage nurse ED CSN Any of the above 4) Which of the following agents are not recommended in the acute stroke pathway for treating elevated blood pressure after a stroke? Labetolol Nicardipine Hydralazine Nitroglycerin 5) Which of the following is NOT an example of an ischemic stroke? Thrombotic Subarachnoind Embolic Cryptogenic 6) Identify the types of Hemorrhagic Strokes? Subdural Hematoma and Subarachnoid Embolic and Intracerebral Intracerebral and Subarachnoid Thrombotic and Subdural 7) Which of the following is NOT an element of Stroke Education? Risk Factors Treatment / Procedures Educational Material Medications Prevention / Discharge Infection Prevention 8) A dysphagia screening must be completed on all stroke patients prior to receiving anything by mouth. True False 9) A Depression screening is completed by social work on all stroke patients? True False 10) Which is NOT a Stroke Core Measure? VTE by End of Day 2 Discharged on Antithrombotic Therapy Antithrombotic by End of day 2 Discharged on a Statin if LDL > 70 Stroke Education Assessed for Rehab Antihypertensive within 2 hours of arrival Back To Course Information

Answer 1

1.A blood pressure of 210/110mmHg is a hypertensive emergency which of not treated can lead to end organ damage.Immediate parental administration of the drug is advised to reduce the elevated blood pressure. Usually trendkenbergy position is used to treat hypotension and reverse trendlenburg position in case of elevated BP but research shows no great alteration so far and its indication introducing high BP

A nitro paste can be used to decrease the blood pressure which is elevated because it can penetrate through the skin and start acting by relaxing the muscles and dilating the blood vessels

Ans:Place one inch of nitro paste on the patient's chest

2.In order to activate the stroke code the patient should have following

• FAST (facial paralysis, arm weakness speech difficulties,time to call healthcare professionals), sudden confusion, loss of vision,severe headache
• The patient should be above or equal to 18 years.
• Symptoms should have occured in about less than 5 hours and the Altepase can be effective only if patient is brought within in 3 hours of symptoms.
• Blood sugar should range between 50 to 400mg/dL

Ans:Patient must have significant stroke symptoms and he within 3 hours of last known well

3.Code stroke can be activated by the desired professionals initially the physician did it ,now the emergency department nurse or triage can apxan activate the code in less than 12 hours,A ED CSN can also activate it

Ans:Any of the above

4.As soon as the patient falls into the criteria of stroke the following treatment has to be initiated .The commonly used first line drug are nitroglycerin, hydrazine, nicardipine labetalol,enalapril.

The sodium nitroprusside is not a drug of choice in acute stroke, Hydrazine can causes reflex tachycardia and may result in injury of myocardium

Ans:Hydralazine