NURSING CLINICAL
Rasmussen College MDC 4 Exam 1 Questions and Answers
2026/2027 | 100% Verified Answers 2026/2027
A+
Complete Blueprint Coverage
A+ 5 100%
QUESTIONS VERIFIED CORE DOMAINS COVERED RATIONALES INCLUDED
CATEGORIES
Stroke & Cerebrovascular Disorders
Increased ICP, Head Injury & Meningitis
Seizures & Status Epilepticus
Degenerative Neurological Disorders
Spinal Cord, Peripheral Nerve & Perioperative Neuro Care
STUVIAACTUALEXAM
, SECTION 1: Stroke & Cerebrovascular Disorders
Q1
Q1. A 68-year-old arrives with sudden right-sided weakness, aphasia, and facial droop beginning 90 minutes ago.
Non-contrast CT rules out hemorrhage. Which priority action supports eligibility for fibrinolytic therapy?
A. Confirm last known well time, complete stroke assessment, control blood pressure per protocol, and prepare for
IV alteplase if within the treatment window and no contraindications exist.
B. Delay all treatment until a full MRI is completed the next day.
C. Administer aspirin only and observe without considering thrombolysis.
D. Perform lumbar puncture before any reperfusion decision.
Correct Answer: A
Rationale:
Time-critical ischemic stroke care requires rapid confirmation of eligibility for IV thrombolysis within the approved window
after hemorrhage is excluded. Delaying imaging or omitting time verification risks missing the treatment opportunity.
Q2
Q2. A patient recovering from a left middle cerebral artery ischemic stroke has expressive aphasia. Which
nursing communication strategy is most appropriate?
A. Speak loudly and use complex multi-step directions.
B. Use simple yes/no questions, allow extra response time, and provide a communication board or written cues as
needed.
C. Avoid all verbal interaction to prevent frustration.
D. Assume comprehension is intact because the patient can follow some commands inconsistently.
Correct Answer: B
Rationale:
Expressive (Broca) aphasia impairs speech production; simplified questions, time, and alternative modalities support
communication without assuming full comprehension.
Q3
Q3. A post-stroke patient with right hemiplegia is at high risk for aspiration. Which intervention best reduces that
risk during meals?
A. Encourage rapid intake of thin liquids while supine.
B. Offer only pureed foods without any positioning guidance.
C. Position upright, use chin-tuck if recommended, provide thickened liquids as ordered, and check for pocketing
after swallows.
D. Allow the patient to eat alone without supervision to promote independence immediately.
Correct Answer: C
Rationale:
Upright positioning, compensatory techniques, texture modification, and monitoring for residual food reduce aspiration risk
after stroke-related dysphagia.
Rasmussen College MDC 4 Exam 1 Questions and Answers 2026/2027 | ... Page 2
, Q4
Q4. A patient with atrial fibrillation develops sudden unilateral weakness. Which stroke mechanism is most likely?
A. Lacunar infarction from small-vessel lipohyalinosis only.
B. Migrainous infarction without vascular risk factors.
C. Primary intracerebral hemorrhage without ischemic component.
D. Cardioembolic ischemic stroke from atrial appendage thrombus.
Correct Answer: D
Rationale:
AF predisposes to emboli from the left atrial appendage, a classic cardioembolic source of ischemic stroke.
Q5
Q5. After receiving IV alteplase for ischemic stroke, a patient develops a sudden severe headache and declining
mental status. Which complication must be suspected immediately?
A. Symptomatic intracranial hemorrhage, requiring urgent notification and reversal protocols per facility policy.
B. Expected therapeutic effect of the medication.
C. Simple migraine that needs only oral analgesia.
D. Hypoglycemia as the sole explanation without further evaluation.
Correct Answer: A
Rationale:
Sudden headache and neurological deterioration after thrombolysis raise concern for hemorrhagic conversion and demand
immediate action.
Q6
Q6. A nurse is teaching a patient about secondary stroke prevention after TIA. Which modifiable risk factor
should be emphasized?
A. Age and family history as the only controllable factors.
B. Hypertension control, statin therapy when indicated, antiplatelet or anticoagulation as appropriate, smoking
cessation, and lifestyle measures.
C. Complete avoidance of all physical activity permanently.
D. Discontinuation of prescribed antihypertensives once symptoms resolve.
Correct Answer: B
Rationale:
Secondary prevention targets controllable risks-BP, lipids, antithrombotic therapy, and lifestyle-to reduce recurrent events.
Q7
Q7. A patient with acute ischemic stroke has a blood pressure of 195/110 mm Hg before alteplase. Which
principle guides management?
A. Allow BP to remain extremely elevated without treatment.
B. Drop mean arterial pressure by 50% within five minutes.
C. Lower BP carefully to protocol targets (often <185/110 before and during thrombolysis) using approved agents to
balance perfusion and hemorrhage risk.
D. Use sublingual nifedipine routinely for rapid reduction.
Correct Answer: C
Rationale:
Controlled BP reduction to thrombolysis thresholds is required; excessive or rapid drops can worsen ischemia.
