NEURO 57 EXAM WITH QUESTIONS
AND CORRECT VERIFIED ANSWERS
WITH COMPLETE SOLUTIONS
1. After a patient experienced a brief episode of tinnitus, diplopia, and dysarthria
with no residual effects, the nurse anticipates teaching the patient about
a. cerebral aneurysm clipping.
b. heparin intravenous infusion.
c. oral low-dose aspirin therapy.
d. tissue plasminogen activator (tape) - ANSWER - ANS: C The patient’s symptoms
are consistent with transient ischemic attack (TIA), and drugs that inhibit platelet
aggregation are prescribed after a TIA to prevent stroke. Continuous heparin
infusion is not routinely used after TIA or with acute ischemic stroke. The
patient’s symptoms are not consistent with a cerebral aneurysm. tape is used
only for acute ischemic stroke, not for TIA.
2. A 68-year-old patient is being admitted with a possible stroke. Which
information from the assessment indicates that the nurse should consult with the
health care provider before giving the prescribed aspirin?
a. The patient has dysphasia.
b. The patient has atrial fibrillation.
c. The patient reports that symptoms began with a severe headache.
d. The patient has a history of brief episodes of right-sided hemiplegia. - ANSWER
- ANS: C A sudden onset headache is typical of a subarachnoid hemorrhage, and
aspirin is contraindicated. Atrial fibrillation, dysphasia, and transient ischemic
attack (TIA) are not contraindications to aspirin use, so the nurse can administer
the aspirin.
,3. A 73-year-old patient with a stroke experiences facial drooping on the right side
and right-sided arm and leg paralysis. When admitting the patient, which clinical
manifestation will the nurse expect to find?
a. Impulsive behavior
b. Right-sided neglect
c. Hyperactive left-sided tendon reflexes
d. Difficulty comprehending instructions - ANSWER - ANS: D Right-sided paralysis
indicates a left-brain stroke, which will lead to difficulty with comprehension and
use of language. The left-side reflexes are likely to be intact. Impulsive behavior
and neglect are more likely with a right-side stroke.
4. During the change of shift report a nurse is told that a patient has an occluded
left posterior cerebral artery. The nurse will anticipate that the patient may have
a. dysphasia.
b. confusion.
c. visual deficits.
d. poor judgment. - ANSWER - ANS: C Visual disturbances are expected with
posterior cerebral artery occlusion. Aphasia occurs with middle cerebral artery
involvement. Cognitive deficits and changes in judgment are more typical of
anterior cerebral artery occlusion.
5. When teaching about clopidogrel (Plavix), the nurse will tell the patient with
cerebral atherosclerosis
a. to monitor and record the blood pressure daily.
b. that Plavix will dissolve clots in the cerebral arteries.
c. that Plavix will reduce cerebral artery plaque formation.
, d. to call the health care provider if stools are bloody or tarry. - ANSWER - ANS: D
Clopidogrel (Plavix) inhibits platelet function and increases the risk for
gastrointestinal bleeding, so patients should be advised to notify the health care
provider about any signs of bleeding. The medication does not lower blood
pressure, decrease plaque formation, or dissolve clots.
6. A patient with carotid atherosclerosis asks the nurse to describe a carotid
endarterectomy. Which response by the nurse is accurate?
a. The obstructing plaque is surgically removed from an artery in the neck.
b. The diseased portion of the artery in the brain is replaced with a synthetic
graft.
c. A wire is threaded through an artery in the leg to the clots in the carotid artery
and the clots are removed.
d. A catheter with a deflated balloon is positioned at the narrow area, and the
balloon is inflated to flatten the plaque. - ANSWER - ANS: A in a carotid
endarterectomy, the carotid artery is incised and the plaque is removed. The
response beginning, the diseased portion of the artery in the brain is replaced
describes an arterial graft procedure. The answer beginning, a catheter with a
deflated balloon is positioned at the narrow area describes an angioplasty. The
final response beginning, a wire is threaded through the artery describes the
mechanical embolus removal in cerebral ischemia (MERCI) procedure.
