NSG 239 Med/Surg Final Exam With
Complete Solutions
CVA - ANSWER Cerebrovascular accident
Stroke
What causes a stroke? - ANSWER interruption of blood and oxygen to the brain
Two types of stroke? - ANSWER -ischemic
-hemorrhagic
What happens during an ischemic stroke? - ANSWER blood vessel in the brain
becomes so narrow that the blood starts to clot/clump, obstructing blood flow to
the brain
What happens during a hemorrhagic stroke? - ANSWER When a vessel in the
brain bursts causing hemorrhage.
Most common type of stroke? - ANSWER ischemic
Less common, more dangerous type of stroke? - ANSWER hemorrhagic
Biggest risk factor for ischemic stroke? - ANSWER A-Fib
Why are pts with A-Fib at a higher risk for ischemic stroke? - ANSWER The atria
are underperforming, not putting enough blood out with each beat, thus allowing
stagnant blood to start clotting. The A-Fib puts them at higher risk for emboli,
which makes them very high risk for ischemic stroke.
Hemorrhagic strokes are commonly seen secondary to... - ANSWER -aneurism
rupture
-severe uncontrolled HTN
S/S of stroke - ANSWER -FAST
-difficulty swallowing
,-altered LOC
-unequal pupils
-seizures
-severe headache
-hemianopsia
-increased ICP
Increased ICP usually indicates a(n) ____________ stroke. - ANSWER
hemorrhagic
What does FAST stand for? - ANSWER *Facial drooping
*Arm drifting
*Speech
*Time
What is hemianopsia? - ANSWER Loss of one side of the visual field
True or False
Stroke damage is ipsilateral. - ANSWER FALSE
Strokes are contralateral, meaning the damaged side affects the opposite side.
Medications contraindicated for hemorrhagic stroke? - ANSWER -anything that
thins the blood
-ASA
-Plavix
-Lovenox
-heparin
-Coumadin
Regular use of blood thinners put a pt at risk for..? - ANSWER hemorrhagic
stroke
Common issue following a stroke where a pt forgets one side of their body -
ANSWER Unilateral Body Neglect Syndrome
Usually caused by right hemisphere damage from a stroke, making it difficult to
pick up on stimuli in the left field of vision.
Examples of Unilateral Body Neglect Syndrome behaviors... - ANSWER -reading
one side of a word
-combing only one side of their hair
-eating only from one side of their plate
, Interventions for pt with Unilateral Body Neglect Syndrome - ANSWER -remind
them to turn their head and look from side to side so that they'll be more aware
of their surroundings
-remind them that the neglected side of the body actually exists.
True of False
Dysphasia means difficulty swallowing. - ANSWER FALSE
Dysphasia is difficulty speaking.
Dysphagia is difficulty swallowing.
Dysphagia puts a pt at risk for.. - ANSWER aspiration
Ways to decrease the risk of aspiration for a pt with dysphagia while eating? -
ANSWER -thickened liquids
-upright position
-put food on unaffected side
-small bites
-limit distractions
What is aphasia? - ANSWER Loss of the ability to understand or produce speech.
Ways to help a pt with aphasia communicate? - ANSWER -use pictures
-be patient
-gestures
Condition often mistaken for a stroke? - ANSWER Bell's Palsy
What is Bell's Palsy? - ANSWER Sudden weakness in the muscles on one half of
the face.
-usually secondary to some sort of damage to Cranial nerve VII (facial nerve)
-progresses over a period of about 48 hours
Big concern with Bell's Palsy? - ANSWER Eye protection.
If one side of the face is paralyzed, the eyelid can't close. This can cause drying
of the eye, or injury since the pt cannot blink.
Eye precautions in Bell's Palsy pts includes.. - ANSWER -eye drops
-eye patch
-bandage over eye (tape)
What is trigeminal neuralgia? - ANSWER painful nerve condition in which a pt
experiences sharp, shooting pains of the face.
