HESI Case Studies- Stroke Exam
Questions and Answers 100% Pass
Which additional clinical manifestations should the nurse expect to find if Mr.
Jones' symptoms have been caused by a stroke? (select all that apply) - ANSWER--
a carotid bruit
-elevated blood pressure
-hyporeflexic deep tendon reflexes
Which assessment findings warrant immediate intervention by the nurse? (select all
that apply) - ANSWER--Mr. Jones' Glasgow Coma Scale (GCS) score changes
from 12 to 9
-Mr. Jones has a positive Babinski's reflex bilaterally
-Mr. Jones is unable to verbalize responses to the nurse's questions
What clinical manifestations further support this assessment? (select all that apply)
- ANSWER--visual field deficit on the left side
-spatial-perceptual deficits
-paresthesia on the left side
©️COPYRIGHT 2025, ALL RIGHTS RESERVED. 1
, -increased distractibility
Which intervention should the nurse implement when preparing Mr. Jones and his
son for this procedure? - ANSWER-Explain that the procedure requires the client
to lie completely still.
Which data warrants immediate intervention by the nurse concerting this
diagnostic test? - ANSWER-Left hip replacement
Which explanation by the nurse is the most therapeutic response? - ANSWER-
Your father has had a stroke, and the blood supply to the brain has been
compromised.
How should the nurse respond? - ANSWER-I know this is scary for you. Would
you like to sit and talk?
How many mg of enoxaparin will the nurse administer in each dose? - ANSWER-
77
With a diagnosis of stroke, which priority intervention should the nurse include in
Mr. Jones' plan of care? (select all that apply) - ANSWER--Monitor PTT daily
-Assess neurological status every hour
-Keep the head of the bed elevated
-Monitor blood glucose levels daily
©️COPYRIGHT 2025, ALL RIGHTS RESERVED. 2
Questions and Answers 100% Pass
Which additional clinical manifestations should the nurse expect to find if Mr.
Jones' symptoms have been caused by a stroke? (select all that apply) - ANSWER--
a carotid bruit
-elevated blood pressure
-hyporeflexic deep tendon reflexes
Which assessment findings warrant immediate intervention by the nurse? (select all
that apply) - ANSWER--Mr. Jones' Glasgow Coma Scale (GCS) score changes
from 12 to 9
-Mr. Jones has a positive Babinski's reflex bilaterally
-Mr. Jones is unable to verbalize responses to the nurse's questions
What clinical manifestations further support this assessment? (select all that apply)
- ANSWER--visual field deficit on the left side
-spatial-perceptual deficits
-paresthesia on the left side
©️COPYRIGHT 2025, ALL RIGHTS RESERVED. 1
, -increased distractibility
Which intervention should the nurse implement when preparing Mr. Jones and his
son for this procedure? - ANSWER-Explain that the procedure requires the client
to lie completely still.
Which data warrants immediate intervention by the nurse concerting this
diagnostic test? - ANSWER-Left hip replacement
Which explanation by the nurse is the most therapeutic response? - ANSWER-
Your father has had a stroke, and the blood supply to the brain has been
compromised.
How should the nurse respond? - ANSWER-I know this is scary for you. Would
you like to sit and talk?
How many mg of enoxaparin will the nurse administer in each dose? - ANSWER-
77
With a diagnosis of stroke, which priority intervention should the nurse include in
Mr. Jones' plan of care? (select all that apply) - ANSWER--Monitor PTT daily
-Assess neurological status every hour
-Keep the head of the bed elevated
-Monitor blood glucose levels daily
©️COPYRIGHT 2025, ALL RIGHTS RESERVED. 2
