Lewis's Medical-Surgical Nursing, 11th Edition Chapter 57: Stroke Harding Exam Questions with Correct Answers

What topic should the nurse anticipate teaching a patient who had a brief episode of tinnitus, diplopia (double vision), and dysarthria (slurred speech) with no residual effects? Correct Answer Oral low-dose aspirin therapy Rational: The patient's symptoms are consistent with transient ischemic attack (TIA), and drugs that inhibit platelet aggregation are prescribed after a TIA to prevent a stroke. Continuous heparin infusion is not routinely used after TIA or with acute ischemic stroke. The patient's symptoms are not consistent with a cerebral aneurysm. tPA is used only for acute ischemic stroke, not for TIA. A patient is being admitted with a possible stroke. Which information from the assessment indicates that the nurse should consult with the health care provider before giving a prescribed dose of aspirin? Correct Answer The patient reports that symptoms began with a severe headache. Rational: A sudden onset headache is typical of a subarachnoid hemorrhage, and aspirin is contraindicated. Atrial fibrillation, dysphasia, and transient ischemic attack are not contraindications to aspirin use. A patient being admitted with a stroke has right-sided facial drooping and right-sided arm and leg paralysis. Which finding should the nurse expect? Correct Answer Difficulty comprehending instructions Rational: Right-sided paralysis indicates a left-brain stroke, which will lead to difficulty with comprehension and use of language. The left-side reflexes are likely to be intact. Impulsive behavior and neglect are more likely with a right-side stroke. During change of shift report, a nurse is told that a patient has an occluded left posterior cerebral artery. What finding should the nurse anticipate? Correct Answer Visual deficits Rational: Visual disturbances are expected with posterior cerebral artery occlusion. Aphasia occurs with middle cerebral artery involvement. Cognitive deficits and changes in judgment are more typical of anterior cerebral artery occlusion. What will the nurse tell the patient who has cerebral atherosclerosis about taking clopidogrel (Plavix)? Correct Answer Call the health care provider if stools are tarry.