Module test - CHSS eLearning

Please provide some personal information before proceeding with this Module Test. This information is required for creating your certificate and will also assist us in evaluating the website.

Each of the Managed Clinical Networks (MCNs) in Scotland will be given the names of those who have been awarded Module Test Certificates within their areas. There are 20 questions and you must answer at least 18 (90%) of these correctly to obtain a certificate of completion. Please note there is no limit to the amount of times you can attempt the assessment.
Name*
First Last
Email*
Do you live / work in Scotland?*
- Yes
- No
Country*
Select your country
Are you:*
- Employed by Scottish Ambulance Service
- Employed by NHS
- Employed by University or other Higher Education
- Employed by Local Authority/Private/Voluntary sector
- A student
- A carer or other
Do you work in a:*
- Hospital
- Community
Your role in SAS is:*
- Paramedic
- Ambulance Technician
Name of service (eg ESD, GP surgery):*

Enter your service name
Ward no. / name or dept:*
You work in:*
Choose your work environment
Is this ward a Stroke Unit?*
- Yes
- No
Hospital name*
Name of institution:*

Enter the name of your institution
Town / City:*

Enter the town / city where you work
NHS Board*
Select your NHS Board
You are a(n):*
- Clinical Academic
You are a(n)*
- AHP student
- Medical student
- Nursing student
Carer*
- Carer
- Person who has had a stroke
Your profession / role*
Select your profession
Profession / role (other)*
Please specify:
AfC Band*
Select your AfC band
University / College*
Select your University / College
University / College (other)*

If you selected Other, please specify:

Part 1. Q. The FAST test (select all that apply).*
- A. Will detect all patients with a stroke
- B. Helps to identify patients with stroke
- C. Is positive if the face or arm or speech is affected
- D. Is negative unless the face, arm and speech are affected
- E. Can distinguish ischaemic and haemorrhagic stroke

Part.1 Answer

Unfortunately, you have answered part 1 incorrectly, or you may not have selected all the correct answers. Revise the learning materials for Hyperacute stroke treatments including thrombolysis and thrombectomy.
Part.1 Answer

Well done, B, and C are correct.

Part 2. Q. Time is Brain (select all that apply).*
- A. The earlier thrombolysis and/or thrombectomy are delivered, the greater the chances of a good recovery
- B. Thrombolysis with alteplase is effective within 6 hours of last being free of stroke symptom
- C. Advanced brain imaging can be used to identify wake up patients who will benefit from hyperacute treatment
- D. Thrombectomy is only effective if started within 4.5 hours of stroke onset
- E. It is dangerous to treat with thrombolysis until all of the blood results are available

Part.2 Answer

Unfortunately, you have answered part 2 incorrectly, or you may not have selected all the correct answers. Revise the learning materials for Hyperacute stroke treatments including thrombolysis and thrombectomy.
Part.2 Answer

Well done, A, and C are correct.

Part 3. Q. The National Institutes of Health Stroke Scale (select all that apply).*
- A. Should be documented before hyperacute treatment is given
- B. The score is usually higher in patients with right hemisphere strokes compared with left hemisphere strokes
- C. Is used to detect neurological worsening after hyperacute treatment
- D. Includes an assessment of visual fields
- E. The arm and leg should be kept up for at least 20 seconds

Part 3. Answer

Unfortunately, you have answered part 3 incorrectly, or you may not have selected all the correct answers. Revise the learning materials for Hyperacute stroke treatments including thrombolysis and thrombectomy.
Part 3. Answer

Well done, A, C and D are correct.

Part 4. Q. Part 4. Q. Which of the following may cause symptoms of an acute stroke? (select all that apply).*
- A. Intracerebral bleed
- B. Migraine with aura
- C. Subdural haematoma
- D. Hypoglycaemia
- E. Epileptic seizure

Part 4. Answer

Unfortunately, you have answered part 4 incorrectly, or you may not have selected all the correct answers. Revise the learning materials for Hyperacute stroke treatments including thrombolysis and thrombectomy.
Part 4. Answer

Well done, they are all correct.

Part 5. Q. A CT scan (select all that apply)*
- A. Can detect an intracerebral bleed
- B. If normal, excludes a diagnosis of ischaemic stroke
- C. Can detect a brain tumour
- D. Identified a subdural haematoma in Keith
- E. Can confirm a diagnosis of migraine

Part 5. Answer

Unfortunately, you have answered part 5 incorrectly, or you may not have selected all the correct answers. Revise the learning materials for Hyperacute stroke treatments including thrombolysis and thrombectomy.
Part 5. Answer

Well done, A, C, and D are correct.

