Med-Surg, Lewis, Ch 58; Stroke
questions with correct answers
In promoting health maintenance for prevention of strokes, the nurse understands that the
highest risk for the most common type of stroke is present in
a. African Americans.
b. women who smoke.
c. individuals with hypertension and diabetes.
d. those who are obese with high dietary-fat intake - correct answer ✔✔ c. Rationale: The
highest risk factors for thrombotic stroke are hypertension and diabetes. African Americans
have a higher risk for stroke than do white persons but probably because they have a greater
incidence of hypertension. Factors such as obesity, diet high in saturated fats and cholesterol,
cigarette smoking, and excessive alcohol use are also risk factors but carry less risk than
hypertension.
A thrombus that develops in a cerebral artery does not always cause a loss of neurologic
function because
a. the body can dissolve atherosclerotic plaques as they form.
b. some tissues of the brain do not require constant blood supply to prevent damage.
c. circulation through the circle of Willis may provide blood supply to the affected area of the
brain.
d. neurologic deficits occur only when major arteries are occluded by thrombus formation
around an atherosclerotic plaque. - correct answer ✔✔ c. Rationale: The communication
between cerebral arteries in the circle of Willis provides a collateral circulation, which may
maintain circulation to an area of the brain if its original blood supply is obstructed. All areas of
the brain require constant blood supply, and atherosclerotic plaques are not readily reversed.
Neurologic deficits can result from ischemia caused by many factors.
,A patient comes to the emergency department immediately after experiencing numbness of the
face and an inability to speak, but while the patient awaits examination, the symptoms
disappear and the patient requests discharge. The nurse stresses that it is important for the
patient to be evaluated primarily because
a. the patient has probably experienced an asymptomatic lacunar stroke.
b. the symptoms are likely to return and progress to worsening neurologic deficit in the next 24
hours.
c. neurologic deficits that are transient occur most often as a result of small hemorrhages that
clot off.
d. the patient has probably experienced a transient ischemic attack (TIA), which is a sign of
progressive cerebral vascular disease. - correct answer ✔✔ d. Rationale: A transient ischemic
attack (TIA) is a temporary focal loss of neurologic function caused by ischemia of an area of the
brain, usually lasting only about 3 hours. TIAs may be due to microemboli from heart disease or
carotid or cerebral thrombi and are a warning of progressive disease. Evaluation is necessary to
determine the cause of the neurologic deficit and provide prophylactic treatment if possible.
The neurologic functions that are affected by a stroke are primarily related to
a. the amount of tissue area involved.
b. the rapidity of the onset of symptoms.
c. the brain area perfused by the affected artery.
d. the presence or absence of collateral circulation. - correct answer ✔✔ c. Rationale: Clinical
manifestations of altered neurologic function differ, depending primarily on the specific cerebral
artery involved and the area of the brain that is perfused by the artery. The degree of
impairment depends on rapidity of onset, the size of the lesion, and the presence of collateral
circulation.
A patient is admitted to the hospital with a left hemiplegia. To determine the size and location
and to ascertain whether a stroke is ischemic or hemorrhagic, the nurse anticipates that the
health care provider will request a
a. CT scan.
b. lumbar puncture.
, c. cerebral arteriogram.
d. positron emission tomography (PET). - correct answer ✔✔ a. Rationale: A CT scan is the most
commonly used
diagnostic test to determine the size and location of the lesion and to differentiate a thrombotic
stroke from a hemorrhagic stroke. Positron emission tomography (PET) will show the metabolic
activity of the brain and provide a depiction of the extent of tissue damage after a stroke.
Lumbar punctures are not performed routinely because of the chance of increased intracranial
pressure causing herniation. Cerebral arteriograms are invasive and may dislodge an embolism
or cause further hemorrhage; they are performed only when no other test can provide the
needed information.
A carotid endarterectomy is being considered as treatment for a patient who has had several
TIAs. The nurse explains to the patient that this surgery
a. is used to restore blood circulation to the brain following an obstruction of a cerebral artery.
b. involves intracranial surgery to join a superficial extracranial artery to an intracranial artery.
c. involves removing an atherosclerotic plaque in the carotid artery to prevent an impending
stroke.
d. is used to open a stenosis in a carotid artery with a balloon and stent to restore cerebral
circulation. - correct answer ✔✔ c. Rationale: An endarterectomy is a removal of an
atherosclerotic plaque, and a plaque in the carotid artery may impair circulation enough to
cause a stroke. A carotid endarterectomy is performed to prevent a cerebrovascular accident
(CVA), as are most other surgical procedures. An extracranial- intracranial bypass involves
cranial surgery to bypass a sclerotic intracranial artery. Percutaneous transluminal angioplasty
uses a balloon to compress stenotic areas in the carotid and vertebrobasilar arteries and often
includes inserting a stent to hold the artery open.
