ESTUDYR
NCLEX-RN Case Study: Ischemic Stroke
(CVA)
Client Scenario:
A 68-year-old female is brought to the Emergency Department (ED) by her husband. He
states she was eating breakfast at 09:15 when she suddenly dropped her fork, began slurring
her words, and couldn't move her right side. History includes Atrial Fibrillation (A-Fib),
Hypertension, and Type 2 Diabetes.
Initial Assessment (10:00):
Neuro: Right-sided facial droop, 0/5 strength in right upper extremity, 2/5 in right
lower extremity. Expressive aphasia present.
Vitals: BP 198/112, HR 102 (Irregular), RR 20, SpO2 96% on RA, Temp 98.8°F.
Item 1: Recognizing Cues (Highlighting)
Question: Click to highlight the findings that require immediate intervention by the nurse.
Findings: 68-year-old female; onset at 09:15; dropped her fork; slurring her words; BP
198/112; 0/5 strength in right upper extremity; expressive aphasia; history of A-Fib.
Correct Selections:
✅Onset at 09:15 (Determines eligibility for tPA/thrombolytics)
✅Slurring her words/Expressive aphasia (Neurological deficit)
✅BP 198/112 (Critically high; must be managed before tPA)
✅0/5 strength in right upper extremity (Acute focal deficit)
Item 2: Analyzing Cues (Matching/Matrix)
NCLEX-RN Case Study: Ischemic Stroke
(CVA)
Client Scenario:
A 68-year-old female is brought to the Emergency Department (ED) by her husband. He
states she was eating breakfast at 09:15 when she suddenly dropped her fork, began slurring
her words, and couldn't move her right side. History includes Atrial Fibrillation (A-Fib),
Hypertension, and Type 2 Diabetes.
Initial Assessment (10:00):
Neuro: Right-sided facial droop, 0/5 strength in right upper extremity, 2/5 in right
lower extremity. Expressive aphasia present.
Vitals: BP 198/112, HR 102 (Irregular), RR 20, SpO2 96% on RA, Temp 98.8°F.
Item 1: Recognizing Cues (Highlighting)
Question: Click to highlight the findings that require immediate intervention by the nurse.
Findings: 68-year-old female; onset at 09:15; dropped her fork; slurring her words; BP
198/112; 0/5 strength in right upper extremity; expressive aphasia; history of A-Fib.
Correct Selections:
✅Onset at 09:15 (Determines eligibility for tPA/thrombolytics)
✅Slurring her words/Expressive aphasia (Neurological deficit)
✅BP 198/112 (Critically high; must be managed before tPA)
✅0/5 strength in right upper extremity (Acute focal deficit)
Item 2: Analyzing Cues (Matching/Matrix)
