Stroke 3.0 Level VII
Discharge &
Prevention Exam
Questions (Verified
Answers)
Question 1
A nurse is providing discharge education to a client who has experienced a stroke. The client has mild
left-sided weakness and requires assistance with ambulation. Which of the following is the most
appropriate discharge recommendation?
A) Discharge to home with home health physical therapy
B) Discharge to a skilled nursing facility for long-term care
C) Discharge to an inpatient rehabilitation facility
D) Discharge to home with family member supervision only
Correct Answer: C) Discharge to an inpatient rehabilitation facility
Rationale: Clients with mild to moderate functional deficits following a stroke who can tolerate 3 hours
of therapy per day benefit most from inpatient rehabilitation. This setting provides intensive physical,
occupational, and speech therapy to maximize functional recovery. Home health may be appropriate for
clients with minimal deficits, while skilled nursing is for those who cannot tolerate intensive therapy.
Question 2
,A stroke survivor is being discharged home. The client's spouse expresses concern about caregiving
responsibilities. Which of the following is the nurse's best response?
A) "You will learn as you go along. It will get easier."
B) "I can provide you with a list of community resources and support groups."
C) "You should consider placing your spouse in a nursing home."
D) "Your spouse will recover fully, so don't worry."
Correct Answer: B) "I can provide you with a list of community resources and support groups."
Rationale: Caregiver burden is common after stroke. Providing resources and support groups helps
prepare the caregiver for the challenges ahead. The nurse should validate the spouse's concerns and
offer practical assistance. Dismissing concerns or making false promises is not appropriate.
Question 3
A client who had a stroke 2 weeks ago is being discharged. The client has a new prescription for warfarin
for atrial fibrillation. Which of the following instructions should the nurse include in discharge teaching?
A) "Take ibuprofen for headaches as needed."
B) "Monitor for signs of bleeding such as bruising or blood in urine."
C) "Avoid all green leafy vegetables to prevent bleeding."
D) "Have your INR checked every 6 months."
Correct Answer: B) "Monitor for signs of bleeding such as bruising or blood in urine."
Rationale: Warfarin increases bleeding risk. Clients should be taught to monitor for signs of bleeding,
including bruising, petechiae, hematuria, and gum bleeding. NSAIDs should be avoided. Green leafy
vegetables contain vitamin K and should be consumed consistently, not avoided completely. INR should
be checked regularly, often weekly to monthly.
Question 4
A nurse is assessing a stroke client's risk for falls prior to discharge. Which of the following factors places
the client at highest risk for falls?
A) Age over 65 years
B) History of hypertension
C) Hemiparesis and impaired balance
D) Use of one medication
Correct Answer: C) Hemiparesis and impaired balance
,Rationale: Hemiparesis and impaired balance are significant risk factors for falls after stroke. These
deficits directly affect mobility and stability. Age and hypertension are also risk factors but are not as
directly related to fall risk. Polypharmacy, not just one medication, increases fall risk.
Question 5
A stroke client is being discharged home with a prescription for aspirin 81 mg daily for secondary stroke
prevention. Which of the following statements by the client indicates understanding of the medication?
A) "I will take this medication only when I have headaches."
B) "I will take this medication every morning with food to prevent stomach upset."
C) "I can stop this medication if I feel fine."
D) "I will double the dose if I miss a day."
Correct Answer: B) "I will take this medication every morning with food to prevent stomach upset."
Rationale: Aspirin should be taken daily as prescribed, typically with food to reduce gastrointestinal
irritation. It should not be taken only for headaches. The client should not stop or adjust the dose without
consulting the healthcare provider. Missing a dose should be handled as directed, not by doubling the
dose.
Question 6
A client who had a stroke is being discharged. The client has moderate dysphagia and requires a
modified diet. Which of the following diet textures is most appropriate?