Complete Solutions
CVA - ANSWER Cerebrovascular accident
Stroke
What causes a stroke? - ANSWER interruption of blood and oxygen to the brain
Two types of stroke? - ANSWER -ischemic
-hemorrhagic
What happens during an ischemic stroke? - ANSWER blood vessel in the brain
becomes so narrow that the blood starts to clot/clump, obstructing blood flow to
the brain
What happens during a hemorrhagic stroke? - ANSWER When a vessel in the
brain bursts causing hemorrhage.
Most common type of stroke? - ANSWER ischemic
Less common, more dangerous type of stroke? - ANSWER hemorrhagic
Biggest risk factor for ischemic stroke? - ANSWER A-Fib
Why are pts with A-Fib at a higher risk for ischemic stroke? - ANSWER The atria
are underperforming, not putting enough blood out with each beat, thus allowing
stagnant blood to start clotting. The A-Fib puts them at higher risk for emboli,
which makes them very high risk for ischemic stroke.
Hemorrhagic strokes are commonly seen secondary to... - ANSWER -aneurism
rupture
-severe uncontrolled HTN
S/S of stroke - ANSWER -FAST
-difficulty swallowing
,-altered LOC
-unequal pupils
-seizures
-severe headache
-hemianopsia
-increased ICP
Increased ICP usually indicates a(n) ____________ stroke. - ANSWER
hemorrhagic
What does FAST stand for? - ANSWER *Facial drooping
*Arm drifting
*Speech
*Time
What is hemianopsia? - ANSWER Loss of one side of the visual field
True or False
Stroke damage is ipsilateral. - ANSWER FALSE
Strokes are contralateral, meaning the damaged side affects the opposite side.
Medications contraindicated for hemorrhagic stroke? - ANSWER -anything that
thins the blood
-ASA
-Plavix
-Lovenox
-heparin
-Coumadin
Regular use of blood thinners put a pt at risk for..? - ANSWER hemorrhagic
stroke
Common issue following a stroke where a pt forgets one side of their body -
ANSWER Unilateral Body Neglect Syndrome
Usually caused by right hemisphere damage from a stroke, making it difficult to
pick up on stimuli in the left field of vision.
Examples of Unilateral Body Neglect Syndrome behaviors... - ANSWER -reading
one side of a word
-combing only one side of their hair
-eating only from one side of their plate
, Interventions for pt with Unilateral Body Neglect Syndrome - ANSWER -remind
them to turn their head and look from side to side so that they'll be more aware
of their surroundings
-remind them that the neglected side of the body actually exists.
True of False
Dysphasia means difficulty swallowing. - ANSWER FALSE
Dysphasia is difficulty speaking.
Dysphagia is difficulty swallowing.
Dysphagia puts a pt at risk for.. - ANSWER aspiration
Ways to decrease the risk of aspiration for a pt with dysphagia while eating? -
ANSWER -thickened liquids
-upright position
-put food on unaffected side
-small bites
-limit distractions
What is aphasia? - ANSWER Loss of the ability to understand or produce speech.
Ways to help a pt with aphasia communicate? - ANSWER -use pictures
-be patient
-gestures
Condition often mistaken for a stroke? - ANSWER Bell's Palsy
What is Bell's Palsy? - ANSWER Sudden weakness in the muscles on one half of
the face.
-usually secondary to some sort of damage to Cranial nerve VII (facial nerve)
-progresses over a period of about 48 hours
Big concern with Bell's Palsy? - ANSWER Eye protection.
If one side of the face is paralyzed, the eyelid can't close. This can cause drying
of the eye, or injury since the pt cannot blink.
Eye precautions in Bell's Palsy pts includes.. - ANSWER -eye drops
-eye patch
-bandage over eye (tape)
What is trigeminal neuralgia? - ANSWER painful nerve condition in which a pt
experiences sharp, shooting pains of the face.
