QUIZ 9 – MS, CVA, AND SPINAL CORD INJURY REVIEW 2025 – 130
MOST TESTED QUESTIONS WITH ANSWERS (GRADED A+)
A patient has weakness on the right side and impaired reasoning after having a cerebrovascular
accident (CVA). What part of the brain is affected?
a. Left hemisphere of the cerebrum
b. Right hemisphere of the cerebrum
c. Left cerebellum
d. Right cerebellum - ANSWER****a. Left hemisphere of the cerebrum
Impaired motor strength on the right side in conjunction with impaired reasoning indicates a
lesion in the left hemisphere of the cerebrum. The cerebellum controls balance and is not
contralateral.
Which patient is at the greatest risk for a CVA?
a. A 20-year-old obese Latin woman who is taking birth control pills
b. A 40-year-old athletic white man with a family history of CVA
c. A 60-year-old Asian woman who smokes occasionally
d. A 65-year-old African American man with hypertension - ANSWER****d. A 65-year-old
African American man with hypertension
Older African Americans have a higher incidence of CVA than occasional smokers, young
persons, or athletes. Hypertension increases the risk.
A patient experienced a period of momentary confusion, dizziness, and slurred speech but
recovered in 2 hours. Which assessment in the diagnosis of this episode would be most helpful?
a. Patients complaint of nausea
b. Blood pressure (BP) of 140/90 mm Hg
c. Patients complaint of headache
d. Auscultation of a bruit over the carotid artery - ANSWER****d. Auscultation of a bruit over
the carotid artery
,A carotid bruit is evidence of a narrowing in that vessel, a symptom of a possible CVA or
transient ischemic attack (TIA). BP of 140/90 mm Hg, although at the high end, is considered
within normal limits. Headache and nausea alone are too common to be definitive.
A nurse is updating a teaching plan for a patient who sustained a TIA. What should the nurse be
sure to include?
a. Daily aspirin dose
b. Long rest periods daily
c. Reduction of fluid intake to 800 mL/day
d. High-carbohydrate diet - ANSWER****a. Daily aspirin dose
Daily aspirin reduces platelet aggregation and may prevent another attack. Reductions of fluid
and long rest periods encourage clot formation.
A patient recovering from a CVA asks the purpose of the warfarin (Coumadin). What is the best
response by the nurse regarding the purpose of Coumadin?
a. Dissolves the clot.
b. Prevents the formation of new clots.
c. Dilates the vessels to improve blood flow.
d. Suppresses the formation of platelets. - ANSWER****b. Prevents the formation of new
clots.
Coumadin and heparin prevent more clots rather than dissolving them. Coumadin has no effect
on vasodilation or blood cell production.
A patient has had a complete stroke as a result of a ruptured vessel in the left hemisphere. How
should this patients CVA be classified?
a. Ischemic, embolic
b. Hemorrhagic, subarachnoid
,c. Hemorrhagic, intracerebral
d. Ischemic, thrombotic - ANSWER****c. Hemorrhagic, intracerebral
A ruptured vessel in a hemisphere is an intracerebral hemorrhagic CVA. It did not occur in the
subarachnoid space. Ischemic CVAs are the result of occluded vessels.
What should a nurse ensure as a priority for a patient immediately after a CVA?
a. Preservation of motor function
b. Airway maintenance
c. Adequate hydration
d. Control of elimination - ANSWER****b. Airway maintenance
Adequate oxygenation prevents hypoxemia, which can extend and worsen effects of the CVA.
When should a nurse recognize that the acute phase of a CVA has ended?
a. Forty-eight hours has passed from its onset.
b. The patient begins to respond verbally.
c. BP drops.
d. Vital signs and neurologic signs stabilize. - ANSWER****d. Vital signs and neurologic signs
stabilize.
When the vital and neurologic signs stabilize, the acute phase has ended. Verbal response,
lower BP, and the passage of time without other signs are not adequate evidence that the acute
phase has ended.
A patient in the acute phase of a CVA who has been speaking distinctly begins to speak
indistinctly and only with great effort but still coherent. What should this nurse determine when
assessing this patient?
a. Stroke in evolution with dysarthria
, b. Lacunar stroke with fluent aphasia
c. Complete stroke with global aphasia
d. Stroke in evolution with dyspraxia - ANSWER****a. Stroke in evolution with dysarthria
As symptoms worsen, the CVA is still evolving. Speech that is coherent but difficult is dysarthria
rather than any type of aphasia. Dyspraxia is a motor impairment, not a speech impairment.
Several days after a CVA, a patients family asks a nurse if tissue plasminogen activator (tPA) is a
drug therapy option now. The nurses response is based on the knowledge that this drug must
be used within how many hours after the onset of symptoms?
a. 3
b. 5
c. 1
d. 24 - ANSWER****a. 3
tPA is to be given within 3 hours of the onset of symptoms per the U.S. Food and Drug
Administrations guidelines. In some special treatment centers this drug is given intravenously
up to 6 hours after the stroke.
A nurse explains that a lumbar puncture is most helpful as a diagnostic tool for a new patient
who has had a CVA. What would this diagnostic test help determine regarding the stroke
a. It is lacunar.
b. It is hemorrhagic or embolic.
c. It is complete or in evolution.
d. It will result in paralysis. - ANSWER****b. It is hemorrhagic or embolic.
Blood in the spinal fluid indicates a hemorrhagic stroke and will help direct medical protocol in
the subsequent treatment.
