Progressive Care Nursing Certification (PCCN) Practice Exam

Which treatment is indicated for a patient diagnosed with an ischemic stroke within two hours of admission?

1. Clopidogrel (Plavix)

2. Heparin

3. Argatroban (Acova)

4. TPA (activase)

The correct answer is: TPA (activase)

For a patient diagnosed with an ischemic stroke within two hours of admission, the administration of TPA (tissue plasminogen activator) is the most appropriate treatment option. TPA is a thrombolytic agent that works by dissolving the blood clot causing the stroke, thereby restoring blood flow to the affected part of the brain. The critical aspect of TPA therapy is that it must be administered within a strict time window—specifically, within 3 to 4.5 hours of the onset of stroke symptoms. Since the patient is admitted within the two-hour mark, they are an ideal candidate for this life-saving intervention. While clopidogrel, heparin, and argatroban have roles in the management of other conditions relating to thrombosis or stroke prevention, they are not indicated for the acute treatment of an ischemic stroke. Clopidogrel is an antiplatelet medication used for secondary prevention of stroke rather than acute intervention. Heparin and argatroban are anticoagulants that are typically not used for the immediate treatment of ischemic strokes, as they do not dissolve existing clots and can potentially complicate the clinical picture if administered without careful consideration of the timing and nature of the stroke.