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Stroke Certified Registered Nurse Exam 2025
Practice test with 150 Recent Test Questions and
Correct Answers/ SCRN Exam Prep Latest (new!)
CBF/MAP/ICP Relationships - ✔✔ANSWER✔✔...CBF:
• Compromise occurs when MAP < 50 mm Hg.
• Compromise occurs even if ICP is normal.
• Brain ischemia is likely when MAP < 40 mm Hg.
• CP = MAP ([systolic - diastolic]/3 + diastolic) - ICP
• With increased ICP, consider keeping MAP > 90 mm Hg.
• Goal MAPs, ICPs, and CPPs should be set for each
patient by the neurology and/or neurosurgical team.
Neuroplasticity + Application for Stroke team: -
✔✔ANSWER✔✔...Neuroplasticity:
• L.e., brain plasticity; plasticity = remoldability
• Alterations in the brain in response to changes in
thinking, learning, injury, or
- environment
• Changes can happen to both brain anatomy (physical)
and physiology (functionality)
• Occurs on a continuum from cellular changes (learning)
to cortical remapping (injury)
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• Application for stroke treatment:
• Recovery of motor and sensory function can occur when
healthy brain tissue adjacent to damaged tissue is
stimulated to take over the functions of the damaged
tissue(s).
• Supports cost/benefit ratios for various therapy
modalities (e.g., ST, OT, PT) as part of post-stroke care
• Some studies show that progesterone injections (may
increase neuroplasticity capabilities) post-brain injury
reduce morbidity and mortality.
CSF Draining - ✔✔ANSWER✔✔...Via pressure line from
inside cerebral ventricle (via ventriculostomy)
• Raising the burette above the zero reference level may
create expected pressures within the brain.
• A 0-cm pressure level is used for maximal pressure
unloading, and the pressure treated from the CSF would
be O.
• If a patient has higher CS pressures at a 0-cm pressure
level, suspect complications such as cerebral edema.
• A 10-cm pressure level above 0 will usually result in
normal pressures (i.e., no CSF drainage will occur).
• A 20-cm pressure level above the 0 reference level will
usually result in an ICP of 20 mm Hg. This pressure can
have a "tamponade" effect on unsecured ruptured
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subarachnoid aneurysm (may be useful when weaning
from EVD).
Stroke: Reperfusion Syndrome - ✔✔ANSWER✔✔...Causes
Restoration of CBF from mechanical revascularization or
from thrombolysis of a clot causing a stroke; risk factors
include HTN, dysautoregulation, and cytokine release.
S/S
Triad: severe ipsilateral headache, contralateral neuro
deficits, seizure(s)
Dx tests
Clinical d; tests for risk: preop transcranial Doppler,
acetazolamide SPECT scan
Nsg dx
Risk for ineffective cerebral tissue perfusion, risk for
injury
Nsg tx
Bedrest, maintain airway, IV access, seizure precautions
Med tx
Prevention is key; studies are currently in progress for
future "stroke cocktail" preparations: control BP: consider
doxycycline or other neuroprotective agents.
Watch for
Stroke Certified Registered Nurse Exam 2025
Practice test with 150 Recent Test Questions and
Correct Answers/ SCRN Exam Prep Latest (new!)
CBF/MAP/ICP Relationships - ✔✔ANSWER✔✔...CBF:
• Compromise occurs when MAP < 50 mm Hg.
• Compromise occurs even if ICP is normal.
• Brain ischemia is likely when MAP < 40 mm Hg.
• CP = MAP ([systolic - diastolic]/3 + diastolic) - ICP
• With increased ICP, consider keeping MAP > 90 mm Hg.
• Goal MAPs, ICPs, and CPPs should be set for each
patient by the neurology and/or neurosurgical team.
Neuroplasticity + Application for Stroke team: -
✔✔ANSWER✔✔...Neuroplasticity:
• L.e., brain plasticity; plasticity = remoldability
• Alterations in the brain in response to changes in
thinking, learning, injury, or
- environment
• Changes can happen to both brain anatomy (physical)
and physiology (functionality)
• Occurs on a continuum from cellular changes (learning)
to cortical remapping (injury)
,2|Page
• Application for stroke treatment:
• Recovery of motor and sensory function can occur when
healthy brain tissue adjacent to damaged tissue is
stimulated to take over the functions of the damaged
tissue(s).
• Supports cost/benefit ratios for various therapy
modalities (e.g., ST, OT, PT) as part of post-stroke care
• Some studies show that progesterone injections (may
increase neuroplasticity capabilities) post-brain injury
reduce morbidity and mortality.
CSF Draining - ✔✔ANSWER✔✔...Via pressure line from
inside cerebral ventricle (via ventriculostomy)
• Raising the burette above the zero reference level may
create expected pressures within the brain.
• A 0-cm pressure level is used for maximal pressure
unloading, and the pressure treated from the CSF would
be O.
• If a patient has higher CS pressures at a 0-cm pressure
level, suspect complications such as cerebral edema.
• A 10-cm pressure level above 0 will usually result in
normal pressures (i.e., no CSF drainage will occur).
• A 20-cm pressure level above the 0 reference level will
usually result in an ICP of 20 mm Hg. This pressure can
have a "tamponade" effect on unsecured ruptured
, 3|Page
subarachnoid aneurysm (may be useful when weaning
from EVD).
Stroke: Reperfusion Syndrome - ✔✔ANSWER✔✔...Causes
Restoration of CBF from mechanical revascularization or
from thrombolysis of a clot causing a stroke; risk factors
include HTN, dysautoregulation, and cytokine release.
S/S
Triad: severe ipsilateral headache, contralateral neuro
deficits, seizure(s)
Dx tests
Clinical d; tests for risk: preop transcranial Doppler,
acetazolamide SPECT scan
Nsg dx
Risk for ineffective cerebral tissue perfusion, risk for
injury
Nsg tx
Bedrest, maintain airway, IV access, seizure precautions
Med tx
Prevention is key; studies are currently in progress for
future "stroke cocktail" preparations: control BP: consider
doxycycline or other neuroprotective agents.
Watch for
