Certified Medical-Surgical Registered Nurse Practice Exam

After a neurological assessment for a suspected stroke, what is the nurse's next step?

1. Administering tissue plasminogen activator.

2. Obtaining a computed tomography scan of the head without contrast.

3. Obtaining a neurosurgical consultation.

4. Preparing for carotid Doppler ultrasonography.

The correct answer is: Obtaining a computed tomography scan of the head without contrast.

The correct next step after conducting a neurological assessment for a suspected stroke is obtaining a computed tomography scan of the head without contrast. This is crucial because the CT scan serves as a primary imaging modality used to determine if the stroke is ischemic or hemorrhagic. Identifying the type of stroke is critical for guiding treatment decisions, especially regarding thrombolytic therapy. If the stroke is identified as ischemic, administration of tissue plasminogen activator (tPA) can be considered, provided that no contraindications exist and the patient meets the criteria for administration. The CT scan helps rule out any bleeding in the brain before proceeding with this treatment. Neurosurgical consultations and carotid Doppler ultrasonography may be necessary at later stages of management, depending on the findings and clinical situation. However, those steps follow the initial imaging assessment to establish the nature of the stroke. Immediate imaging with CT is essential for effective and timely intervention in stroke management.