NCLEX RN Next Generation NGN Case
Study Exam 6 Questions And Correct
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Case Study 1: Acute Ischemic Stroke
A 68-year-old client arrives in the emergency department with sudden
right-sided weakness, facial drooping, and difficulty speaking.
Symptoms began 45 minutes ago. Blood pressure is 178/96 mm Hg,
heart rate 88/min, respirations 18/min, oxygen saturation 97% on room
air. The client is awake but has expressive aphasia.
101. Which assessment finding is the nurse's priority?
A. Blood pressure of 178/96 mm Hg
B. Difficulty speaking
C. Sudden unilateral weakness
D. Oxygen saturation of 97%
Answer: _Sudden unilateral weakness_
Sudden unilateral weakness is a classic manifestation of acute stroke
and requires immediate assessment and intervention to minimize
neurologic injury.
102. Which diagnostic test should the nurse anticipate first?
A. Electroencephalogram
B. Noncontrast computed tomography of the head
,C. Carotid ultrasound
D. Magnetic resonance angiography
Answer: _Noncontrast computed tomography of the head_
An urgent noncontrast CT identifies intracranial hemorrhage and helps
determine whether thrombolytic therapy may be appropriate.
103. Which findings support an acute ischemic stroke? Select all that
apply.
A. Sudden facial drooping
B. Unilateral weakness
C. Aphasia
D. Gradual bilateral leg weakness
E. Sudden visual disturbance
Answers: _Sudden facial drooping, Unilateral weakness, Aphasia,
Sudden visual disturbance_
These are common sudden neurologic manifestations of stroke.
104. The CT scan shows no intracranial bleeding. Which intervention
should the nurse anticipate?
A. Administration of alteplase if eligibility criteria are met
B. Administration of warfarin immediately
C. Administration of aspirin before brain imaging
D. Restriction of all fluids
Answer: _Administration of alteplase if eligibility criteria are met_
Eligible clients with acute ischemic stroke may receive thrombolytic
therapy within the appropriate treatment window.
105. Which finding would make thrombolytic therapy unsafe?
,A. Blood pressure within treatment parameters
B. Recent intracranial hemorrhage
C. Symptoms beginning less than 1 hour ago
D. Normal blood glucose
Answer: _Recent intracranial hemorrhage**_
Recent intracranial bleeding is a major contraindication to thrombolytic
therapy because it increases the risk of catastrophic bleeding.
106. Which nursing action is most appropriate before administering
oral fluids?
A. Place the client flat
B. Perform a swallowing assessment
C. Give water through a straw
D. Encourage rapid drinking
Answer: _Perform a swallowing assessment**_
Stroke can impair the gag and swallowing reflexes, increasing the risk
for aspiration.
107. Which finding indicates possible worsening cerebral edema?
A. Improved speech
B. Increasing level of consciousness
C. Decreasing level of consciousness
D. Improved muscle strength
Answer: _Decreasing level of consciousness**_
An acute decline in consciousness may indicate increased intracranial
pressure or worsening cerebral edema.
108. Which interventions are appropriate? Select all that apply.
, A. Maintain airway patency
B. Monitor neurologic status frequently
C. Keep the client NPO until swallowing is evaluated
D. Give oral medications immediately
E. Monitor blood pressure
Answers: _Maintain airway patency, Monitor neurologic status
frequently, Keep the client NPO until swallowing is evaluated, Monitor
blood pressure**_
Airway protection, neurologic monitoring, aspiration prevention, and
blood-pressure management are priorities in acute stroke.
109. The client develops sudden severe headache and vomiting after
thrombolytic therapy. What should the nurse do first?
A. Give an antiemetic
B. Stop the thrombolytic infusion and notify the provider
C. Encourage oral fluids
D. Ambulate the client
Answer: _Stop the thrombolytic infusion and notify the provider**_
Sudden severe headache and vomiting can indicate intracranial
hemorrhage after thrombolytic therapy.
110. Which outcome indicates improvement?
A. New-onset confusion
B. Increased facial drooping
C. Improved ability to follow commands
D. Decreased level of consciousness
Answer: _Improved ability to follow commands**_
Improved neurologic responsiveness indicates stabilization or recovery
of neurologic function.
