**CH 45 CARE OF CRITICALLY ILL PATIENTS WITH
NEUROLOGIC PROBLEMS**QUESTIONS WITH CORRECT
ANSWERS
1. Which clinical finding could help the health care team differentiate a transient ischemic attack from a
stroke?
a. Patient has a unilateral facial droop.
b. Patient has slurred speech.
c. Symptoms resolve in 30-60 minutes.
d. Electrocardiogram is normal. - ANSWER - c. Symptoms resolve in 30-60 minutes.
2. The nurse is preparing to discharge a patient with transient ischemic attacks. What topics does the
nurse include in discharge teaching? Select all that apply.
a. Reduction of high blood pressure
b. Drug teaching for aspirin or other antiplatelet drug
c. Lifestyle changes such as smoking cessation
d. Self-care for managing chronic conditions, such as diabetes
e. Increased risk for stroke and signs/ symptoms
f. Benefits of taking vitamin supplements - ANSWER - a. Reduction of high blood pressure
b. Drug teaching for aspirin or other antiplatelet drug
c. Lifestyle changes such as smoking cessation
d. Self-care for managing chronic conditions, such as diabetes
e. Increased risk for stroke and signs/ symptoms
3. The home health nurse is assessing a patient who had a stroke that affected the right hemisphere.
What would the nurse expect to observe?
,a. Patient is overly anxious and cautious when asked to do a new task.
b. Patient is euphoric and smiling but disoriented to person, place, and time.
c. Patient is depressed and expresses ongoing worries about the future.
d. Patient has a flat affect but is able to answer most questions appropriately. - ANSWER - b. Patient is
euphoric and smiling but disoriented to person, place, and time.
4. The nurse is assessing a patient who was brought to the emergency department for altered mental
status. In the absence of family members or witnesses to give a history, what does the nurse do to
identify two conditions that could mimic emergent neurologic conditions?
a. Check skin turgor and perform a bladder scan.
b. Check blood glucose and oxygen saturation.
C. Observe for jugular vein distention and pitting edema.
d. Observe for jaundice and abdominal distention. - ANSWER - b. Check blood glucose and oxygen
saturation.
5. Following a left cerebral hemisphere stroke, the patient has expressive (Boca’s) aphasia. Which
intervention is best to use when communicating with this patient?
a. Repeat the names of objects on a routine basis.
b. Face the patient and speak slowly and clearly.
c. Obtain a whiteboard with an erasable marker.
d. Use a picture board that displays objects and activities. - ANSWER - d. Use a picture board that
displays objects and activities.
6. The nurse is caring for a patient with right cerebral hemisphere damage. The patient demonstrates
disorientation to time and place and neglect of the left visual field, and he has poor depth perception.
Which task is best delegated to unlicensed assistive personnel?
a. Move the patient's bed so that his affected side faces the door.
b. Teach the patient to wash both sides of his face.
C. Ensure a safe environment by removing clutter.
, d. Suggest to the family that they bring familiar family photos. - ANSWER - C. Ensure a safe environment
by removing clutter.
7. A patient with a right cerebral hemisphere stroke may have safety issues related to which factor?
a. Poor impulse control
b. Alexia and agraphia
c. Loss of language and analytical skills
D. Slow and cautious behavior - ANSWER - a. Poor impulse control
8. A stroke patient is at risk for increased intracranial pressure and is receiving oxygen 2 L via nasal
cannula. The nurse is reviewing arterial blood gas (ABG) results. Which ABG value is of greatest concern
for this patient?
a. pH 7.32
b. Paco2 of 60 mm Hg
c. Pao2 of 95 mm Hg
d. HCO3' of 28 mEq/L - ANSWER - b. Paco2 of 60 mm Hg
9. What is the priority concept for the interdisciplinary care and treatment of a patient who is suspected
of having a stroke?
a. Pain
b. Cognition
C. Perfusion
d. Sensory perception - ANSWER - C. Perfusion
10. The preferred administration time for intravenous (systemic) fibrinolytic therapy is generally within
what time frame of stroke symptom onset?
