Key Concepts
Introduction
RN You coordinate the hyperacute pathway: neuro assessment frequency, NIHSS when trained/ordered, two large-bore IVs when stem expects it, lab draw, CT readiness, tPA bundle elements per protocol, and post-tPA neuro checks. For ICP, implement head-of-bed, osmotic therapy, sedation/analgesia, CSF drainage per orders, and avoid interventions that spike ICP when the item tests that (straining, inappropriate positioning). High-yield forks: who to assess first among multiple clients (acute neuro change wins), BP management around thrombolysis teaching, seizure versus stroke mimic, posterior circulation symptoms (vertigo, diplopia), and do-not answers such as delaying activation for paperwork. For NCLEX-RN (United States), questions rarely announce the topic in the first sentence. They hide it inside vitals, labs, and a short story. Your job is to name the clinical problem, justify why it matters now, and select the safest next step for the role you are given—before you let distractors pull you toward busywork or out-of-scope heroics. When two answers feel partly right, pick the one that closes risk first and matches your license in the stem. On the exam, writers often pair stable-sounding options with...