NCSO EXAM NEWEST 2025 ACTUAL
EXAM| COMPLETE REAL EXAM
QUESTIONS AND CORRECT VERIFIED
ANSWERS/ ALREADY GRADED A+| NCSO
REVIEW 2025/2026 (BRAND NEW!!)
Q1
A patient presents with left facial droop and right-sided weakness that
began 45 minutes ago. CT head is negative for hemorrhage. Blood
pressure is 190/100 mmHg.
What is the most appropriate next step?
A. Withhold IV alteplase due to high BP
B. Lower BP to <185/110 then give alteplase
C. Proceed to mechanical thrombectomy
D. Obtain MRI before treatment
Correct Answer: B
Rationale
• Eligibility for IV alteplase requires BP <185/110 mmHg.
• The correct approach is rapid BP lowering with IV agents
(labetalol/nicardipine), then give alteplase.
• No delay for MRI if CT excludes bleed.
, • MT (C) is indicated if large vessel occlusion on CTA.
Q2
Which imaging modality is preferred to rapidly identify an acute
intracerebral hemorrhage?
A. MRI DWI
B. Non-contrast CT
C. CT perfusion
D. CTA
Correct Answer: B
Rationale
• Non-contrast CT is the fastest and most widely available tool to
detect ICH.
• MRI is more sensitive but slower and not first-line in emergency
settings.
Q3
A stroke patient arrives with suspected large vessel occlusion. Last known
well: 2.5 hours ago.
Which imaging best determines eligibility for mechanical
thrombectomy?
A. CT perfusion and vessel imaging
B. Non-contrast CT only
C. MRI T2
D. Carotid duplex
, Correct Answer: A
Rationale
• MT requires identification of LVO (CTA) and assessment of
penumbra vs core (CTP or MRI).
• Non-contrast CT alone is insufficient for MT decision.
Q4
Which finding on CT is most consistent with early ischemia?
A. Hyperdense MCA sign
B. Ring-enhancing lesion
C. Subdural collection
D. Central pontine hypodensity
Correct Answer: A
Rationale
• Hyperdense MCA = clot in middle cerebral artery.
• Early predictor of ischemic stroke and MT benefit.
Q5
What is the target glucose range in acute ischemic stroke management?
A. 40–100 mg/dL
B. 140–180 mg/dL
C. 200–250 mg/dL
D. Any level is acceptable
, Correct Answer: B
Rationale
• Hyperglycemia worsens outcomes.
• Maintain 140–180 range to prevent secondary injury.
Q6
What is the maximum door-to-needle time recommended for IV
alteplase?
A. 15 min
B. 30 min
C. 60 min
D. 90 min
Correct Answer: C
Rationale
• AHA/ASA recommends door-to-needle <60 minutes.
• Many centers aim for 30 min, but 60 is the benchmark.
Q7
A patient is post-alteplase. BP rises to 200/115 mmHg.
Which is the best management?
A. Wait, BP will normalize
B. Start labetalol or nicardipine drip
EXAM| COMPLETE REAL EXAM
QUESTIONS AND CORRECT VERIFIED
ANSWERS/ ALREADY GRADED A+| NCSO
REVIEW 2025/2026 (BRAND NEW!!)
Q1
A patient presents with left facial droop and right-sided weakness that
began 45 minutes ago. CT head is negative for hemorrhage. Blood
pressure is 190/100 mmHg.
What is the most appropriate next step?
A. Withhold IV alteplase due to high BP
B. Lower BP to <185/110 then give alteplase
C. Proceed to mechanical thrombectomy
D. Obtain MRI before treatment
Correct Answer: B
Rationale
• Eligibility for IV alteplase requires BP <185/110 mmHg.
• The correct approach is rapid BP lowering with IV agents
(labetalol/nicardipine), then give alteplase.
• No delay for MRI if CT excludes bleed.
, • MT (C) is indicated if large vessel occlusion on CTA.
Q2
Which imaging modality is preferred to rapidly identify an acute
intracerebral hemorrhage?
A. MRI DWI
B. Non-contrast CT
C. CT perfusion
D. CTA
Correct Answer: B
Rationale
• Non-contrast CT is the fastest and most widely available tool to
detect ICH.
• MRI is more sensitive but slower and not first-line in emergency
settings.
Q3
A stroke patient arrives with suspected large vessel occlusion. Last known
well: 2.5 hours ago.
Which imaging best determines eligibility for mechanical
thrombectomy?
A. CT perfusion and vessel imaging
B. Non-contrast CT only
C. MRI T2
D. Carotid duplex
, Correct Answer: A
Rationale
• MT requires identification of LVO (CTA) and assessment of
penumbra vs core (CTP or MRI).
• Non-contrast CT alone is insufficient for MT decision.
Q4
Which finding on CT is most consistent with early ischemia?
A. Hyperdense MCA sign
B. Ring-enhancing lesion
C. Subdural collection
D. Central pontine hypodensity
Correct Answer: A
Rationale
• Hyperdense MCA = clot in middle cerebral artery.
• Early predictor of ischemic stroke and MT benefit.
Q5
What is the target glucose range in acute ischemic stroke management?
A. 40–100 mg/dL
B. 140–180 mg/dL
C. 200–250 mg/dL
D. Any level is acceptable
, Correct Answer: B
Rationale
• Hyperglycemia worsens outcomes.
• Maintain 140–180 range to prevent secondary injury.
Q6
What is the maximum door-to-needle time recommended for IV
alteplase?
A. 15 min
B. 30 min
C. 60 min
D. 90 min
Correct Answer: C
Rationale
• AHA/ASA recommends door-to-needle <60 minutes.
• Many centers aim for 30 min, but 60 is the benchmark.
Q7
A patient is post-alteplase. BP rises to 200/115 mmHg.
Which is the best management?
A. Wait, BP will normalize
B. Start labetalol or nicardipine drip
