N136 Week 4 - Lewis Adaptive Quizzing #4 UPDATED ACTUAL Questions and
CORRECT Answers
Which aspects of the medical history of a female patient Current use of high—dose oral contraceptives
are risk factors for stroke? Select all that apply. History of migraine headaches with aura
|:| Chronic low back pain
|:| Current use of high—dose oral contraceptives Oral contraceptive pills with high levels of progestin and estrogen increase a
|:| History of long—standing hair loss woman's chance for experiencing stroke. People with migraine are at an increased
El History of migraine headaches with aura risk oforstroke, although the mechanism for the increased risk in women with
El Past employment involving exposure to chemical dyes migraines remains unknown. Low back pain, hair loss, and past employment
working with dyes do not increase the risk for stroke. Test-Taking Tip: Survey the
test before you start answering the questions. Plan how to complete the exam in
the time allowed. Read the directions carefully and answer the questions you
know for sure first. p.1332
Which action can the nurse delegate to the unlicensed Cut up the meat for the patient.
assistive personnel (UAP) to reduce fatigue for a patient
recovering from a stroke at mealtimes? The nurse should instruct the UAP to cut up the meat at mealtimes and to assist
0 Feed the patient the meal. with eating as needed. The ability to drink water during the meal may be limited if
0 Provide water during the meal. the patient has problems swallowing, but this will not address fatigue. Placing the
0 Cut up the meat for the patient. head of the bed at 30 degrees is not high enough for eating and will not reduce
0 Place the head of the bed at 30 degrees. fatigue during the meal. Feeding this patient reduces independence and should
be avoided as the first action. p. 1345
, Which nursing intervention would be included in the plan Checking for stool impaction
of care for a patient who is admitted with a stroke and is
complaining about having liquid stools? Stool impaction is the development of a solid immobile mass offecal matter in the
O Administering enemas rectum, which may result in liquid stool. Therefore the nurse should assess for this
O Administering psyllium first. An enema helps to facilitate bowel movements but should be avoided
0 Checking for stool impaction because it increases the intracranial pressure. Psyllium is a form offiber used to
O Discouraging physical activity increase the solid mass in the intestine so that the feces can pass easily. Physical
activity stimulates bowel function, so the nurse should encourage the patient to
perform physical activity. p. 1345
A nurse is admitting a patient with a thrombotic stroke. "It is not safe to allow you to have anything by mouth until a swallow assessment
The patient is NPO but is requesting a drink of water. can be performed."
Which response by a nurse is appropriate?
0 "You can have a couple of ice chips to wet your mouth." Stroke patients are at high risk for aspiration pneumonia. The Centers for Medicare
0 "A barium swallow test is required for stroke patients and Medicaid Services (CMS) recommends that patients be kept strict NPO until
before giving PO fluids." cleared by a swallow screen or swallow evaluation. Strict NPO includes ice chips,
0 "We need to keep you NPO in case a procedure needs all fluids, food, and oral medications. A barium swallow test is not required for all
to be performed today." stroke patients but is performed on individuals with inconclusive swallow
0 "It is not safe to allow you to have anything by mouth screening or evaluations. "We need to keep you NPO in case a procedure needs
until a swallow assessment can be performed." to be performed today'l is incorrect because the primary reason a patient is kept
NPO is the high risk of aspiration pneumonia. p. 1344
Which behavior would be exhibited by a patient who has impulsive and impatient
suffered a right-brain stroke?
0 Very cautious A patient who has suffered a stroke on the right side of the brain will behave
0 Difficulty with words impulsively and act impatiently. A left—brain stroke survivor is aware of the
0 impulsive and impatient deficiency and failure in mental functioning and is very cautious. After a stroke, a
Q Accomplishes tasks quickly patient will be much slower while undertaking actions. Survivors of left-brain
damage will experience communication problems and have difficulty with words.
p. 1336
Which food would be included in the diet for a patient Mashed potatoes
who had a stroke and has dysphagia?
Q Milkshakes Patients who had a stroke and have dysphagia have difficulty chewing and
0 Chicken soup swallowing. Thus the nurse would include mashed potatoes because the food is
0 Mashed potatoes easy to swallow and provides enough texture. Milkshakes and all milk products
0 Pureed cooked rice should be avoided because they increase the viscosity of mucus, which leads to
an increase in salivation. Chicken soup is a thin liquid that may be difficult to
swallow and could trigger coughing or choking. Pureed cooked rice is bland to
the taste and may stick to the palate, which poses a risk for aspiration. p. 1345
Which action would be beneficial to a patient with a Remove clutter and obstacles.
right-brain stroke?