NEUROLOGIC PROBLEMS**QUESTIONS WITH CORRECT
ANSWERS
1. Which clinical finding could help the health care team differentiate a transient ischemic attack from a
stroke?
a. Patient has a unilateral facial droop.
b. Patient has slurred speech.
c. Symptoms resolve in 30-60 minutes.
d. Electrocardiogram is normal. - ANSWER - c. Symptoms resolve in 30-60 minutes.
2. The nurse is preparing to discharge a patient with transient ischemic attacks. What topics does the
nurse include in discharge teaching? Select all that apply.
a. Reduction of high blood pressure
b. Drug teaching for aspirin or other antiplatelet drug
c. Lifestyle changes such as smoking cessation
d. Self-care for managing chronic conditions, such as diabetes
e. Increased risk for stroke and signs/ symptoms
f. Benefits of taking vitamin supplements - ANSWER - a. Reduction of high blood pressure
b. Drug teaching for aspirin or other antiplatelet drug
c. Lifestyle changes such as smoking cessation
d. Self-care for managing chronic conditions, such as diabetes
e. Increased risk for stroke and signs/ symptoms
3. The home health nurse is assessing a patient who had a stroke that affected the right hemisphere.
What would the nurse expect to observe?
,a. Patient is overly anxious and cautious when asked to do a new task.
b. Patient is euphoric and smiling but disoriented to person, place, and time.
c. Patient is depressed and expresses ongoing worries about the future.
d. Patient has a flat affect but is able to answer most questions appropriately. - ANSWER - b. Patient is
euphoric and smiling but disoriented to person, place, and time.
4. The nurse is assessing a patient who was brought to the emergency department for altered mental
status. In the absence of family members or witnesses to give a history, what does the nurse do to
identify two conditions that could mimic emergent neurologic conditions?
a. Check skin turgor and perform a bladder scan.
b. Check blood glucose and oxygen saturation.
C. Observe for jugular vein distention and pitting edema.
d. Observe for jaundice and abdominal distention. - ANSWER - b. Check blood glucose and oxygen
saturation.
5. Following a left cerebral hemisphere stroke, the patient has expressive (Boca’s) aphasia. Which
intervention is best to use when communicating with this patient?
a. Repeat the names of objects on a routine basis.
b. Face the patient and speak slowly and clearly.
c. Obtain a whiteboard with an erasable marker.
d. Use a picture board that displays objects and activities. - ANSWER - d. Use a picture board that
displays objects and activities.
6. The nurse is caring for a patient with right cerebral hemisphere damage. The patient demonstrates
disorientation to time and place and neglect of the left visual field, and he has poor depth perception.
Which task is best delegated to unlicensed assistive personnel?
a. Move the patient's bed so that his affected side faces the door.
b. Teach the patient to wash both sides of his face.
C. Ensure a safe environment by removing clutter.
, d. Suggest to the family that they bring familiar family photos. - ANSWER - C. Ensure a safe environment
by removing clutter.
7. A patient with a right cerebral hemisphere stroke may have safety issues related to which factor?
a. Poor impulse control
b. Alexia and agraphia
c. Loss of language and analytical skills
D. Slow and cautious behavior - ANSWER - a. Poor impulse control
8. A stroke patient is at risk for increased intracranial pressure and is receiving oxygen 2 L via nasal
cannula. The nurse is reviewing arterial blood gas (ABG) results. Which ABG value is of greatest concern
for this patient?
a. pH 7.32
b. Paco2 of 60 mm Hg
c. Pao2 of 95 mm Hg
d. HCO3' of 28 mEq/L - ANSWER - b. Paco2 of 60 mm Hg
9. What is the priority concept for the interdisciplinary care and treatment of a patient who is suspected
of having a stroke?
a. Pain
b. Cognition
C. Perfusion
d. Sensory perception - ANSWER - C. Perfusion
10. The preferred administration time for intravenous (systemic) fibrinolytic therapy is generally within
what time frame of stroke symptom onset?
