HEMISPHERE IV-RAPID STROKE
RESPONSE PRACTICE EXAM WITH
ACCURATE SOLUTIONS (VERIFIED)
1. EMS Goal on Scene
Question: What is the primary goal for EMS personnel when arriving on scene for a
suspected stroke patient?
A) Complete paperwork and wait for hospital transfer
B) Rapid assessment and stabilization to minimize time to treatment
C) Perform full diagnostic imaging on scene
D) Begin thrombolytic therapy immediately
Correct Answer: B) Rapid assessment and stabilization to minimize time to treatment
Explanation: EMS should focus on rapid assessment, airway management, vital signs,
and symptom onset identification. Early recognition allows activation of the stroke team
and reduces time to thrombolytic therapy or thrombectomy. Minimizing on-scene time
improves patient outcomes.
2. Oxygen Saturation in Stroke
Question: What is the target oxygen saturation for most stroke patients in prehospital
care?
A) 88–90%
B) 92–94%
C) >94%
D) 100%
Correct Answer: C) >94%
Explanation: Maintaining oxygen saturation above 94% ensures adequate tissue
oxygenation without causing oxygen toxicity. Hypoxia worsens ischemic injury, while
unnecessary high oxygen can create oxidative stress. Monitoring SpO₂ is essential
during prehospital transport.
3. Onset of Symptoms to Thrombolytic Therapy
Question: What is the maximum recommended time from symptom onset to IV
thrombolytic administration for eligible patients?
,A) 3 hours
B) 4.5 hours
C) 6 hours
D) 24 hours
Correct Answer: B) 4.5 hours
Explanation: IV thrombolytics are most effective when given within 4.5 hours of
symptom onset. Beyond this window, risks of hemorrhage outweigh benefits. Accurate
onset time is crucial for decision-making in the field and hospital.
4. Onset of Symptoms to Thrombectomy
Question: Up to how many hours from symptom onset can mechanical thrombectomy
be considered for select patients?
A) 6 hours
B) 12 hours
C) 24 hours
D) 48 hours
Correct Answer: C) 24 hours
Explanation: Advanced imaging allows identification of salvageable brain tissue.
Thrombectomy may be performed up to 24 hours in select cases, especially for large
vessel occlusions. Time is critical, but tissue-based selection expands eligibility.
5. Stroke Center Designations
Question: Which of the following are recognized stroke center designations?
A) Primary Stroke Center (PSC)
B) Comprehensive Stroke Center (CSC)
C) Acute Stroke Ready Hospital (ASRH)
D) All of the above
Correct Answer: D) All of the above
Explanation: Stroke centers are designated based on their capabilities. CSCs provide
advanced interventions like thrombectomy, PSCs manage standard stroke care, and
ASRHs stabilize patients for transfer. Understanding designations helps EMS direct
patients appropriately.
6. Door-to-Door Transfer Time
Question: What is the recommended maximum inter-hospital transfer time for stroke
,patients?
A) ≤30 minutes
B) ≤60 minutes
C) ≤90 minutes
D) ≤120 minutes
Correct Answer: B) ≤60 minutes
Explanation: Timely transfer between hospitals is critical for patients requiring higher-
level stroke interventions. Delays can reduce eligibility for thrombolysis or
thrombectomy. EMS coordination ensures patients arrive within this recommended
timeframe.
7. Associated Symptoms of Stroke
Question: Which of the following symptoms are commonly associated with cerebellar
or hemorrhagic stroke?
A) Vomiting and nausea
B) SBP >220 mmHg
C) Stiff neck and photophobia
D) All of the above
Correct Answer: D) All of the above
Explanation: Hemorrhagic and cerebellar strokes often present with severe headaches,
vomiting, high blood pressure, neck stiffness, or photophobia. Recognizing these signs
helps differentiate stroke types and prioritize imaging and treatment.
8. Overlooked Symptoms of Stroke
Question: Which subtle symptoms can be easily overlooked in stroke patients?
