Stroke - Practice Questions
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1. After a patient experienced a brief c. oral low-dose aspirin therapy.
episode of tinnitus, diplopia, and
dysarthria with no residual effects, the The patient's symptoms are consistent with
nurse anticipates teaching the patient transient ischemic attack (TIA), and drugs that
about inhibit platelet aggregation are prescribed af-
ter a TIA to prevent stroke. Continuous heparin
a. cerebral aneurysm clipping. infusion is not routinely used after TIA or with
b. heparin intravenous infusion. acute ischemic stroke. The patient's symptoms
c. oral low-dose aspirin therapy. are not consistent with a cerebral aneurysm.
d. tissue plasminogen activator (tPA). tPA is used only for acute ischemic stroke, not
for TIA.
2. A 68-year-old patient is being admitted c. The patient reports that symptoms began
with a possible stroke. Which information with a severe headache.
from the assessment indicates that the
nurse should consult with the health care A sudden onset headache is typical of a sub-
provider before giving the prescribed as- arachnoid hemorrhage, and aspirin is con-
pirin? traindicated. Atrial fibrillation, dysphasia, and
transient ischemic attack (TIA) are not con-
a. The patient has dysphasia. traindications to aspirin use, so the nurse can
b. The patient has atrial fibrillation. administer the aspirin.
c. The patient reports that symptoms be-
gan with a severe headache.
d. The patient has a history of brief
episodes of right-sided hemiplegia.
3. A 73-year-old patient with a stroke expe- d. Difficulty comprehending instructions
riences facial drooping on the right side
and right-sided arm and leg paralysis. Right-sided paralysis indicates a left-brain
When admitting the patient, which clini- stroke, which will lead to difficulty with com-
cal manifestation will the nurse expect to prehension and use of language. The left-side
find? reflexes are likely to be intact. Impulsive behav-
, Stroke - Practice Questions
Study online at https://quizlet.com/_8mo6fp
ior and neglect are more likely with a right-side
a. Impulsive behavior stroke.
b. Right-sided neglect
c. Hyperactive left-sided tendon reflexes
d. Difficulty comprehending instructions
4. During the change of shift report a nurse c. visual deficits.
is told that a patient has an occluded left
posterior cerebral artery. The nurse will Visual disturbances are expected with poste-
anticipate that the patient may have rior cerebral artery occlusion. Aphasia occurs
with middle cerebral artery involvement. Cog-
a. dysphasia. nitive deficits and changes in judgment are
b. confusion. more typical of anterior cerebral artery occlu-
c. visual deficits. sion.
d. poor judgment.
5. When teaching about clopidogrel (Plav- b. to call the health care provider if stools are
ix), the nurse will tell the patient with tarry.
cerebral atherosclerosis
Clopidogrel inhibits platelet function and in-
a. to monitor and record the blood pres- creases the risk for gastrointestinal bleeding,
sure daily. so patients should be advised to notify the
b. to call the health care provider if stools health care provider about any signs of bleed-
are tarry. ing. The medication does not lower blood
c. that clopidogrel will dissolve clots in the pressure, decrease plaque formation, or dis-
cerebral arteries. solve
d. that clopidogrel will reduce cerebral
artery plaque formation.
6. A patient with carotid atherosclerosis a. "The obstructing plaque is surgically re-
asks the nurse to describe a carotid en- moved from an artery in the neck."
darterectomy. Which response by the
nurse is accurate? In a carotid endarterectomy, the carotid artery
, Stroke - Practice Questions
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is incised and the plaque is removed. The re-
a. "The obstructing plaque is surgically sponse beginning, "The diseased portion of
removed from an artery in the neck." the artery in the brain is replaced" describes
b. "The diseased portion of the artery an arterial graft procedure. The answer be-
in the brain is replaced with a synthetic ginning, "A catheter with a deflated balloon is
graft." positioned at the narrow area" describes an
c. "A wire is threaded through an artery angioplasty. The final response beginning, "A
in the leg to the clots in the carotid artery wire is threaded through the artery" describes
and the clots are removed." the mechanical embolus removal in cerebral
d. "A catheter with a deflated balloon is ischemia (MERCI) procedure.
positioned at the narrow area, and the
balloon is inflated to flatten the plaque."
7. A patient admitted with possible stroke d. Administer a labetalol (Normodyne) drip to
has been aphasic for 3 hours and his keep BP less than 140/90 mm Hg.
current blood pressure (BP) is 174/94
mm Hg. Which order by the health care Because elevated BP may be a protective re-
provider should the nurse question? sponse to maintain cerebral perfusion, anti-
hypertensive therapy is recommended only if
a. Keep head of bed elevated at least 30 mean arterial pressure (MAP) is >130 mm Hg
degrees. or systolic pressure is >220 mm Hg. Fluid in-
b. Infuse normal saline intravenously at take should be 1500 to 2000 mL daily to main-
75 mL/hr. tain cerebral blood flow. The head of the bed
c. Administer tissue plasminogen activa- should be elevated to at least 30 degrees, un-
tor (tPA) per protocol. less the patient has symptoms of poor tissue
d. Administer a labetalol (Normodyne) perfusion. tPA may be administered if the pa-
drip to keep BP less than 140/90 mm Hg. tient meets the other criteria for tPA use.
