NSG 3250 Adult Health I Exams 3 and 4
Review – 50 Questions with Correct
Answers in Each Exam/ NSG 3250 Exam
3/ NSG 3250 Exam 4
Questions 1–50: Exam 3 (Neurological & Sensory Disorders)
1. A patient presents to the emergency department with sudden-
onset right-sided weakness and slurred speech that began 2 hours
ago. What is the nurse’s priority action?
A) Obtain a full set of vital signs
B) Start an IV line of normal saline
C) Prepare for immediate CT scan without contrast
D) Administer aspirin 325 mg orally
✅ Correct ,,,,answer,,,,: C
Rationale: A non-contrast head CT is the priority to distinguish
ischemic from hemorrhagic stroke before any thrombolytic or
antiplatelet therapy is given. Time is brain – the CT must be obtained as
quickly as possible.
2. Which blood pressure reading would be an absolute
contraindication to administering IV alteplase (tPA) for acute
ischemic stroke?
,A) 150/90 mm Hg
B) 170/100 mm Hg
C) 185/110 mm Hg
D) 195/115 mm Hg
✅ Correct ,,,,answer,,,,: D
Rationale: tPA requires BP ≤185/110 mm Hg. A reading of 195/115
mm Hg is above the safe threshold and significantly increases the risk of
hemorrhagic conversion.
3. A client with a left-hemisphere stroke is most likely to exhibit
which clinical manifestation?
A) Left-sided neglect
B) Impulsive behavior
C) Expressive aphasia
D) Poor judgment
✅ Correct ,,,,answer,,,,: C
Rationale: Left-hemisphere strokes typically affect language centers
(Broca’s or Wernicke’s area), leading to aphasia. Right-hemisphere
strokes cause left neglect, impulsivity, and poor judgment.
4. The nurse is caring for a patient with a right-hemisphere stroke.
Which finding is consistent with this diagnosis?
A) Right-sided hemiplegia
B) Aware of deficits
C) Loss of depth perception
D) Slow, cautious behavior
✅ Correct ,,,,answer,,,,: C
,Rationale: Right-hemisphere damage often causes spatial-perceptual
problems, including loss of depth perception, left-sided neglect, and
impulsive behavior.
5. Within what time window must IV tPA be administered from the
patient’s last known normal (LSN) time?
A) 1 hour
B) 3 hours
C) 4.5 hours
D) 6 hours
✅ Correct ,,,,answer,,,,: C
Rationale: The approved window for IV tPA in eligible patients is
within 3 hours, but up to 4.5 hours for certain patients (e.g., under 80, no
diabetes, NIHSS <25). After 4.5 hours, benefit is outweighed by risk.
6. A patient with acute ischemic stroke has a BP of 210/120 mm Hg
and is not a candidate for tPA. What is the appropriate nursing
action?
A) Administer IV labetalol immediately
B) Maintain head of bed flat and recheck BP in 15 minutes
C) Notify the provider and prepare for BP reduction if >220/120 mm Hg
D) Start a nicardipine drip at 10 mg/hour
✅ Correct ,,,,answer,,,,: C
Rationale: In non-tPA patients, permissive hypertension is allowed up
to 220/120 mm Hg to preserve cerebral perfusion. BP is only treated if it
exceeds that level or there are other end-organ concerns.
7. The nurse is preparing to perform a swallow screen on a stroke
patient. Which finding indicates the patient should remain NPO?
A) Hoarse voice after swallowing 5 mL water
, B) Intact gag reflex
C) Clear speech after the test
D) Ability to cough on command
✅ Correct ,,,,answer,,,,: A
Rationale: Hoarseness or change in voice after swallowing is a sign of
aspiration. An intact gag reflex and ability to cough do not guarantee
safe swallowing; a formal swallow evaluation is needed.
8. A patient with a suspected stroke has a blood glucose of 45
mg/dL. What is the nurse’s priority intervention?
A) Administer IV tPA immediately
B) Give 50% dextrose IV push
C) Repeat the glucose check in 30 minutes
D) Order a non-contrast head CT
✅ Correct ,,,,answer,,,,: B
Rationale: Hypoglycemia can mimic stroke symptoms. Treat
hypoglycemia first (IV dextrose) and then reassess the patient. tPA is
contraindicated until hypoglycemia is corrected and symptoms persist.
9. The nurse is teaching a patient about modifiable risk factors for
stroke. Which factor is the most important to control?
A) Atrial fibrillation
B) Physical inactivity
C) Hypertension
D) Diabetes mellitus
✅ Correct ,,,,answer,,,,: C
Rationale: Hypertension is the single most important modifiable risk
factor for both ischemic and hemorrhagic stroke. Controlling BP reduces
stroke risk by approximately 40%.