A) Dizziness and headache
B) General weakness or fatigue
C) Disorientation or confusion
D) All of the above
Correct Answer: D) All of the above
Explanation: Stroke presentations can be subtle, especially in elderly patients or those
with posterior circulation strokes. Early recognition of these symptoms improves rapid
diagnosis and treatment initiation. EMS and clinicians should maintain high suspicion
even for non-classical signs.
, 9. Door-to-Doctor Time
Question: What is the recommended target for a stroke patient’s evaluation by a
physician after arrival at the hospital?
A) ASAP - 10 minutes
B) Within 30 minutes
C) Within 1 hour
D) Within 2 hours
Correct Answer: A) ASAP - 10 minutes
Explanation: Early physician evaluation ensures rapid assessment and initiation of
stroke protocols. Delays in assessment correlate with worse neurological outcomes.
Hospitals streamline triage to minimize this interval.
10. Blood Pressure Management Parameters
Question: When should elevated blood pressure be treated in acute stroke?
A) Always treat SBP >140
B) Only if concurrent MI, heart failure, aortic dissection, or hemorrhagic stroke
C) Only if SBP >180
D) Never treat elevated BP
Correct Answer: B) Only if concurrent MI, heart failure, aortic dissection, or hemorrhagic
stroke
Explanation: In ischemic stroke, elevated BP may help maintain cerebral perfusion.
Aggressive lowering can worsen outcomes. Treatment is reserved for specific comorbid
conditions or hemorrhagic cases.
11. Door-to-Stroke Team Time
Question: What is the recommended time to activate a stroke team with neurological
expertise after hospital arrival?
A) ASAP - 15 minutes
B) 30 minutes
C) 45 minutes
D) 60 minutes
Correct Answer: A) ASAP - 15 minutes
Explanation: Rapid access to a stroke team improves diagnostic accuracy and timely
intervention. Neurology input is critical for decision-making regarding thrombolytics
and thrombectomy. Protocols aim to minimize delays.
RESPONSE PRACTICE EXAM WITH
ACCURATE SOLUTIONS (VERIFIED)
1. EMS Goal on Scene
Question: What is the primary goal for EMS personnel when arriving on scene for a
suspected stroke patient?
A) Complete paperwork and wait for hospital transfer
B) Rapid assessment and stabilization to minimize time to treatment
C) Perform full diagnostic imaging on scene
D) Begin thrombolytic therapy immediately
Correct Answer: B) Rapid assessment and stabilization to minimize time to treatment
Explanation: EMS should focus on rapid assessment, airway management, vital signs,
and symptom onset identification. Early recognition allows activation of the stroke team
and reduces time to thrombolytic therapy or thrombectomy. Minimizing on-scene time
improves patient outcomes.
2. Oxygen Saturation in Stroke
Question: What is the target oxygen saturation for most stroke patients in prehospital
care?
A) 88–90%
B) 92–94%
C) >94%
D) 100%
Correct Answer: C) >94%
Explanation: Maintaining oxygen saturation above 94% ensures adequate tissue
oxygenation without causing oxygen toxicity. Hypoxia worsens ischemic injury, while
unnecessary high oxygen can create oxidative stress. Monitoring SpO₂ is essential
during prehospital transport.
3. Onset of Symptoms to Thrombolytic Therapy
Question: What is the maximum recommended time from symptom onset to IV
thrombolytic administration for eligible patients?
,A) 3 hours
B) 4.5 hours
C) 6 hours
D) 24 hours
Correct Answer: B) 4.5 hours
Explanation: IV thrombolytics are most effective when given within 4.5 hours of
symptom onset. Beyond this window, risks of hemorrhage outweigh benefits. Accurate
onset time is crucial for decision-making in the field and hospital.
4. Onset of Symptoms to Thrombectomy
Question: Up to how many hours from symptom onset can mechanical thrombectomy
be considered for select patients?