8. A 56-year-old patient arrives in the emer- d. tissue plasminogen activator (tPA) infusion.
gency department with hemiparesis and
dysarthria that started 2 hours previous- The patient's history and clinical manifestations
ly, and health records show a history of suggest an acute ischemic stroke and a patient
who is seen within 4.5 hours of stroke onset
, Stroke - Practice Questions
Study online at https://quizlet.com/_8mo6fp
several transient ischemic attacks (TIAs). is likely to receive tPA (after screening with a
The nurse anticipates preparing the pa- CT scan). Heparin administration in the emer-
tient for gency phase is not indicated. Emergent carotid
transluminal angioplasty or endarterectomy is
a. surgical endarterectomy. not indicated for the patient who is having an
b. transluminal angioplasty. acute ischemic stroke.
c. intravenous heparin administration.
d. tissue plasminogen activator (tPA) infu-
sion.
9. A female patient who had a stroke 24 a. ask questions that the patient can answer
hours ago has expressive aphasia. The with "yes" or "no."
nurse identifies the nursing diagnosis of
impaired verbal communication. An ap- Communication will be facilitated and less
propriate nursing intervention to help frustrating to the patient when questions that
the patient communicate is to require a "yes" or "no" response are used.
When the language areas of the brain are in-
a. ask questions that the patient can an- jured, the patient might not be able to read
swer with "yes" or "no." or recite words, which will frustrate the patient
b. develop a list of words that the patient without improving communication. Expressive
can read and practice reciting. aphasia is caused by damage to the language
c. have the patient practice her facial and areas of the brain, not by the areas that control
tongue exercises with a mirror. the motor aspects of speech. The nurse should
d. prevent embarrassing the patient by allow time for the patient to respond.
answering for her if she does not re-
spond.
10. For a patient who had a right hemisphere b. risk for injury related to denial of deficits and
stroke, the nurse anticipates planning in- impulsiveness.
terventions to manage
The patient with right-sided brain damage typ-
a. impaired physical mobility related to ically denies any deficits and has poor impulse
right-sided hemiplegia. control, leading to risk for injury when the
Study online at https://quizlet.com/_8mo6fp
1. After a patient experienced a brief c. oral low-dose aspirin therapy.
episode of tinnitus, diplopia, and
dysarthria with no residual effects, the The patient's symptoms are consistent with
nurse anticipates teaching the patient transient ischemic attack (TIA), and drugs that
about inhibit platelet aggregation are prescribed af-
ter a TIA to prevent stroke. Continuous heparin
a. cerebral aneurysm clipping. infusion is not routinely used after TIA or with
b. heparin intravenous infusion. acute ischemic stroke. The patient's symptoms
c. oral low-dose aspirin therapy. are not consistent with a cerebral aneurysm.
d. tissue plasminogen activator (tPA). tPA is used only for acute ischemic stroke, not
for TIA.
2. A 68-year-old patient is being admitted c. The patient reports that symptoms began
with a possible stroke. Which information with a severe headache.
from the assessment indicates that the
nurse should consult with the health care A sudden onset headache is typical of a sub-
provider before giving the prescribed as- arachnoid hemorrhage, and aspirin is con-
pirin? traindicated. Atrial fibrillation, dysphasia, and
transient ischemic attack (TIA) are not con-
a. The patient has dysphasia. traindications to aspirin use, so the nurse can
b. The patient has atrial fibrillation. administer the aspirin.
c. The patient reports that symptoms be-
gan with a severe headache.
d. The patient has a history of brief
episodes of right-sided hemiplegia.
3. A 73-year-old patient with a stroke expe- d. Difficulty comprehending instructions
riences facial drooping on the right side
and right-sided arm and leg paralysis. Right-sided paralysis indicates a left-brain
When admitting the patient, which clini- stroke, which will lead to difficulty with com-
cal manifestation will the nurse expect to prehension and use of language. The left-side
find? reflexes are likely to be intact. Impulsive behav-
, Stroke - Practice Questions
Study online at https://quizlet.com/_8mo6fp
ior and neglect are more likely with a right-side
a. Impulsive behavior stroke.
b. Right-sided neglect
c. Hyperactive left-sided tendon reflexes
d. Difficulty comprehending instructions
4. During the change of shift report a nurse c. visual deficits.
is told that a patient has an occluded left
posterior cerebral artery. The nurse will Visual disturbances are expected with poste-
anticipate that the patient may have rior cerebral artery occlusion. Aphasia occurs
with middle cerebral artery involvement. Cog-
a. dysphasia. nitive deficits and changes in judgment are
b. confusion. more typical of anterior cerebral artery occlu-
c. visual deficits. sion.
d. poor judgment.
