Test Bank for High Acuity Nursing 6th Edition by Wagner and Pierce
Chapter 15: Alterations in Cardiac Output
Question 1
Type: MCSA
A patient, admitted with the diagnosis of stroke, has left hemiparesis involving the
face, arm, and leg. The nurse explains that this stroke most likely involves which
artery?
1. Right vertebral
2. Left posterior communicating
3. Left middle cerebral
4. Right middle cerebral
Correct Answer: 4
Rationale 1: The right vertebral area is not the most common site of
damage causing a stroke.
Rationale 2: The posterior communicating arteries are part of the circle
of Willis, but are not the most common areas involved in stroke.
Rationale 3: The middle cerebral arteries supply blood to the lateral surfaces of
the frontal, temporal, and parietal lobes. These arteries are often involved in
stroke. The motor fibers cross so the left side of the brain controls the right side of
the body.
Rationale 4: The middle cerebral arteries supply blood to the lateral surfaces of
the frontal, temporal, and parietal lobes. These arteries are often involved in
stroke. The motor fibers cross so the right side of the brain controls the left side of
the body.
Global Rationale:
Cognitive Level: Analyzing
,Client Need: Physiological Integrity
Client Need Sub: Physiological Adaptation
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 15-1
Question 2
Type: MCSA
A patient recovering from a frontal craniotomy is positioned with the head of the
bed elevated 45 degrees at all times. What rationale would the nurse provide for
this position?
1. The brain will compress the cerebral veins less in this position.
2. The ventricles of the brain will drain better in this position.
3. This position allows for less pain for the patient.
4. The cerebral spinal veins are valveless and drain by gravity.
Correct Answer: 4
Rationale 1: This statement is not physiologically correct.
Rationale 2: This statement is not physiologically correct.
Rationale 3: There is no reason that pain would be reduced in this position.
Rationale 4: The cerebral spinal veins drain best via gravity, an important
characteristic to remember when caring for patients with the risk for
increased intracranial pressure as would be present in intracranial surgeries.
Global Rationale:
Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Physiological Adaptation
, Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 15-1
Question 3
Type: MCSA
The nurse is providing care for a patient who sustained a severe head injury.
The nurse would intervene to prevent which occurrence that increases cerebral
blood flow?
1. Oversedation
2. Hypothermia
3. Fever
4. Paralysis
Correct Answer: 3
Rationale 1: Sedation will decrease cerebral blood flow.
Rationale 2: Hypothermia will decrease cerebral blood flow.
Rationale 3: Fever increases the body’s metabolic rate and will increase
cerebral blood flow.
Rationale 4: Paralysis, often initiated chemically, will decrease cerebral
blood flow.
Global Rationale:
Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Physiological Adaptation
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 15-1
Chapter 15: Alterations in Cardiac Output
Question 1
Type: MCSA
A patient, admitted with the diagnosis of stroke, has left hemiparesis involving the
face, arm, and leg. The nurse explains that this stroke most likely involves which
artery?
1. Right vertebral
2. Left posterior communicating
3. Left middle cerebral
4. Right middle cerebral
Correct Answer: 4
Rationale 1: The right vertebral area is not the most common site of
damage causing a stroke.
Rationale 2: The posterior communicating arteries are part of the circle
of Willis, but are not the most common areas involved in stroke.
Rationale 3: The middle cerebral arteries supply blood to the lateral surfaces of
the frontal, temporal, and parietal lobes. These arteries are often involved in
stroke. The motor fibers cross so the left side of the brain controls the right side of
the body.
Rationale 4: The middle cerebral arteries supply blood to the lateral surfaces of
the frontal, temporal, and parietal lobes. These arteries are often involved in
stroke. The motor fibers cross so the right side of the brain controls the left side of
the body.
Global Rationale:
Cognitive Level: Analyzing
,Client Need: Physiological Integrity
Client Need Sub: Physiological Adaptation
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 15-1
Question 2
Type: MCSA
A patient recovering from a frontal craniotomy is positioned with the head of the
bed elevated 45 degrees at all times. What rationale would the nurse provide for
this position?
1. The brain will compress the cerebral veins less in this position.
2. The ventricles of the brain will drain better in this position.
3. This position allows for less pain for the patient.
4. The cerebral spinal veins are valveless and drain by gravity.
Correct Answer: 4
Rationale 1: This statement is not physiologically correct.
Rationale 2: This statement is not physiologically correct.
Rationale 3: There is no reason that pain would be reduced in this position.
Rationale 4: The cerebral spinal veins drain best via gravity, an important
characteristic to remember when caring for patients with the risk for
increased intracranial pressure as would be present in intracranial surgeries.
Global Rationale:
Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Physiological Adaptation
, Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 15-1
Question 3
Type: MCSA
The nurse is providing care for a patient who sustained a severe head injury.
The nurse would intervene to prevent which occurrence that increases cerebral
blood flow?
1. Oversedation
2. Hypothermia
3. Fever
4. Paralysis
Correct Answer: 3
Rationale 1: Sedation will decrease cerebral blood flow.
Rationale 2: Hypothermia will decrease cerebral blood flow.
Rationale 3: Fever increases the body’s metabolic rate and will increase
cerebral blood flow.
Rationale 4: Paralysis, often initiated chemically, will decrease cerebral
blood flow.
Global Rationale:
Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Physiological Adaptation
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 15-1
