Lewis Chapter 62 – Stroke (Exam 2) 2025-2026 Complete Nursing
Study Guide with Detailed Notes, Key Concepts, and Practice
Questions for Exam Success||Latest Version!!!Graded A+
The nurse is discharging a patient admitted with a transient ischemic
attack (TIA). For which medications might the nurse expect to
provide discharge instructions (select all that apply)?
A. Clopidogrel (Plavix)
B. Enoxaparin (Lovenox)
C. Dipyridamole (Persantine)
D. Enteric-coated aspirin (Ecotrin)
E. Tissue plasminogen activator (tPA)
A. Clopidogrel (Plavix)
C. Dipyridamole (Persantine)
D. Enteric-coated aspirin (Ecotrin)
Aspirin (low dose 81mg/day) is the most frequently used antiplatelet
agent. Other drugs to prevent clot formation include clopidogrel
(Plavix), dipyridamole (Persantine), ticlopidine (Ticlid), combined
dipyridamole and aspirin (Aggrenox), and anticoagulant drugs, such
as oral warfarin (Coumadin). Tissue plasminogen activator is a
fibrinolytic medication used to treat ischemic stroke not prevent TIAs
or strokes. pg 1524
Which intervention is most appropriate when communicating with a
patient suffering from aphasia following a stroke?
A. Present several thoughts at once so that the patient can connect the
ideas.
B. Ask open-ended questions to provide the patient the opportunity to
speak.
C. Finish the patient's sentences to minimize frustration associated
with slow speech.
pg. 1
,D. Use simple, short sentences accompanied by visual cues to
enhance comprehension.
D. Use simple, short sentences accompanied by visual cues to
enhance comprehension.
When communicating with a patient with aphasia, the nurse should
present one thought or idea at a time. Ask questions that can be
answered with a "yes," "no," or simple word. Use visual cues and
allow time for the individual to comprehend and respond to the
conversation. pg 1532, Table 62.14
Computed tomography (CT) of a 68-year-old male patient's head
reveals that he has experienced a hemorrhagic stroke. What is the
priority nursing intervention in the emergency department?
A. Maintenance of patient's airway.
B. Positioning to promote cerebral perfusion.
C. Control of fluid and electrolyte imbalances.
D. Administration of tissue plasminogen activator (tPA)
A. Maintenance of patient's airway.
Maintenance of a patent airway is the priority in the acute care of a
patient with a hemorrhagic stroke. It supersedes the importance of
fluid and electrolyte imbalance and positioning. tPA is contraindicated
in hemorrhagic stroke.
A female patient has left-sided hemiplegia following an ischemic
stroke that she experienced 4 days earlier. How should the nurse best
promote the health of the patient's integumentary system?
A. Position the patient on her weak side the majority of the time.
B. Alternate the patient's positioning between supine and side-lying.
C. Avoid the use of pillows in order to promote independence in
positioning.
pg. 2
,D. Establish a schedule for the massage of areas where skin
breakdown emerges.
B. Alternate the patient's positioning between supine and side-lying.
A position change schedule should be established for stroke patients.
An example is side-back-side, with a maximum duration of 2 hours
for any position. The patient should be positioned on the weak or
paralyzed side for only 30 minutes. Pillows may be used to facilitate
positioning. Areas of skin breakdown should never be massaged. pg
1530, 1531
Which sensory-perceptual deficit is associated with left-sided stroke
(right hemiplegia)?
A. Overestimation of physical abilities.
B. Difficulty judging position and distance.
C. Slow and possibly fearful performance of tasks.
D. Impulsivity and impatience at performing tasks.
C. Slow and possibly fearful performance of tasks.
Patients with a left-sided stroke (right hemiplegia) commonly are
slower in organization and performance of tasks and may have a
fearful, anxious response to a stroke. Overconfidence, spatial
disorientation, and impulsivity are more commonly associated with a
right-sided stroke.
The female patient has been brought to the ED with a sudden onset of
a severe headache that is different from any other headache she has
had previously. When considering the possibility of a stroke, which
type of stroke should the nurse know is most likely occurring?
A. TIA
B. Embolic stroke
C. Thrombotic stroke
D. Subarachnoid haemorrhage
pg. 3
, D. Subarachnoid haemorrhage
Headache is common in a patient who has a subarachnoid
haemorrhage or an intracerebral haemorrhage. A TIA is a transient
loss of neurologic function usually without a headache. A headache
may occur with an ischemic embolic stroke, but severe neurologic
deficits are the initial symptoms. The ischemic thrombotic stroke
manifestations progress in the first 72 hours as infarction and cerebral
edema increase.
The patient with diabetes mellitus has had a right-sided stroke. Which
nursing intervention should the nurse plan to provide for this patient
related to expected manifestations of this stroke?
A. Safety measures
B. Patience with communication
C. Mobility assistance on the right side
D. Place food in the left side of patient's mouth
A. Safety measures
A patient with a right-sided stroke has spatial-perceptual deficits,
tends to minimize problems, has a short attention span, is impulsive,
and may have impaired judgment. Safety is the biggest concern for
this patient. Hemiplegia occurs on the left side of this patient's body.
The patient with a left-sided stroke has hemiplegia on the right, is
more likely to have communication problems, and needs mobility
assistance on the right side with food placed on the left side if the
patient needs to be fed after a swallow evaluation has taken place.
The nurse is planning psychosocial support for the patient and family
of the patient who suffered a stroke. What factor will most likely have
the greatest impact on positive family coping with the situation?