A) 6 hours
B) 12 hours
C) 24 hours
D) 48 hours
Correct Answer: C) 24 hours
Explanation: Advanced imaging allows identification of salvageable brain tissue.
Thrombectomy may be performed up to 24 hours in select cases, especially for large
vessel occlusions. Time is critical, but tissue-based selection expands eligibility.
5. Stroke Center Designations
Question: Which of the following are recognized stroke center designations?
A) Primary Stroke Center (PSC)
B) Comprehensive Stroke Center (CSC)
C) Acute Stroke Ready Hospital (ASRH)
D) All of the above
Correct Answer: D) All of the above
Explanation: Stroke centers are designated based on their capabilities. CSCs provide
advanced interventions like thrombectomy, PSCs manage standard stroke care, and
ASRHs stabilize patients for transfer. Understanding designations helps EMS direct
patients appropriately.
6. Door-to-Door Transfer Time
Question: What is the recommended maximum inter-hospital transfer time for stroke
,patients?
A) ≤30 minutes
B) ≤60 minutes
C) ≤90 minutes
D) ≤120 minutes
Correct Answer: B) ≤60 minutes
Explanation: Timely transfer between hospitals is critical for patients requiring higher-
level stroke interventions. Delays can reduce eligibility for thrombolysis or
thrombectomy. EMS coordination ensures patients arrive within this recommended
timeframe.
7. Associated Symptoms of Stroke
Question: Which of the following symptoms are commonly associated with cerebellar
or hemorrhagic stroke?
A) Vomiting and nausea
B) SBP >220 mmHg
C) Stiff neck and photophobia
D) All of the above
Correct Answer: D) All of the above
Explanation: Hemorrhagic and cerebellar strokes often present with severe headaches,
vomiting, high blood pressure, neck stiffness, or photophobia. Recognizing these signs
helps differentiate stroke types and prioritize imaging and treatment.
8. Overlooked Symptoms of Stroke
Question: Which subtle symptoms can be easily overlooked in stroke patients?
A) Dizziness and headache
B) General weakness or fatigue
C) Disorientation or confusion
D) All of the above
Correct Answer: D) All of the above
Explanation: Stroke presentations can be subtle, especially in elderly patients or those
with posterior circulation strokes. Early recognition of these symptoms improves rapid
diagnosis and treatment initiation. EMS and clinicians should maintain high suspicion
even for non-classical signs.
, 9. Door-to-Doctor Time
Question: What is the recommended target for a stroke patient’s evaluation by a
physician after arrival at the hospital?
A) ASAP - 10 minutes
B) Within 30 minutes
C) Within 1 hour
D) Within 2 hours
Correct Answer: A) ASAP - 10 minutes
Explanation: Early physician evaluation ensures rapid assessment and initiation of
stroke protocols. Delays in assessment correlate with worse neurological outcomes.
Hospitals streamline triage to minimize this interval.
10. Blood Pressure Management Parameters
Question: When should elevated blood pressure be treated in acute stroke?
A) Always treat SBP >140
B) Only if concurrent MI, heart failure, aortic dissection, or hemorrhagic stroke
C) Only if SBP >180
D) Never treat elevated BP
Correct Answer: B) Only if concurrent MI, heart failure, aortic dissection, or hemorrhagic
stroke
Explanation: In ischemic stroke, elevated BP may help maintain cerebral perfusion.
Aggressive lowering can worsen outcomes. Treatment is reserved for specific comorbid
conditions or hemorrhagic cases.
11. Door-to-Stroke Team Time
Question: What is the recommended time to activate a stroke team with neurological
expertise after hospital arrival?
A) ASAP - 15 minutes
B) 30 minutes
C) 45 minutes
D) 60 minutes
Correct Answer: A) ASAP - 15 minutes
Explanation: Rapid access to a stroke team improves diagnostic accuracy and timely
intervention. Neurology input is critical for decision-making regarding thrombolytics
and thrombectomy. Protocols aim to minimize delays.