7. A patient admitted with possible stroke has been aphasic for 3 hours and his
current blood pressure (BP) is 174/94 mm Hg. Which order by the health care
provider should the nurse question?
a. Keep head of bed elevated at least 30 degrees.
b. Infuse normal saline intravenously at 75 mL/hr.
c. Administer tissue plasminogen activator (tape) per protocol.
d. Administer a labetalol (Norm dyne) drip to keep BP less than 140/90 mm Hg. -
ANSWER - ANS: D Because elevated BP may be a protective response to maintain
AND CORRECT VERIFIED ANSWERS
WITH COMPLETE SOLUTIONS
1. After a patient experienced a brief episode of tinnitus, diplopia, and dysarthria
with no residual effects, the nurse anticipates teaching the patient about
a. cerebral aneurysm clipping.
b. heparin intravenous infusion.
c. oral low-dose aspirin therapy.
d. tissue plasminogen activator (tape) - ANSWER - ANS: C The patient’s symptoms
are consistent with transient ischemic attack (TIA), and drugs that inhibit platelet
aggregation are prescribed after a TIA to prevent stroke. Continuous heparin
infusion is not routinely used after TIA or with acute ischemic stroke. The
patient’s symptoms are not consistent with a cerebral aneurysm. tape is used
only for acute ischemic stroke, not for TIA.
2. A 68-year-old patient is being admitted with a possible stroke. Which
information from the assessment indicates that the nurse should consult with the
health care provider before giving the prescribed aspirin?
a. The patient has dysphasia.
b. The patient has atrial fibrillation.
c. The patient reports that symptoms began with a severe headache.
d. The patient has a history of brief episodes of right-sided hemiplegia. - ANSWER
- ANS: C A sudden onset headache is typical of a subarachnoid hemorrhage, and
aspirin is contraindicated. Atrial fibrillation, dysphasia, and transient ischemic
attack (TIA) are not contraindications to aspirin use, so the nurse can administer
the aspirin.
,3. A 73-year-old patient with a stroke experiences facial drooping on the right side
and right-sided arm and leg paralysis. When admitting the patient, which clinical
manifestation will the nurse expect to find?
a. Impulsive behavior
b. Right-sided neglect
c. Hyperactive left-sided tendon reflexes
d. Difficulty comprehending instructions - ANSWER - ANS: D Right-sided paralysis
indicates a left-brain stroke, which will lead to difficulty with comprehension and
use of language. The left-side reflexes are likely to be intact. Impulsive behavior
and neglect are more likely with a right-side stroke.
4. During the change of shift report a nurse is told that a patient has an occluded
left posterior cerebral artery. The nurse will anticipate that the patient may have
a. dysphasia.
b. confusion.
c. visual deficits.
d. poor judgment. - ANSWER - ANS: C Visual disturbances are expected with
posterior cerebral artery occlusion. Aphasia occurs with middle cerebral artery
involvement. Cognitive deficits and changes in judgment are more typical of
anterior cerebral artery occlusion.
5. When teaching about clopidogrel (Plavix), the nurse will tell the patient with
cerebral atherosclerosis
a. to monitor and record the blood pressure daily.
b. that Plavix will dissolve clots in the cerebral arteries.
c. that Plavix will reduce cerebral artery plaque formation.
, d. to call the health care provider if stools are bloody or tarry. - ANSWER - ANS: D
Clopidogrel (Plavix) inhibits platelet function and increases the risk for
gastrointestinal bleeding, so patients should be advised to notify the health care
provider about any signs of bleeding. The medication does not lower blood
pressure, decrease plaque formation, or dissolve clots.
6. A patient with carotid atherosclerosis asks the nurse to describe a carotid
endarterectomy. Which response by the nurse is accurate?
a. The obstructing plaque is surgically removed from an artery in the neck.
b. The diseased portion of the artery in the brain is replaced with a synthetic
graft.
c. A wire is threaded through an artery in the leg to the clots in the carotid artery
and the clots are removed.
d. A catheter with a deflated balloon is positioned at the narrow area, and the
balloon is inflated to flatten the plaque. - ANSWER - ANS: A in a carotid
endarterectomy, the carotid artery is incised and the plaque is removed. The
response beginning, the diseased portion of the artery in the brain is replaced
describes an arterial graft procedure. The answer beginning, a catheter with a
deflated balloon is positioned at the narrow area describes an angioplasty. The
final response beginning, a wire is threaded through the artery describes the
mechanical embolus removal in cerebral ischemia (MERCI) procedure.
7. A patient admitted with possible stroke has been aphasic for 3 hours and his
current blood pressure (BP) is 174/94 mm Hg. Which order by the health care
provider should the nurse question?
a. Keep head of bed elevated at least 30 degrees.
b. Infuse normal saline intravenously at 75 mL/hr.
c. Administer tissue plasminogen activator (tape) per protocol.
d. Administer a labetalol (Norm dyne) drip to keep BP less than 140/90 mm Hg. -
ANSWER - ANS: D Because elevated BP may be a protective response to maintain