The incidence of ischemic stroke in patients with TIAs and other risk factors is reduced with the
administration of a. furosemide (Lasix).
b. lovastatin (Mevacor).
c. daily low-dose aspirin.
d. nimodipine (Nimotop). - correct answer ✔✔ c. Rationale: The administration of antiplatelet
agents, such as aspirin, dipyridamole (Persantine), and ticlopidine (Ticlid), reduces the incidence
questions with correct answers
In promoting health maintenance for prevention of strokes, the nurse understands that the
highest risk for the most common type of stroke is present in
a. African Americans.
b. women who smoke.
c. individuals with hypertension and diabetes.
d. those who are obese with high dietary-fat intake - correct answer ✔✔ c. Rationale: The
highest risk factors for thrombotic stroke are hypertension and diabetes. African Americans
have a higher risk for stroke than do white persons but probably because they have a greater
incidence of hypertension. Factors such as obesity, diet high in saturated fats and cholesterol,
cigarette smoking, and excessive alcohol use are also risk factors but carry less risk than
hypertension.
A thrombus that develops in a cerebral artery does not always cause a loss of neurologic
function because
a. the body can dissolve atherosclerotic plaques as they form.
b. some tissues of the brain do not require constant blood supply to prevent damage.
c. circulation through the circle of Willis may provide blood supply to the affected area of the
brain.
d. neurologic deficits occur only when major arteries are occluded by thrombus formation
around an atherosclerotic plaque. - correct answer ✔✔ c. Rationale: The communication
between cerebral arteries in the circle of Willis provides a collateral circulation, which may
maintain circulation to an area of the brain if its original blood supply is obstructed. All areas of
the brain require constant blood supply, and atherosclerotic plaques are not readily reversed.
Neurologic deficits can result from ischemia caused by many factors.
,A patient comes to the emergency department immediately after experiencing numbness of the
face and an inability to speak, but while the patient awaits examination, the symptoms
disappear and the patient requests discharge. The nurse stresses that it is important for the
patient to be evaluated primarily because
a. the patient has probably experienced an asymptomatic lacunar stroke.
b. the symptoms are likely to return and progress to worsening neurologic deficit in the next 24
hours.
c. neurologic deficits that are transient occur most often as a result of small hemorrhages that
clot off.
d. the patient has probably experienced a transient ischemic attack (TIA), which is a sign of
progressive cerebral vascular disease. - correct answer ✔✔ d. Rationale: A transient ischemic
attack (TIA) is a temporary focal loss of neurologic function caused by ischemia of an area of the
brain, usually lasting only about 3 hours. TIAs may be due to microemboli from heart disease or
carotid or cerebral thrombi and are a warning of progressive disease. Evaluation is necessary to
determine the cause of the neurologic deficit and provide prophylactic treatment if possible.
The neurologic functions that are affected by a stroke are primarily related to
a. the amount of tissue area involved.
b. the rapidity of the onset of symptoms.
c. the brain area perfused by the affected artery.
d. the presence or absence of collateral circulation. - correct answer ✔✔ c. Rationale: Clinical
manifestations of altered neurologic function differ, depending primarily on the specific cerebral
artery involved and the area of the brain that is perfused by the artery. The degree of
impairment depends on rapidity of onset, the size of the lesion, and the presence of collateral
circulation.
A patient is admitted to the hospital with a left hemiplegia. To determine the size and location
and to ascertain whether a stroke is ischemic or hemorrhagic, the nurse anticipates that the
health care provider will request a
a. CT scan.
b. lumbar puncture.
, c. cerebral arteriogram.
d. positron emission tomography (PET). - correct answer ✔✔ a. Rationale: A CT scan is the most
commonly used
diagnostic test to determine the size and location of the lesion and to differentiate a thrombotic
stroke from a hemorrhagic stroke. Positron emission tomography (PET) will show the metabolic
activity of the brain and provide a depiction of the extent of tissue damage after a stroke.
Lumbar punctures are not performed routinely because of the chance of increased intracranial
pressure causing herniation. Cerebral arteriograms are invasive and may dislodge an embolism
or cause further hemorrhage; they are performed only when no other test can provide the
needed information.
A carotid endarterectomy is being considered as treatment for a patient who has had several
TIAs. The nurse explains to the patient that this surgery
a. is used to restore blood circulation to the brain following an obstruction of a cerebral artery.
b. involves intracranial surgery to join a superficial extracranial artery to an intracranial artery.
c. involves removing an atherosclerotic plaque in the carotid artery to prevent an impending
stroke.
d. is used to open a stenosis in a carotid artery with a balloon and stent to restore cerebral
circulation. - correct answer ✔✔ c. Rationale: An endarterectomy is a removal of an
atherosclerotic plaque, and a plaque in the carotid artery may impair circulation enough to
cause a stroke. A carotid endarterectomy is performed to prevent a cerebrovascular accident
(CVA), as are most other surgical procedures. An extracranial- intracranial bypass involves
cranial surgery to bypass a sclerotic intracranial artery. Percutaneous transluminal angioplasty
uses a balloon to compress stenotic areas in the carotid and vertebrobasilar arteries and often
includes inserting a stent to hold the artery open.
The incidence of ischemic stroke in patients with TIAs and other risk factors is reduced with the
administration of a. furosemide (Lasix).
b. lovastatin (Mevacor).
c. daily low-dose aspirin.
d. nimodipine (Nimotop). - correct answer ✔✔ c. Rationale: The administration of antiplatelet
agents, such as aspirin, dipyridamole (Persantine), and ticlopidine (Ticlid), reduces the incidence