5. When teaching about clopidogrel (Plav- b. to call the health care provider if stools are
ix), the nurse will tell the patient with tarry.
cerebral atherosclerosis
Clopidogrel inhibits platelet function and in-
a. to monitor and record the blood pres- creases the risk for gastrointestinal bleeding,
sure daily. so patients should be advised to notify the
b. to call the health care provider if stools health care provider about any signs of bleed-
are tarry. ing. The medication does not lower blood
c. that clopidogrel will dissolve clots in the pressure, decrease plaque formation, or dis-
cerebral arteries. solve
d. that clopidogrel will reduce cerebral
artery plaque formation.
6. A patient with carotid atherosclerosis a. "The obstructing plaque is surgically re-
asks the nurse to describe a carotid en- moved from an artery in the neck."
darterectomy. Which response by the
nurse is accurate? In a carotid endarterectomy, the carotid artery
, Stroke - Practice Questions
Study online at https://quizlet.com/_8mo6fp
is incised and the plaque is removed. The re-
a. "The obstructing plaque is surgically sponse beginning, "The diseased portion of
removed from an artery in the neck." the artery in the brain is replaced" describes
b. "The diseased portion of the artery an arterial graft procedure. The answer be-
in the brain is replaced with a synthetic ginning, "A catheter with a deflated balloon is
graft." positioned at the narrow area" describes an
c. "A wire is threaded through an artery angioplasty. The final response beginning, "A
in the leg to the clots in the carotid artery wire is threaded through the artery" describes
and the clots are removed." the mechanical embolus removal in cerebral
d. "A catheter with a deflated balloon is ischemia (MERCI) procedure.
positioned at the narrow area, and the
balloon is inflated to flatten the plaque."
7. A patient admitted with possible stroke d. Administer a labetalol (Normodyne) drip to
has been aphasic for 3 hours and his keep BP less than 140/90 mm Hg.
current blood pressure (BP) is 174/94
mm Hg. Which order by the health care Because elevated BP may be a protective re-
provider should the nurse question? sponse to maintain cerebral perfusion, anti-
hypertensive therapy is recommended only if
a. Keep head of bed elevated at least 30 mean arterial pressure (MAP) is >130 mm Hg
degrees. or systolic pressure is >220 mm Hg. Fluid in-
b. Infuse normal saline intravenously at take should be 1500 to 2000 mL daily to main-
75 mL/hr. tain cerebral blood flow. The head of the bed
c. Administer tissue plasminogen activa- should be elevated to at least 30 degrees, un-
tor (tPA) per protocol. less the patient has symptoms of poor tissue
d. Administer a labetalol (Normodyne) perfusion. tPA may be administered if the pa-
drip to keep BP less than 140/90 mm Hg. tient meets the other criteria for tPA use.
8. A 56-year-old patient arrives in the emer- d. tissue plasminogen activator (tPA) infusion.
gency department with hemiparesis and
dysarthria that started 2 hours previous- The patient's history and clinical manifestations
ly, and health records show a history of suggest an acute ischemic stroke and a patient
who is seen within 4.5 hours of stroke onset
, Stroke - Practice Questions
Study online at https://quizlet.com/_8mo6fp
several transient ischemic attacks (TIAs). is likely to receive tPA (after screening with a
The nurse anticipates preparing the pa- CT scan). Heparin administration in the emer-
tient for gency phase is not indicated. Emergent carotid
transluminal angioplasty or endarterectomy is
a. surgical endarterectomy. not indicated for the patient who is having an
b. transluminal angioplasty. acute ischemic stroke.
c. intravenous heparin administration.
d. tissue plasminogen activator (tPA) infu-
sion.
9. A female patient who had a stroke 24 a. ask questions that the patient can answer
hours ago has expressive aphasia. The with "yes" or "no."
nurse identifies the nursing diagnosis of
impaired verbal communication. An ap- Communication will be facilitated and less
propriate nursing intervention to help frustrating to the patient when questions that
the patient communicate is to require a "yes" or "no" response are used.
When the language areas of the brain are in-
a. ask questions that the patient can an- jured, the patient might not be able to read
swer with "yes" or "no." or recite words, which will frustrate the patient
b. develop a list of words that the patient without improving communication. Expressive
can read and practice reciting. aphasia is caused by damage to the language
c. have the patient practice her facial and areas of the brain, not by the areas that control
tongue exercises with a mirror. the motor aspects of speech. The nurse should
d. prevent embarrassing the patient by allow time for the patient to respond.
answering for her if she does not re-
spond.
10. For a patient who had a right hemisphere b. risk for injury related to denial of deficits and
stroke, the nurse anticipates planning in- impulsiveness.
terventions to manage
The patient with right-sided brain damage typ-
a. impaired physical mobility related to ically denies any deficits and has poor impulse
right-sided hemiplegia. control, leading to risk for injury when the