Part 6. Q. Which of the following must be carried out before the hyperacute patient goes to CT (select all that apply)*
- A. Bolus of alteplase
- B. Insertion of iv cannula
- C. 12 lead ECG
- D. Weigh the patient
- E. Full medical clerking

Part 6. Answer

Unfortunately, you have answered part 6 incorrectly, or you may not have selected all the correct answers. Revise the learning materials for Hyperacute stroke treatments including thrombolysis and thrombectomy.
Part 6. Answer

Well done, B is correct.

Part 7. Q. A CT angiography (CTA) (select all that apply).*
- A. Involves an injection of contrast into an iv cannula
- B. Can show a large blocked artery suitable for thrombectomy
- C. Is completely safe
- D. Can show a narrowing (stenosis) in the carotid artery
- E. Can exclude an ischaemic stroke

Part 7. Answer

Unfortunately, you have answered part 7 incorrectly, or you may not have selected all the correct answers. Revise the learning materials for Hyperacute stroke treatments including thrombolysis and thrombectomy.
Part 7. Answer

Well done, A, B, and D are correct.

Part 8. Q. The Door to needle time (DTN) (select all that apply)*
- A. Is an important measure of stroke service performance
- B. May be increased by poor team work
- C. Is the delay from patient leaving home to the bolus of alteplase
- D. Is reduced by an ambulance pre-alert
- E. Cannot be less than 30 min

Part 8. Answer

Unfortunately, you have answered part 8 incorrectly, or you may not have selected all the correct answers. Revise the learning materials for Hyperacute stroke treatments including thrombolysis and thrombectomy.
Part 8. Answer

Well done, A, B and D are correct.

Part 9. Q. Which of the following are absolute contraindications to alteplase (select all that apply)*
- A. High blood sugar
- B. High blood pressure
- C. Acute intracranial haemorrhage
- D. Severe bleeding at a non-compressible site
- E. Taken a Direct Oral Anticoagulants (DOAC) within last 24 hours

Part 9. Answer

Unfortunately, you have answered part 9 incorrectly, or you may not have selected all the correct answers. Revise the learning materials for Hyperacute stroke treatments including thrombolysis and thrombectomy.
Part 9. Answer

Well done, C, D, and E are correct.

Part 10. Q. Alteplase (select all that apply)*
- A. Will usually result in the patient making a full recovery
- B. The dose is usually 0.9mg/kg
- C. Will benefit about 1 in 10 treated patients on average
- D. 20% of total dose is given as a bolus
- E. Causes blood clots in 10% of patients

Part 10. Answer

Unfortunately, you have answered part 10 incorrectly, or you may not have selected all the correct answers. Revise the learning materials for Hyperacute stroke treatments including thrombolysis and thrombectomy.
Part 10. Answer

Well done, B, and C are correct.

Part 11. Q. Oral Anticoagulation (select all that apply)*
- A. Increases the risk of intracranial bleeding
- B. Meant that Iain was unsuitable for thrombolysis
- C. Patients on warfarin must have an INR result before being treated with thrombolysis
- D. Is a contraindication for thrombectomy
- E. Should be started immediately after thrombolysis

Part 11. Answer

Unfortunately, you have answered part 11 incorrectly, or you may not have selected all the correct answers. Revise the learning materials for Hyperacute stroke treatments including thrombolysis and thrombectomy.
Part 11. Answer

Well done, A, B, and C are correct.

Part 12. Q. Post thrombolysis monitoring should include (select all that apply)*
- A. Peak flow
- B. Hourly urine volumes
- C. Neurological deficits
- D. Pulse rate
- E. Blood pressure

Part 12. Answer

Unfortunately, you have answered part 12 incorrectly, or you may not have selected all the correct answers. Revise the learning materials for Hyperacute stroke treatments including thrombolysis and thrombectomy.
Part 12. Answer

Well done, C, D, and E are correct.

