Free BCEN Certified Emergency Nurse (CEN) Practice Question

In the management of ischemic stroke, intravenous thrombolytic therapy with tissue plasminogen activator (tPA) is the treatment of choice, provided the patient presents within a defined window from symptom onset and has no contraindications such as recent surgery, bleeding, or anticoagulation. Other options might have some role in stroke management but are not the priority treatment in the hyperacute phase as presented in the scenario. Antihypertensive therapy is typically considered when blood pressure is extremely high and might compromise the safety of thrombolytic therapy or when there is no intention to administer thrombolytics. Antiplatelet therapy is generally initiated after the acute phase of an ischemic stroke. Immediate anticoagulation is not recommended initially in the acute management without ruling out stroke etiology, as it could be harmful in the case of hemorrhagic stroke.