Review – 50 Questions with Correct
Answers in Each Exam/ NSG 3250 Exam
3/ NSG 3250 Exam 4
Questions 1–50: Exam 3 (Neurological & Sensory Disorders)
1. A patient presents to the emergency department with sudden-
onset right-sided weakness and slurred speech that began 2 hours
ago. What is the nurse’s priority action?
A) Obtain a full set of vital signs
B) Start an IV line of normal saline
C) Prepare for immediate CT scan without contrast
D) Administer aspirin 325 mg orally
✅ Correct ,,,,answer,,,,: C
Rationale: A non-contrast head CT is the priority to distinguish
ischemic from hemorrhagic stroke before any thrombolytic or
antiplatelet therapy is given. Time is brain – the CT must be obtained as
quickly as possible.
2. Which blood pressure reading would be an absolute
contraindication to administering IV alteplase (tPA) for acute
ischemic stroke?
,A) 150/90 mm Hg
B) 170/100 mm Hg
C) 185/110 mm Hg
D) 195/115 mm Hg
✅ Correct ,,,,answer,,,,: D
Rationale: tPA requires BP ≤185/110 mm Hg. A reading of 195/115
mm Hg is above the safe threshold and significantly increases the risk of
hemorrhagic conversion.
3. A client with a left-hemisphere stroke is most likely to exhibit
which clinical manifestation?
A) Left-sided neglect
B) Impulsive behavior
C) Expressive aphasia
D) Poor judgment
✅ Correct ,,,,answer,,,,: C
Rationale: Left-hemisphere strokes typically affect language centers
(Broca’s or Wernicke’s area), leading to aphasia. Right-hemisphere
strokes cause left neglect, impulsivity, and poor judgment.
4. The nurse is caring for a patient with a right-hemisphere stroke.
Which finding is consistent with this diagnosis?
A) Right-sided hemiplegia
B) Aware of deficits
C) Loss of depth perception
D) Slow, cautious behavior
✅ Correct ,,,,answer,,,,: C
,Rationale: Right-hemisphere damage often causes spatial-perceptual
problems, including loss of depth perception, left-sided neglect, and
impulsive behavior.
5. Within what time window must IV tPA be administered from the
patient’s last known normal (LSN) time?
A) 1 hour
B) 3 hours
C) 4.5 hours
D) 6 hours
✅ Correct ,,,,answer,,,,: C
Rationale: The approved window for IV tPA in eligible patients is
within 3 hours, but up to 4.5 hours for certain patients (e.g., under 80, no
diabetes, NIHSS <25). After 4.5 hours, benefit is outweighed by risk.
6. A patient with acute ischemic stroke has a BP of 210/120 mm Hg
and is not a candidate for tPA. What is the appropriate nursing
action?
A) Administer IV labetalol immediately
B) Maintain head of bed flat and recheck BP in 15 minutes
C) Notify the provider and prepare for BP reduction if >220/120 mm Hg
D) Start a nicardipine drip at 10 mg/hour
✅ Correct ,,,,answer,,,,: C
Rationale: In non-tPA patients, permissive hypertension is allowed up
to 220/120 mm Hg to preserve cerebral perfusion. BP is only treated if it
exceeds that level or there are other end-organ concerns.
7. The nurse is preparing to perform a swallow screen on a stroke
patient. Which finding indicates the patient should remain NPO?
A) Hoarse voice after swallowing 5 mL water
, B) Intact gag reflex
C) Clear speech after the test
D) Ability to cough on command
✅ Correct ,,,,answer,,,,: A
Rationale: Hoarseness or change in voice after swallowing is a sign of
aspiration. An intact gag reflex and ability to cough do not guarantee
safe swallowing; a formal swallow evaluation is needed.
8. A patient with a suspected stroke has a blood glucose of 45
mg/dL. What is the nurse’s priority intervention?
A) Administer IV tPA immediately
B) Give 50% dextrose IV push
C) Repeat the glucose check in 30 minutes
D) Order a non-contrast head CT
✅ Correct ,,,,answer,,,,: B
Rationale: Hypoglycemia can mimic stroke symptoms. Treat
hypoglycemia first (IV dextrose) and then reassess the patient. tPA is
contraindicated until hypoglycemia is corrected and symptoms persist.
9. The nurse is teaching a patient about modifiable risk factors for
stroke. Which factor is the most important to control?
A) Atrial fibrillation
B) Physical inactivity
C) Hypertension
D) Diabetes mellitus
✅ Correct ,,,,answer,,,,: C
Rationale: Hypertension is the single most important modifiable risk
factor for both ischemic and hemorrhagic stroke. Controlling BP reduces
stroke risk by approximately 40%.
