The SCRN is the board credential for nurses who care for stroke patients, whether in the emergency department, on a stroke unit, in rehab or in a prevention clinic. It is awarded by the American Board of Neuroscience Nursing (ABNN), and its exam runs only in fixed testing windows, so the calendar shapes your preparation as much as the content does.
Fludrocortisone is added for cerebral salt wasting in a patient recovering from a coiled aneurysm. Because of its mineralocorticoid action, the nurse monitors MOST closely for
Answer and why, all 4 options
Fludrocortisone does not slow the heart; its cardiovascular risks are fluid retention, hypertension and arrhythmia from potassium loss.
Fludrocortisone has little glucocorticoid action, and corticosteroids push glucose up rather than down, so low glucose is not the expected problem.
This reverses the mineralocorticoid effect; a high potassium is a risk of aldosterone blockade (spironolactone), not of an aldosterone-like drug.
Fludrocortisone acts like aldosterone: it makes the kidney hold sodium and excrete potassium, so falling potassium is the lab to follow while it corrects the sodium loss of cerebral salt wasting.
Item 1876821
A stroke credential for every setting
The board calls this a generalist exam: it is not pitched at one level of care, and its items cover stroke patients across the lifespan and in many settings (candidate handbook, pp. 18–19). A hyperacute alert, a day-three hemorrhage on the unit and a clinic visit about blood pressure can all appear in the same sitting.
Who can apply:RN + 2,080 h in 3 years, counting direct or indirect stroke nursing. Teaching, supervising, research and consultation about stroke count as indirect practice, so stroke coordinators and educators qualify too. The full rules are on exam facts.
The board counted 7,143 certified stroke nurses at the close of 2024 (exam page).
SCRN numbers, each traced to ABNN
Dates, retakes and renewal: exam facts. Every fee: cost. Four years of results: pass rate. Read Nov 11, 2026, in the board's handbooks for both years and on its exam page.
Three testing windows a year: February 1–28, May 1–31 and September 1–30Application deadlines for 2027 are January 7, April 1 and August 5. A window cannot be extended or postponed, and PSI will not book a seat on its last day.
Scaled score of 200; the raw cut stays privateThe raw passing score of each form is set equal to 200, so forms of slightly different difficulty share one scale.
An unrestricted, current RN license (US, Canada or a US territory) plus 2,080 hours (one year full time) of direct or indirect stroke nursing in the last 3 yearsIndirect practice means stroke-related supervision, teaching, administration, research or consultation. ABNN audits 5% of applications at random.
932 of 1,389 test takers passed in 2024 (67.1%)70.4% in 2021, 71.5% in 2022 and 66.0% in 2023. ABNN counts everyone who tested, not only first-time candidates, and puts the five-year figure at 71%.
The board publishes item counts, not percentages. The two middle sections, hyperacute and acute care, carry 42 counted items each; post-acute care and prevention are the smallest.
Vascular anatomy; brain structure; stroke types; stroke syndromes; associated stroke disorders, such as etiology; stroke mimics; neuroplasticity; cellular composition and changes, such as the penumbra.
Initial triage; assessments; diagnostic tests; treatment considerations; thrombolytic therapy; hemorrhagic and ischemic interventions; advanced interventions such as thrombectomy and surgery; complication management and education; medications; quality stroke metrics such as door to needle; patient disposition.
Assessment and diagnostic tests; hemorrhagic and ischemic interventions; complication management; multidisciplinary plan of care; safety measures; individualized care for activities of daily living; therapeutic environment, such as sensory needs and positioning; psychosocial care; education; quality stroke metrics; medications; early rehabilitation and discharge planning.
Multidisciplinary plan of care; goals of rehabilitation; levels of rehabilitative care; rehabilitation considerations such as spasticity and safety; stroke education; medication management; community resources such as support groups.
Comorbidities and stroke risk factors; prevention measures and social determinants of health; diagnostic tests such as imaging and lab work; medication education and management; quality stroke metrics such as patient education; community health education.
19 items12.7%
In the order the board lists them; bars on one scale[2][3]
Hyperacute care, 42 items: last known well, thrombolysis and thrombectomy decisions, the NIHSS, door-to-needle metrics
Acute care, 42 items: the first days on the stroke unit, hemorrhage care, swallowing, complications
Post-acute care, 19 items: levels of rehab, spasticity, caregiver teaching, community resources
Stroke prevention, 19 items: risk factors, antithrombotic choices after stroke or TIA, community programs
4 stroke questions to start with
Post-acute Care · 19 items
At the 90-day visit, a stroke survivor walks without help and needs no help with self-care but can no longer work or do all previous activities. The modified Rankin Scale score is
Answer and why, all 4 options
A score of 4 means the person cannot walk or attend to bodily needs without help, which does not fit someone who walks and does self-care alone.
A modified Rankin score of 2 is slight disability: the person cannot do everything they did before (here, work) but looks after their own affairs without help.
A score of 1 means symptoms without significant disability, with all usual duties and activities still possible; losing the ability to work rules it out.