Rasmussen College MDC 4 Exam 1 Questions and Answers 2026/2027 | ... Page 3
Rasmussen College MDC 4 Exam 1 Questions and Answers
2026/2027 | 100% Verified Answers 2026/2027
A+
Complete Blueprint Coverage
A+ 5 100%
QUESTIONS VERIFIED CORE DOMAINS COVERED RATIONALES INCLUDED
CATEGORIES
Stroke & Cerebrovascular Disorders
Increased ICP, Head Injury & Meningitis
Seizures & Status Epilepticus
Degenerative Neurological Disorders
Spinal Cord, Peripheral Nerve & Perioperative Neuro Care
STUVIAACTUALEXAM
, SECTION 1: Stroke & Cerebrovascular Disorders
Q1
Q1. A 68-year-old arrives with sudden right-sided weakness, aphasia, and facial droop beginning 90 minutes ago.
Non-contrast CT rules out hemorrhage. Which priority action supports eligibility for fibrinolytic therapy?
A. Confirm last known well time, complete stroke assessment, control blood pressure per protocol, and prepare for
IV alteplase if within the treatment window and no contraindications exist.
B. Delay all treatment until a full MRI is completed the next day.
C. Administer aspirin only and observe without considering thrombolysis.
D. Perform lumbar puncture before any reperfusion decision.
Correct Answer: A
Rationale:
Time-critical ischemic stroke care requires rapid confirmation of eligibility for IV thrombolysis within the approved window
after hemorrhage is excluded. Delaying imaging or omitting time verification risks missing the treatment opportunity.
Q2
Q2. A patient recovering from a left middle cerebral artery ischemic stroke has expressive aphasia. Which
nursing communication strategy is most appropriate?
A. Speak loudly and use complex multi-step directions.
B. Use simple yes/no questions, allow extra response time, and provide a communication board or written cues as
needed.
C. Avoid all verbal interaction to prevent frustration.
D. Assume comprehension is intact because the patient can follow some commands inconsistently.
Correct Answer: B
Rationale:
Expressive (Broca) aphasia impairs speech production; simplified questions, time, and alternative modalities support
communication without assuming full comprehension.
Q3
Q3. A post-stroke patient with right hemiplegia is at high risk for aspiration. Which intervention best reduces that
risk during meals?
A. Encourage rapid intake of thin liquids while supine.
B. Offer only pureed foods without any positioning guidance.
C. Position upright, use chin-tuck if recommended, provide thickened liquids as ordered, and check for pocketing
after swallows.
D. Allow the patient to eat alone without supervision to promote independence immediately.
Correct Answer: C
Rationale:
Upright positioning, compensatory techniques, texture modification, and monitoring for residual food reduce aspiration risk
after stroke-related dysphagia.
Rasmussen College MDC 4 Exam 1 Questions and Answers 2026/2027 | ... Page 2
, Q4
Q4. A patient with atrial fibrillation develops sudden unilateral weakness. Which stroke mechanism is most likely?
A. Lacunar infarction from small-vessel lipohyalinosis only.
B. Migrainous infarction without vascular risk factors.
C. Primary intracerebral hemorrhage without ischemic component.
D. Cardioembolic ischemic stroke from atrial appendage thrombus.
Correct Answer: D
Rationale:
AF predisposes to emboli from the left atrial appendage, a classic cardioembolic source of ischemic stroke.
Q5
Q5. After receiving IV alteplase for ischemic stroke, a patient develops a sudden severe headache and declining
mental status. Which complication must be suspected immediately?
A. Symptomatic intracranial hemorrhage, requiring urgent notification and reversal protocols per facility policy.
B. Expected therapeutic effect of the medication.
C. Simple migraine that needs only oral analgesia.
D. Hypoglycemia as the sole explanation without further evaluation.
Correct Answer: A
Rationale:
Sudden headache and neurological deterioration after thrombolysis raise concern for hemorrhagic conversion and demand
immediate action.
Q6
Q6. A nurse is teaching a patient about secondary stroke prevention after TIA. Which modifiable risk factor
should be emphasized?
A. Age and family history as the only controllable factors.
B. Hypertension control, statin therapy when indicated, antiplatelet or anticoagulation as appropriate, smoking
cessation, and lifestyle measures.
C. Complete avoidance of all physical activity permanently.
D. Discontinuation of prescribed antihypertensives once symptoms resolve.
Correct Answer: B
Rationale:
Secondary prevention targets controllable risks-BP, lipids, antithrombotic therapy, and lifestyle-to reduce recurrent events.
Q7
Q7. A patient with acute ischemic stroke has a blood pressure of 195/110 mm Hg before alteplase. Which
principle guides management?
A. Allow BP to remain extremely elevated without treatment.
B. Drop mean arterial pressure by 50% within five minutes.
C. Lower BP carefully to protocol targets (often <185/110 before and during thrombolysis) using approved agents to
balance perfusion and hemorrhage risk.
D. Use sublingual nifedipine routinely for rapid reduction.
Correct Answer: C
Rationale:
Controlled BP reduction to thrombolysis thresholds is required; excessive or rapid drops can worsen ischemia.
Rasmussen College MDC 4 Exam 1 Questions and Answers 2026/2027 | ... Page 3