A. Specific patient neurologic deficits
B. The patient's ability to communicate
C. Rehabilitation potential of the patient
pg. 4
Study Guide with Detailed Notes, Key Concepts, and Practice
Questions for Exam Success||Latest Version!!!Graded A+
The nurse is discharging a patient admitted with a transient ischemic
attack (TIA). For which medications might the nurse expect to
provide discharge instructions (select all that apply)?
A. Clopidogrel (Plavix)
B. Enoxaparin (Lovenox)
C. Dipyridamole (Persantine)
D. Enteric-coated aspirin (Ecotrin)
E. Tissue plasminogen activator (tPA)
A. Clopidogrel (Plavix)
C. Dipyridamole (Persantine)
D. Enteric-coated aspirin (Ecotrin)
Aspirin (low dose 81mg/day) is the most frequently used antiplatelet
agent. Other drugs to prevent clot formation include clopidogrel
(Plavix), dipyridamole (Persantine), ticlopidine (Ticlid), combined
dipyridamole and aspirin (Aggrenox), and anticoagulant drugs, such
as oral warfarin (Coumadin). Tissue plasminogen activator is a
fibrinolytic medication used to treat ischemic stroke not prevent TIAs
or strokes. pg 1524
Which intervention is most appropriate when communicating with a
patient suffering from aphasia following a stroke?
A. Present several thoughts at once so that the patient can connect the
ideas.
B. Ask open-ended questions to provide the patient the opportunity to
speak.
C. Finish the patient's sentences to minimize frustration associated
with slow speech.
pg. 1
,D. Use simple, short sentences accompanied by visual cues to
enhance comprehension.
D. Use simple, short sentences accompanied by visual cues to
enhance comprehension.
When communicating with a patient with aphasia, the nurse should
present one thought or idea at a time. Ask questions that can be
answered with a "yes," "no," or simple word. Use visual cues and
allow time for the individual to comprehend and respond to the
conversation. pg 1532, Table 62.14
Computed tomography (CT) of a 68-year-old male patient's head
reveals that he has experienced a hemorrhagic stroke. What is the
priority nursing intervention in the emergency department?
A. Maintenance of patient's airway.
B. Positioning to promote cerebral perfusion.
C. Control of fluid and electrolyte imbalances.
D. Administration of tissue plasminogen activator (tPA)
A. Maintenance of patient's airway.
Maintenance of a patent airway is the priority in the acute care of a
patient with a hemorrhagic stroke. It supersedes the importance of
fluid and electrolyte imbalance and positioning. tPA is contraindicated
in hemorrhagic stroke.
A female patient has left-sided hemiplegia following an ischemic
stroke that she experienced 4 days earlier. How should the nurse best
promote the health of the patient's integumentary system?
A. Position the patient on her weak side the majority of the time.
B. Alternate the patient's positioning between supine and side-lying.
C. Avoid the use of pillows in order to promote independence in
positioning.
pg. 2
,D. Establish a schedule for the massage of areas where skin
breakdown emerges.
B. Alternate the patient's positioning between supine and side-lying.
A position change schedule should be established for stroke patients.
An example is side-back-side, with a maximum duration of 2 hours
for any position. The patient should be positioned on the weak or
paralyzed side for only 30 minutes. Pillows may be used to facilitate
positioning. Areas of skin breakdown should never be massaged. pg
1530, 1531
Which sensory-perceptual deficit is associated with left-sided stroke
(right hemiplegia)?
A. Overestimation of physical abilities.
B. Difficulty judging position and distance.
C. Slow and possibly fearful performance of tasks.
D. Impulsivity and impatience at performing tasks.
C. Slow and possibly fearful performance of tasks.
Patients with a left-sided stroke (right hemiplegia) commonly are
slower in organization and performance of tasks and may have a
fearful, anxious response to a stroke. Overconfidence, spatial
disorientation, and impulsivity are more commonly associated with a
right-sided stroke.
The female patient has been brought to the ED with a sudden onset of
a severe headache that is different from any other headache she has
had previously. When considering the possibility of a stroke, which
type of stroke should the nurse know is most likely occurring?
A. TIA
B. Embolic stroke
C. Thrombotic stroke
D. Subarachnoid haemorrhage
pg. 3
, D. Subarachnoid haemorrhage
Headache is common in a patient who has a subarachnoid
haemorrhage or an intracerebral haemorrhage. A TIA is a transient
loss of neurologic function usually without a headache. A headache
may occur with an ischemic embolic stroke, but severe neurologic
deficits are the initial symptoms. The ischemic thrombotic stroke
manifestations progress in the first 72 hours as infarction and cerebral
edema increase.
The patient with diabetes mellitus has had a right-sided stroke. Which
nursing intervention should the nurse plan to provide for this patient
related to expected manifestations of this stroke?
A. Safety measures
B. Patience with communication
C. Mobility assistance on the right side
D. Place food in the left side of patient's mouth
A. Safety measures
A patient with a right-sided stroke has spatial-perceptual deficits,
tends to minimize problems, has a short attention span, is impulsive,
and may have impaired judgment. Safety is the biggest concern for
this patient. Hemiplegia occurs on the left side of this patient's body.
The patient with a left-sided stroke has hemiplegia on the right, is
more likely to have communication problems, and needs mobility
assistance on the right side with food placed on the left side if the
patient needs to be fed after a swallow evaluation has taken place.
The nurse is planning psychosocial support for the patient and family
of the patient who suffered a stroke. What factor will most likely have
the greatest impact on positive family coping with the situation?
A. Specific patient neurologic deficits
B. The patient's ability to communicate
C. Rehabilitation potential of the patient
pg. 4