A) Regular diet with thin liquids
B) Mechanical soft diet with thickened liquids
C) Pureed diet with nectar-thick liquids
D) Clear liquid diet only
Correct Answer: C) Pureed diet with nectar-thick liquids
Rationale: A client with moderate dysphagia may require a pureed diet and thickened liquids (nectar-
thick) to reduce aspiration risk. The diet consistency should be based on a speech-language pathologist's
recommendation. Regular and mechanical soft diets may be too challenging. A clear liquid diet is not
nutritionally adequate for long-term use.
Question 7
A nurse is providing discharge teaching to a stroke client about preventing future strokes. Which of the
following modifiable risk factors should the nurse emphasize?
, A) Age
B) Gender
C) Hypertension
D) Family history
Correct Answer: C) Hypertension
Rationale: Hypertension is the most important modifiable risk factor for stroke. Controlling blood
pressure significantly reduces stroke risk. Age, gender, and family history are non-modifiable risk factors.
The nurse should focus education on lifestyle modifications and medication adherence for hypertension
control.
Question 8
A stroke client is being discharged with a referral for outpatient speech therapy. The client asks why
speech therapy is needed since they can speak clearly. Which of the following is the nurse's best
response?
A) "Speech therapy is for communication and swallowing, which may be affected after stroke."
B) "If you can speak clearly, you probably don't need speech therapy."
C) "You need speech therapy to prevent another stroke."
D) "Your healthcare provider ordered it, so you should go."
Correct Answer: A) "Speech therapy is for communication and swallowing, which may be affected
after stroke."
Rationale: Speech-language pathologists assess and treat communication (expressive and receptive
aphasia) and swallowing disorders (dysphagia) after stroke. Even if the client speaks clearly, other
deficits may be present. The nurse should explain the purpose of the referral and encourage
participation.
Question 9
A nurse is evaluating a stroke client's readiness for discharge. Which of the following is the most
important factor in determining discharge readiness?
A) Client's ability to perform activities of daily living (ADLs)
B) Family's ability to provide care
C) Client's mood and motivation
D) Client's medical stability and functional status
Discharge &
Prevention Exam
Questions (Verified
Answers)
Question 1
A nurse is providing discharge education to a client who has experienced a stroke. The client has mild
left-sided weakness and requires assistance with ambulation. Which of the following is the most
appropriate discharge recommendation?
A) Discharge to home with home health physical therapy
B) Discharge to a skilled nursing facility for long-term care
C) Discharge to an inpatient rehabilitation facility
D) Discharge to home with family member supervision only
Correct Answer: C) Discharge to an inpatient rehabilitation facility
Rationale: Clients with mild to moderate functional deficits following a stroke who can tolerate 3 hours
of therapy per day benefit most from inpatient rehabilitation. This setting provides intensive physical,
occupational, and speech therapy to maximize functional recovery. Home health may be appropriate for
clients with minimal deficits, while skilled nursing is for those who cannot tolerate intensive therapy.
Question 2
,A stroke survivor is being discharged home. The client's spouse expresses concern about caregiving
responsibilities. Which of the following is the nurse's best response?
A) "You will learn as you go along. It will get easier."
B) "I can provide you with a list of community resources and support groups."
C) "You should consider placing your spouse in a nursing home."
D) "Your spouse will recover fully, so don't worry."
Correct Answer: B) "I can provide you with a list of community resources and support groups."
Rationale: Caregiver burden is common after stroke. Providing resources and support groups helps
prepare the caregiver for the challenges ahead. The nurse should validate the spouse's concerns and
offer practical assistance. Dismissing concerns or making false promises is not appropriate.
Question 3
A client who had a stroke 2 weeks ago is being discharged. The client has a new prescription for warfarin
for atrial fibrillation. Which of the following instructions should the nurse include in discharge teaching?
A) "Take ibuprofen for headaches as needed."
B) "Monitor for signs of bleeding such as bruising or blood in urine."
C) "Avoid all green leafy vegetables to prevent bleeding."
D) "Have your INR checked every 6 months."