Part 13. Q. Angioedema after thrombolysis (select all that apply)*
- A. May cause facial swelling
- B. May cause breathing difficulty
- C. Is treated with clotting factors
- D. May cause a rash
- E. May cause back pain

Part 13. Answer

Unfortunately, you have answered part 13 incorrectly, or you may not have selected all the correct answers. Revise the learning materials for Hyperacute stroke treatments including thrombolysis and thrombectomy.
Part 13. Answer

Well done, A, B, and D are correct.

Part 14. Q. Thrombectomy may involve (select all that apply)*
- A. An intra muscular injection
- B. A suction catheter
- C. An arterial puncture
- D. Use of a stentriever
- E. Chest incision

Part 14. Answer

Unfortunately, you have answered part 14 incorrectly, or you may not have selected all the correct answers. Revise the learning materials for Hyperacute stroke treatments including thrombolysis and thrombectomy.
Part 14. Answer

Well done, B, C, and D are correct.

Part 15. Q. Post thrombectomy monitoring aims to detect (select all that apply)*
- A. Bleeding in the groin
- B. Neurological worsening
- C. Reactions to contrast media
- D. Weight loss
- E. Bleeding into the back from a high puncture

Part 15. Answer

Unfortunately, you have answered part 15 incorrectly, or you may not have selected all the correct answers. Revise the learning materials for Hyperacute stroke treatments including thrombolysis and thrombectomy.
Part 15. Answer

Well done, A, B, C and E are correct.

Part 16. Q. Drip and Ship reduces (select all that apply)*
- A. Effectiveness of thrombolysis
- B. Delays to thrombolysis
- C. Unnecessary admissions to thrombectomy hub
- D. Delay to thrombectomy
- E. Number of ambulance journeys

Part 16. Answer

Unfortunately, you have answered part 16 incorrectly, or you may not have selected all the correct answers. Revise the learning materials for Hyperacute stroke treatments including thrombolysis and thrombectomy.
Part 16. Answer

Well done, B and C are correct.

Part 17. Q. During an ambulance transfer to a thrombectomy hub (select all that apply).*
- A. An appropriately trained nurse must always accompany the patient
- B. An anaesthetist may be required if the conscious level or airway is compromised
- C. Alteplase infusion should be stopped unless a nurse accompanies the patient
- D. The paramedics are responsible for deciding whether the ambulance should be diverted
- E. Tenecteplase should be stopped.

Part 17. Answer

Unfortunately, you have answered part 17 incorrectly, or you may not have selected all the correct answers. Revise the learning materials for Hyperacute stroke treatments including thrombolysis and thrombectomy.
Part 17. Answer

Well done, B is correct.

Part 18. Q. A by-pass or mothership usually reduces (select all that apply)*
- A. Effectiveness of thrombectomy
- B. Delay to thrombectomy
- C. Acute stroke admissions to spoke hospitals
- D. Delay to thrombolysis
- E. Unnecessary admissions to thrombectomy hubs

Part 18. Answer

Unfortunately, you have answered part 18 incorrectly, or you may not have selected all the correct answers. Revise the learning materials for Hyperacute stroke treatments including thrombolysis and thrombectomy.
Part 18. Answer

Well done, B and C are correct.

Part 19. Q. Hyperacute treatment for ischaemic stroke may include (select all that apply)*
- A. Just thrombolysis with alteplase
- B. Just thrombolysis with tenecteplase
- C. Just thrombectomy
- D. Thrombolysis and thrombectomy
- E. Intravenous heparin

Part 19. Answer

Unfortunately, you have answered part 19 incorrectly, or you may not have selected all the correct answers. Revise the learning materials for Hyperacute stroke treatments including thrombolysis and thrombectomy.
Part 19. Answer

Well done, A, B, C and D are correct.

Part 20. Q. Repatriation (select all that apply)*
- A. The timing depends on the patient’s fitness to travel
- B. Should not occur before 72 hours after a thrombectomy
- C. Depends on the availability of an emergency ambulance
- D. Requires a nurse escort
- E. May be delayed in patients with malignant MCA syndrome

Part 20. Answer

Unfortunately, you have answered part 20 incorrectly, or you may not have selected all the correct answers. Revise the learning materials for Hyperacute stroke treatments including thrombolysis and thrombectomy.
Part 20. Answer

Well done, A and E are correct.

Stroke Training and Awareness Resources (STARs)

Part.1 Answer

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Part.2 Answer

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Part 3. Answer

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Part 11. Answer

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Part 13. Answer

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Part 14. Answer

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Part 15. Answer

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Part 16. Answer

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