SCRN Practice Questions (2026) — Free Sample Questions with Answers

Answer: C

Right middle cerebral artery: A right MCA stroke causes left-sided weakness, often with neglect, and the eyes deviate to the right. It would not cause aphasia in a right-handed patient.

Left anterior cerebral artery: ACA strokes cause contralateral leg weakness greater than arm, which is the opposite pattern.

Left middle cerebral artery: Correct. Contralateral (right) face and arm weakness more than leg, aphasia from the dominant hemisphere and gaze deviation toward the lesion (left) localize to the left MCA.

Basilar artery at its top: Top-of-the-basilar syndrome causes visual, oculomotor and consciousness changes, not dominant-hemisphere aphasia with face and arm weakness.

MCA = face and arm more than leg (plus aphasia if dominant, neglect if nondominant), eyes look toward the lesion; ACA = leg more than arm.

Answer: D

Within 30 minutes of arrival: 30 minutes is a stretch goal for a share of patients, not the primary benchmark.

Within 45 minutes of arrival: 45 minutes is a secondary, more advanced goal in national quality programs.

Within 90 minutes of arrival: 90 minutes is a door-to-device (thrombectomy) style interval and is far too slow for door-to-needle.

Within 60 minutes of arrival: Correct. Thrombolysis within 60 minutes of arrival is the core benchmark tracked by Get With The Guidelines–Stroke and certification programs, with faster stretch goals.

Door-to-needle 60 minutes or less is the core metric; faster stretch goals (45 and 30 minutes) are tracked for a share of patients.

Answer: B

05:30, when she woke up and noticed the weakness: Symptom discovery is not onset. A stroke on waking could have started at any time after she was last seen normal.

22:00, when she was last seen at her baseline: Correct. Last known well is the last time she was confirmed normal. Wake-up strokes may still qualify for reperfusion based on advanced imaging.

06:15, the time she arrived at the hospital: Arrival time is used for door-to-treatment metrics, not for onset.

05:45, when her husband called 911: The time EMS was called does not establish when the stroke began.

Last known well = the last time the patient was confirmed at baseline. For wake-up stroke it is the time they went to sleep, unless they were seen normal later.

Answer: B

Give the medications crushed in applesauce, since puree is safe: No consistency is known to be safe until swallowing has been screened; purees can still be aspirated.

Keep her NPO, including meds, until she passes a swallow screen: Correct. Screen for dysphagia before any oral intake, including medications, to reduce aspiration pneumonia. Give needed medications by another route in the meantime.

Allow small sips of water if her gag reflex is present: A present gag reflex does not predict a safe swallow; silent aspiration is common after stroke.

Give the pills with thickened liquid until speech therapy sees her: Choosing a modified diet before any screen or evaluation is not appropriate and still exposes her to aspiration risk.

No food, fluids or oral meds until a validated dysphagia screen is passed; the gag reflex is not a reliable screen.

Answer: A

Support the arm on a pillow or lap tray and avoid pulling on it: Correct. Supporting the arm in sitting and lying and never pulling on the affected limb prevent traction injury and hemiplegic shoulder pain.

Help the patient up by pulling under the affected arm: Pulling on or lifting by the weak arm can worsen subluxation and cause injury and pain.

Let the arm hang freely to gently stretch the shoulder: Gravity on an unsupported flaccid arm increases subluxation.

Use overhead pulley exercises to raise the arm daily: Overhead pulleys cause uncontrolled abduction and are linked to hemiplegic shoulder pain; they should be avoided.

Hemiplegic shoulder: position and support it, handle it gently, never pull on the arm, and avoid overhead pulleys.

Answer: C

Aspirin plus clopidogrel as a safer substitute: Dual antiplatelet therapy is less effective than anticoagulation for AF-related stroke and still carries real bleeding risk.

Aspirin alone, because her stroke was small: Aspirin does not adequately prevent cardioembolic stroke from AF, whatever the size of the stroke.

An oral anticoagulant, usually a DOAC: Correct. Oral anticoagulation is recommended for secondary prevention in AF; a DOAC is generally preferred over warfarin in nonvalvular AF.

No therapy until a repeat Holter confirms AF: AF is already diagnosed; delaying anticoagulation leaves her at high risk of early recurrence.

Cardioembolic stroke from AF: anticoagulate (DOAC preferred unless a mechanical valve or moderate-to-severe mitral stenosis is present), not antiplatelets.