Correct Answer: B) "Monitor for signs of bleeding such as bruising or blood in urine."
Rationale: Warfarin increases bleeding risk. Clients should be taught to monitor for signs of bleeding,
including bruising, petechiae, hematuria, and gum bleeding. NSAIDs should be avoided. Green leafy
vegetables contain vitamin K and should be consumed consistently, not avoided completely. INR should
be checked regularly, often weekly to monthly.
Question 4
A nurse is assessing a stroke client's risk for falls prior to discharge. Which of the following factors places
the client at highest risk for falls?
A) Age over 65 years
B) History of hypertension
C) Hemiparesis and impaired balance
D) Use of one medication
Correct Answer: C) Hemiparesis and impaired balance
,Rationale: Hemiparesis and impaired balance are significant risk factors for falls after stroke. These
deficits directly affect mobility and stability. Age and hypertension are also risk factors but are not as
directly related to fall risk. Polypharmacy, not just one medication, increases fall risk.
Question 5
A stroke client is being discharged home with a prescription for aspirin 81 mg daily for secondary stroke
prevention. Which of the following statements by the client indicates understanding of the medication?
A) "I will take this medication only when I have headaches."
B) "I will take this medication every morning with food to prevent stomach upset."
C) "I can stop this medication if I feel fine."
D) "I will double the dose if I miss a day."
Correct Answer: B) "I will take this medication every morning with food to prevent stomach upset."
Rationale: Aspirin should be taken daily as prescribed, typically with food to reduce gastrointestinal
irritation. It should not be taken only for headaches. The client should not stop or adjust the dose without
consulting the healthcare provider. Missing a dose should be handled as directed, not by doubling the
dose.
Question 6
A client who had a stroke is being discharged. The client has moderate dysphagia and requires a
modified diet. Which of the following diet textures is most appropriate?
A) Regular diet with thin liquids
B) Mechanical soft diet with thickened liquids
C) Pureed diet with nectar-thick liquids
D) Clear liquid diet only
Correct Answer: C) Pureed diet with nectar-thick liquids
Rationale: A client with moderate dysphagia may require a pureed diet and thickened liquids (nectar-
thick) to reduce aspiration risk. The diet consistency should be based on a speech-language pathologist's
recommendation. Regular and mechanical soft diets may be too challenging. A clear liquid diet is not
nutritionally adequate for long-term use.
Question 7
A nurse is providing discharge teaching to a stroke client about preventing future strokes. Which of the
following modifiable risk factors should the nurse emphasize?
, A) Age
B) Gender
C) Hypertension
D) Family history
Correct Answer: C) Hypertension
Rationale: Hypertension is the most important modifiable risk factor for stroke. Controlling blood
pressure significantly reduces stroke risk. Age, gender, and family history are non-modifiable risk factors.
The nurse should focus education on lifestyle modifications and medication adherence for hypertension
control.
Question 8
A stroke client is being discharged with a referral for outpatient speech therapy. The client asks why
speech therapy is needed since they can speak clearly. Which of the following is the nurse's best
response?
A) "Speech therapy is for communication and swallowing, which may be affected after stroke."
B) "If you can speak clearly, you probably don't need speech therapy."
C) "You need speech therapy to prevent another stroke."
D) "Your healthcare provider ordered it, so you should go."
Correct Answer: A) "Speech therapy is for communication and swallowing, which may be affected
after stroke."
Rationale: Speech-language pathologists assess and treat communication (expressive and receptive
aphasia) and swallowing disorders (dysphagia) after stroke. Even if the client speaks clearly, other
deficits may be present. The nurse should explain the purpose of the referral and encourage
participation.
Question 9
A nurse is evaluating a stroke client's readiness for discharge. Which of the following is the most
important factor in determining discharge readiness?
A) Client's ability to perform activities of daily living (ADLs)
B) Family's ability to provide care
C) Client's mood and motivation
D) Client's medical stability and functional status