0 Wear shoes when out of bed. A right-brain stroke survivor is at a higher risk for injury due to mobility issues.
0 Arrange food on the left side. Therefore all clutter and obstacles should be removed, and proper lighting
0 Remove clutter and obstacles. should be provided. Patients should wear nonslip and skid- resistant socks when
0 Give directions nonverbally. out of bed to prevent falls. A right-brain stroke patient will tend to neglect the left
side of the body; food should not be placed on the left side. All directions for
activities should be given verbally to facilitate comprehension. pp. 1336—1337
CORRECT Answers
Which aspects of the medical history of a female patient Current use of high—dose oral contraceptives
are risk factors for stroke? Select all that apply. History of migraine headaches with aura
|:| Chronic low back pain
|:| Current use of high—dose oral contraceptives Oral contraceptive pills with high levels of progestin and estrogen increase a
|:| History of long—standing hair loss woman's chance for experiencing stroke. People with migraine are at an increased
El History of migraine headaches with aura risk oforstroke, although the mechanism for the increased risk in women with
El Past employment involving exposure to chemical dyes migraines remains unknown. Low back pain, hair loss, and past employment
working with dyes do not increase the risk for stroke. Test-Taking Tip: Survey the
test before you start answering the questions. Plan how to complete the exam in
the time allowed. Read the directions carefully and answer the questions you
know for sure first. p.1332
Which action can the nurse delegate to the unlicensed Cut up the meat for the patient.
assistive personnel (UAP) to reduce fatigue for a patient
recovering from a stroke at mealtimes? The nurse should instruct the UAP to cut up the meat at mealtimes and to assist
0 Feed the patient the meal. with eating as needed. The ability to drink water during the meal may be limited if
0 Provide water during the meal. the patient has problems swallowing, but this will not address fatigue. Placing the
0 Cut up the meat for the patient. head of the bed at 30 degrees is not high enough for eating and will not reduce
0 Place the head of the bed at 30 degrees. fatigue during the meal. Feeding this patient reduces independence and should
be avoided as the first action. p. 1345
, Which nursing intervention would be included in the plan Checking for stool impaction
of care for a patient who is admitted with a stroke and is
complaining about having liquid stools? Stool impaction is the development of a solid immobile mass offecal matter in the
O Administering enemas rectum, which may result in liquid stool. Therefore the nurse should assess for this
O Administering psyllium first. An enema helps to facilitate bowel movements but should be avoided
0 Checking for stool impaction because it increases the intracranial pressure. Psyllium is a form offiber used to
O Discouraging physical activity increase the solid mass in the intestine so that the feces can pass easily. Physical
activity stimulates bowel function, so the nurse should encourage the patient to
perform physical activity. p. 1345
A nurse is admitting a patient with a thrombotic stroke. "It is not safe to allow you to have anything by mouth until a swallow assessment
The patient is NPO but is requesting a drink of water. can be performed."
Which response by a nurse is appropriate?
0 "You can have a couple of ice chips to wet your mouth." Stroke patients are at high risk for aspiration pneumonia. The Centers for Medicare
0 "A barium swallow test is required for stroke patients and Medicaid Services (CMS) recommends that patients be kept strict NPO until
before giving PO fluids." cleared by a swallow screen or swallow evaluation. Strict NPO includes ice chips,
0 "We need to keep you NPO in case a procedure needs all fluids, food, and oral medications. A barium swallow test is not required for all
to be performed today." stroke patients but is performed on individuals with inconclusive swallow
0 "It is not safe to allow you to have anything by mouth screening or evaluations. "We need to keep you NPO in case a procedure needs
until a swallow assessment can be performed." to be performed today'l is incorrect because the primary reason a patient is kept
NPO is the high risk of aspiration pneumonia. p. 1344
Which behavior would be exhibited by a patient who has impulsive and impatient
suffered a right-brain stroke?
0 Very cautious A patient who has suffered a stroke on the right side of the brain will behave
0 Difficulty with words impulsively and act impatiently. A left—brain stroke survivor is aware of the
0 impulsive and impatient deficiency and failure in mental functioning and is very cautious. After a stroke, a
Q Accomplishes tasks quickly patient will be much slower while undertaking actions. Survivors of left-brain
damage will experience communication problems and have difficulty with words.
p. 1336
Which food would be included in the diet for a patient Mashed potatoes
who had a stroke and has dysphagia?
Q Milkshakes Patients who had a stroke and have dysphagia have difficulty chewing and
0 Chicken soup swallowing. Thus the nurse would include mashed potatoes because the food is
0 Mashed potatoes easy to swallow and provides enough texture. Milkshakes and all milk products
0 Pureed cooked rice should be avoided because they increase the viscosity of mucus, which leads to
an increase in salivation. Chicken soup is a thin liquid that may be difficult to
swallow and could trigger coughing or choking. Pureed cooked rice is bland to
the taste and may stick to the palate, which poses a risk for aspiration. p. 1345
Which action would be beneficial to a patient with a Remove clutter and obstacles.
right-brain stroke?
0 Wear shoes when out of bed. A right-brain stroke survivor is at a higher risk for injury due to mobility issues.
0 Arrange food on the left side. Therefore all clutter and obstacles should be removed, and proper lighting
0 Remove clutter and obstacles. should be provided. Patients should wear nonslip and skid- resistant socks when
0 Give directions nonverbally. out of bed to prevent falls. A right-brain stroke patient will tend to neglect the left
side of the body; food should not be placed on the left side. All directions for
activities should be given verbally to facilitate comprehension. pp. 1336—1337