A score of 3 means moderate disability with a need for some help, though the person walks without assistance; this survivor needs no help at all.
Item 1876556
Anatomy, Physiology, and Pathophysiology of Stroke · 28 items
Sudden coma from a stroke implies damage to the ascending reticular activating system, which runs through the
Answer and why, all 4 options
A unilateral hemispheric lesion does not cause coma unless it is large enough to shift and compress the opposite side or the brainstem.
Bilateral occipital infarcts cause cortical blindness, sometimes with denial of blindness, but the patient stays awake.
The arousal network runs from the tegmentum of the pons and midbrain up through the thalami, so a small infarct there, as in top-of-the-basilar occlusion, can cause coma.
A cerebellar infarct causes ataxia and vertigo; it lowers consciousness only later, when swelling compresses the brainstem or blocks CSF flow.
Item 1981317
Primary and Secondary Preventative Care · 19 items
A stroke coordinator tracking discharge prescriptions for statins is monitoring which Joint Commission measure?
Answer and why, all 4 options
STK-6 tracks whether ischemic stroke patients are discharged on statin therapy, which makes it the measure a coordinator follows for discharge statin prescriptions.
STK-1 is VTE prophylaxis by the end of hospital day 2, an inpatient measure unrelated to discharge lipid therapy.
STK-4 counts IV thrombolytic started within 3 hours of last known well in patients who arrive within 2 hours; it is a hyperacute measure, not a discharge one.
STK-10 is assessment for rehabilitation; it concerns therapy referral, not lipid-lowering prescriptions.
Item 420068
Your score: – fills in as you answer; nothing is saved.Doubt a key? Note the item number — how corrections work →
Three windows a year, not a 90-day pass
The other boards in this hub let you book any open day after approval: BCEN gives a 90-day window for its trauma and transport exams, and AACN, for now, a 180-day window for the CMC (normally 90 days). This board does not. The exam is given only in February 1–28, May 1–31 and September 1–30, in person or through remote proctoring, and each window has an application deadline weeks earlier. For 2027 the deadlines are January 7, April 1 and August 5, 2027.
Two consequences. A missed deadline costs you a whole window, not a few days. And a candidate who fails waits for the next window to try again, so plan the first attempt early in the year if you want room for a second. Dates by window: exam facts.
SCRN or an NIHSS certificate?
Search for stroke certification for nurses and half the results are NIH Stroke Scale courses. Those are different things:
An NIHSS certificate shows you can score the scale reliably. Courses from the American Heart Association and other education providers issue it, and it puts no letters after your name.
The SCRN is a board certification. It needs stroke practice hours and a proctored exam covering the whole outline, and it lapses after 5 years unless renewed.
The exam does test NIHSS scoring rules, inside hyperacute care: NIHSS on the exam. This site does not issue either credential.
SCRN or ABNN's wider CNRN
The same board runs a broader credential, the CNRN (Certified Neuroscience Registered Nurse), with 220 questions in 4 h at the same fees. Its outline spans neuroscience nursing as a whole: brain and spinal trauma, tumors, infections, neuromuscular and neurodegenerative disease, seizures and developmental conditions, with cerebrovascular disease as one part (CNRN candidate handbook, p. 21).
Holders:3,659 CNRNs (2024), about half the number of stroke-certified nurses.
Fit: a nurse whose patients are mostly stroke patients, including in the ED or on a telestroke team, is the candidate this exam is written for; a neuro ICU or neurosurgery nurse may get more use from the CNRN.
Some nurses hold both; each is applied for, paid for and renewed on its own.
Percentages the board never published often repeated
Prep sites still print the outline as percentages, and some add up the pretest questions or copy an older outline. The handbook gives item counts out of the 150 scored questions only, as in the bars above. In a November 2026 search, the 2023 candidate handbook also still ranked near the top; fees and windows here come from the 2026 and 2027 editions, read on Nov 11, 2026.
SCRN practice test60 stroke nursing items balanced like the real exam, every option explained
SCRN exam factsWindows, eligibility, format, retakes, results and the three renewal routes
SCRN costExam fee, the AANN discount, retakes at full price and renewal fees
SCRN pass rateYearly counts 2021–2024, all takers, and the scaled 200 pass point
SCRN study guideA review plan built on the item counts and the testing windows
SCRN basics, short answers
Do I have to work on a certified stroke unit to qualify?
No. The board counts direct or indirect stroke nursing hours in any setting, including the ED, ICU, rehab and outpatient care. The requirement is RN + 2,080 h in 3 years; see eligibility.
Can the SCRN exam be taken from home?
Yes. Yes: a live remote proctor is one of the two ways to sit the exam, besides a PSI test center. Either way, the test happens inside one of the three windows.
How many years is an SCRN valid?
It lasts 5 years, ending December 31 of the fifth year. Renewal can be by exam or by practice hours plus continuing education: renewal options.
Does the SCRN replace my RN title?
No. The handbook says the credential is used alongside RN, not in place of it (handbook, p. 16).