Study Exam 6 Questions And Correct
Answers (Verified Answers) Plus
Rationales 2026 Q&A Instant Download
Case Study 1: Acute Ischemic Stroke
A 68-year-old client arrives in the emergency department with sudden
right-sided weakness, facial drooping, and difficulty speaking.
Symptoms began 45 minutes ago. Blood pressure is 178/96 mm Hg,
heart rate 88/min, respirations 18/min, oxygen saturation 97% on room
air. The client is awake but has expressive aphasia.
101. Which assessment finding is the nurse's priority?
A. Blood pressure of 178/96 mm Hg
B. Difficulty speaking
C. Sudden unilateral weakness
D. Oxygen saturation of 97%
Answer: _Sudden unilateral weakness_
Sudden unilateral weakness is a classic manifestation of acute stroke
and requires immediate assessment and intervention to minimize
neurologic injury.
102. Which diagnostic test should the nurse anticipate first?
A. Electroencephalogram
B. Noncontrast computed tomography of the head
,C. Carotid ultrasound
D. Magnetic resonance angiography
Answer: _Noncontrast computed tomography of the head_
An urgent noncontrast CT identifies intracranial hemorrhage and helps
determine whether thrombolytic therapy may be appropriate.
103. Which findings support an acute ischemic stroke? Select all that
apply.
A. Sudden facial drooping
B. Unilateral weakness
C. Aphasia
D. Gradual bilateral leg weakness
E. Sudden visual disturbance
Answers: _Sudden facial drooping, Unilateral weakness, Aphasia,
Sudden visual disturbance_
These are common sudden neurologic manifestations of stroke.
104. The CT scan shows no intracranial bleeding. Which intervention
should the nurse anticipate?
A. Administration of alteplase if eligibility criteria are met
B. Administration of warfarin immediately
C. Administration of aspirin before brain imaging
D. Restriction of all fluids
Answer: _Administration of alteplase if eligibility criteria are met_
Eligible clients with acute ischemic stroke may receive thrombolytic
therapy within the appropriate treatment window.
105. Which finding would make thrombolytic therapy unsafe?
,A. Blood pressure within treatment parameters
B. Recent intracranial hemorrhage
C. Symptoms beginning less than 1 hour ago
D. Normal blood glucose
Answer: _Recent intracranial hemorrhage**_
Recent intracranial bleeding is a major contraindication to thrombolytic
therapy because it increases the risk of catastrophic bleeding.
106. Which nursing action is most appropriate before administering
oral fluids?
A. Place the client flat
B. Perform a swallowing assessment
C. Give water through a straw
D. Encourage rapid drinking
Answer: _Perform a swallowing assessment**_
Stroke can impair the gag and swallowing reflexes, increasing the risk
for aspiration.
107. Which finding indicates possible worsening cerebral edema?
A. Improved speech
B. Increasing level of consciousness
C. Decreasing level of consciousness
D. Improved muscle strength
Answer: _Decreasing level of consciousness**_
An acute decline in consciousness may indicate increased intracranial
pressure or worsening cerebral edema.
108. Which interventions are appropriate? Select all that apply.
, A. Maintain airway patency
B. Monitor neurologic status frequently
C. Keep the client NPO until swallowing is evaluated
D. Give oral medications immediately
E. Monitor blood pressure
Answers: _Maintain airway patency, Monitor neurologic status
frequently, Keep the client NPO until swallowing is evaluated, Monitor
blood pressure**_
Airway protection, neurologic monitoring, aspiration prevention, and
blood-pressure management are priorities in acute stroke.
109. The client develops sudden severe headache and vomiting after
thrombolytic therapy. What should the nurse do first?
A. Give an antiemetic
B. Stop the thrombolytic infusion and notify the provider
C. Encourage oral fluids
D. Ambulate the client
Answer: _Stop the thrombolytic infusion and notify the provider**_
Sudden severe headache and vomiting can indicate intracranial
hemorrhage after thrombolytic therapy.
110. Which outcome indicates improvement?
A. New-onset confusion
B. Increased facial drooping
C. Improved ability to follow commands
D. Decreased level of consciousness
Answer: _Improved ability to follow commands**_
Improved neurologic responsiveness indicates stabilization or recovery
of neurologic function.