MOST TESTED QUESTIONS WITH ANSWERS (GRADED A+)
A patient has weakness on the right side and impaired reasoning after having a cerebrovascular
accident (CVA). What part of the brain is affected?
a. Left hemisphere of the cerebrum
b. Right hemisphere of the cerebrum
c. Left cerebellum
d. Right cerebellum - ANSWER****a. Left hemisphere of the cerebrum
Impaired motor strength on the right side in conjunction with impaired reasoning indicates a
lesion in the left hemisphere of the cerebrum. The cerebellum controls balance and is not
contralateral.
Which patient is at the greatest risk for a CVA?
a. A 20-year-old obese Latin woman who is taking birth control pills
b. A 40-year-old athletic white man with a family history of CVA
c. A 60-year-old Asian woman who smokes occasionally
d. A 65-year-old African American man with hypertension - ANSWER****d. A 65-year-old
African American man with hypertension
Older African Americans have a higher incidence of CVA than occasional smokers, young
persons, or athletes. Hypertension increases the risk.
A patient experienced a period of momentary confusion, dizziness, and slurred speech but
recovered in 2 hours. Which assessment in the diagnosis of this episode would be most helpful?
a. Patients complaint of nausea
b. Blood pressure (BP) of 140/90 mm Hg
c. Patients complaint of headache
d. Auscultation of a bruit over the carotid artery - ANSWER****d. Auscultation of a bruit over
the carotid artery
,A carotid bruit is evidence of a narrowing in that vessel, a symptom of a possible CVA or
transient ischemic attack (TIA). BP of 140/90 mm Hg, although at the high end, is considered
within normal limits. Headache and nausea alone are too common to be definitive.
A nurse is updating a teaching plan for a patient who sustained a TIA. What should the nurse be
sure to include?
a. Daily aspirin dose
b. Long rest periods daily
c. Reduction of fluid intake to 800 mL/day
d. High-carbohydrate diet - ANSWER****a. Daily aspirin dose
Daily aspirin reduces platelet aggregation and may prevent another attack. Reductions of fluid
and long rest periods encourage clot formation.
A patient recovering from a CVA asks the purpose of the warfarin (Coumadin). What is the best
response by the nurse regarding the purpose of Coumadin?
a. Dissolves the clot.
b. Prevents the formation of new clots.
c. Dilates the vessels to improve blood flow.
d. Suppresses the formation of platelets. - ANSWER****b. Prevents the formation of new
clots.
Coumadin and heparin prevent more clots rather than dissolving them. Coumadin has no effect
on vasodilation or blood cell production.
A patient has had a complete stroke as a result of a ruptured vessel in the left hemisphere. How
should this patients CVA be classified?
a. Ischemic, embolic
b. Hemorrhagic, subarachnoid
,c. Hemorrhagic, intracerebral
d. Ischemic, thrombotic - ANSWER****c. Hemorrhagic, intracerebral
A ruptured vessel in a hemisphere is an intracerebral hemorrhagic CVA. It did not occur in the
subarachnoid space. Ischemic CVAs are the result of occluded vessels.
What should a nurse ensure as a priority for a patient immediately after a CVA?
a. Preservation of motor function
b. Airway maintenance
c. Adequate hydration
d. Control of elimination - ANSWER****b. Airway maintenance
Adequate oxygenation prevents hypoxemia, which can extend and worsen effects of the CVA.
When should a nurse recognize that the acute phase of a CVA has ended?
a. Forty-eight hours has passed from its onset.
b. The patient begins to respond verbally.
c. BP drops.
d. Vital signs and neurologic signs stabilize. - ANSWER****d. Vital signs and neurologic signs
stabilize.
When the vital and neurologic signs stabilize, the acute phase has ended. Verbal response,
lower BP, and the passage of time without other signs are not adequate evidence that the acute
phase has ended.
A patient in the acute phase of a CVA who has been speaking distinctly begins to speak
indistinctly and only with great effort but still coherent. What should this nurse determine when
assessing this patient?
a. Stroke in evolution with dysarthria
, b. Lacunar stroke with fluent aphasia
c. Complete stroke with global aphasia
d. Stroke in evolution with dyspraxia - ANSWER****a. Stroke in evolution with dysarthria
As symptoms worsen, the CVA is still evolving. Speech that is coherent but difficult is dysarthria
rather than any type of aphasia. Dyspraxia is a motor impairment, not a speech impairment.
Several days after a CVA, a patients family asks a nurse if tissue plasminogen activator (tPA) is a
drug therapy option now. The nurses response is based on the knowledge that this drug must
be used within how many hours after the onset of symptoms?
a. 3
b. 5
c. 1
d. 24 - ANSWER****a. 3
tPA is to be given within 3 hours of the onset of symptoms per the U.S. Food and Drug
Administrations guidelines. In some special treatment centers this drug is given intravenously
up to 6 hours after the stroke.
A nurse explains that a lumbar puncture is most helpful as a diagnostic tool for a new patient
who has had a CVA. What would this diagnostic test help determine regarding the stroke
a. It is lacunar.
b. It is hemorrhagic or embolic.
c. It is complete or in evolution.
d. It will result in paralysis. - ANSWER****b. It is hemorrhagic or embolic.
Blood in the spinal fluid indicates a hemorrhagic stroke and will help direct medical protocol in
the subsequent treatment.
