NCLEX RN Next Generation Case Study
Exam 6 100 Questions And Correct
Answers (Verified Answers) Plus
Rationales 2026 Q&A Instant
Download Pdf
CASE STUDY 1: Acute Ischemic Stroke
A 72-year-old client is brought to the emergency department with sudden
right-sided weakness, facial drooping, and difficulty speaking that began 45
minutes ago. The client has a history of hypertension and atrial fibrillation. BP
is 184/96 mm Hg, HR 92/min and irregular, RR 18/min, and SpO₂ 96% on room
air. The client is awake but has expressive aphasia and right arm weakness.
Question 1
Which assessment finding is the priority for the nurse to report?
Answer: Sudden onset of expressive aphasia and right-sided weakness
Rationale: Sudden focal neurologic deficits are classic manifestations of an
acute stroke. Rapid recognition and treatment are essential because cerebral
tissue is highly time-sensitive.
Question 2
Which diagnostic test should the nurse anticipate first?
Answer: Noncontrast CT scan of the head
Rationale: A noncontrast head CT is performed urgently to differentiate
ischemic stroke from intracranial hemorrhage before thrombolytic therapy is
considered.
Question 3
,The CT scan shows no evidence of hemorrhage. Which intervention should the
nurse anticipate?
Answer: Administration of IV thrombolytic therapy if eligibility criteria are
met
Rationale: Eligible clients with acute ischemic stroke may receive IV
thrombolytic therapy within the appropriate treatment window after
hemorrhage has been excluded.
Question 4
Which finding would require immediate intervention after thrombolytic
therapy?
Answer: Sudden severe headache with vomiting and worsening neurologic
deficits
Rationale: These findings may indicate intracranial hemorrhage, a potentially
life-threatening complication of thrombolytic therapy.
Question 5
Which nursing action is appropriate before giving oral medications?
Answer: Perform a swallowing assessment
Rationale: Stroke can impair swallowing and increase the risk for aspiration.
Oral intake should be withheld until swallowing ability has been evaluated.
Question 6
Which client finding indicates an improvement in neurologic status?
Answer: The client correctly follows a two-step command
Rationale: Improved ability to understand and follow commands indicates
improved neurologic function.
Question 7
The client develops difficulty swallowing. Which intervention is appropriate?
Answer: Keep the client NPO until swallowing safety is established
, Rationale: Dysphagia following stroke increases aspiration risk. Maintaining
NPO status until evaluation helps prevent aspiration pneumonia.
Question 8
Which position is most appropriate during meals once swallowing has been
cleared?
Answer: Sit upright at 90 degrees
Rationale: An upright position promotes safer swallowing and decreases the
risk of aspiration.
Question 9
Which long-term medication would the nurse expect for a client with atrial
fibrillation and ischemic stroke?
Answer: An anticoagulant
Rationale: Atrial fibrillation promotes thrombus formation in the atria, and
anticoagulation reduces the risk of recurrent embolic stroke when clinically
appropriate.
Question 10
Which statement by the client indicates understanding of stroke prevention?
Answer: “I will take my prescribed medications consistently and monitor my
blood pressure.”
Rationale: Medication adherence and blood-pressure control are important
strategies for reducing recurrent stroke risk.
CASE STUDY 2: Diabetic Ketoacidosis
A 24-year-old client with type 1 diabetes mellitus presents with nausea,
vomiting, abdominal pain, and extreme thirst. The client reports missing insulin
doses for 2 days. Vital signs: BP 92/58 mm Hg, HR 118/min, RR 30/min with
deep respirations, and SpO₂ 98%. Laboratory results include glucose 524
mg/dL, pH 7.19, bicarbonate 12 mEq/L, and positive serum ketones.
Exam 6 100 Questions And Correct
Answers (Verified Answers) Plus
Rationales 2026 Q&A Instant
Download Pdf
CASE STUDY 1: Acute Ischemic Stroke
A 72-year-old client is brought to the emergency department with sudden
right-sided weakness, facial drooping, and difficulty speaking that began 45
minutes ago. The client has a history of hypertension and atrial fibrillation. BP
is 184/96 mm Hg, HR 92/min and irregular, RR 18/min, and SpO₂ 96% on room
air. The client is awake but has expressive aphasia and right arm weakness.
Question 1
Which assessment finding is the priority for the nurse to report?
Answer: Sudden onset of expressive aphasia and right-sided weakness
Rationale: Sudden focal neurologic deficits are classic manifestations of an
acute stroke. Rapid recognition and treatment are essential because cerebral
tissue is highly time-sensitive.
Question 2
Which diagnostic test should the nurse anticipate first?
Answer: Noncontrast CT scan of the head
Rationale: A noncontrast head CT is performed urgently to differentiate
ischemic stroke from intracranial hemorrhage before thrombolytic therapy is
considered.
Question 3
,The CT scan shows no evidence of hemorrhage. Which intervention should the
nurse anticipate?
Answer: Administration of IV thrombolytic therapy if eligibility criteria are
met
Rationale: Eligible clients with acute ischemic stroke may receive IV
thrombolytic therapy within the appropriate treatment window after
hemorrhage has been excluded.
Question 4
Which finding would require immediate intervention after thrombolytic
therapy?
Answer: Sudden severe headache with vomiting and worsening neurologic
deficits
Rationale: These findings may indicate intracranial hemorrhage, a potentially
life-threatening complication of thrombolytic therapy.
Question 5
Which nursing action is appropriate before giving oral medications?
Answer: Perform a swallowing assessment
Rationale: Stroke can impair swallowing and increase the risk for aspiration.
Oral intake should be withheld until swallowing ability has been evaluated.
Question 6
Which client finding indicates an improvement in neurologic status?
Answer: The client correctly follows a two-step command
Rationale: Improved ability to understand and follow commands indicates
improved neurologic function.
Question 7
The client develops difficulty swallowing. Which intervention is appropriate?
Answer: Keep the client NPO until swallowing safety is established
, Rationale: Dysphagia following stroke increases aspiration risk. Maintaining
NPO status until evaluation helps prevent aspiration pneumonia.
Question 8
Which position is most appropriate during meals once swallowing has been
cleared?
Answer: Sit upright at 90 degrees
Rationale: An upright position promotes safer swallowing and decreases the
risk of aspiration.
Question 9
Which long-term medication would the nurse expect for a client with atrial
fibrillation and ischemic stroke?
Answer: An anticoagulant
Rationale: Atrial fibrillation promotes thrombus formation in the atria, and
anticoagulation reduces the risk of recurrent embolic stroke when clinically
appropriate.
Question 10
Which statement by the client indicates understanding of stroke prevention?
Answer: “I will take my prescribed medications consistently and monitor my
blood pressure.”
Rationale: Medication adherence and blood-pressure control are important
strategies for reducing recurrent stroke risk.
CASE STUDY 2: Diabetic Ketoacidosis
A 24-year-old client with type 1 diabetes mellitus presents with nausea,
vomiting, abdominal pain, and extreme thirst. The client reports missing insulin
doses for 2 days. Vital signs: BP 92/58 mm Hg, HR 118/min, RR 30/min with
deep respirations, and SpO₂ 98%. Laboratory results include glucose 524
mg/dL, pH 7.19, bicarbonate 12 mEq/L, and positive serum ketones.
