(verified) already passed
1. After a patient experienced a brief episode of tinnitus, diplopia, and dysarthria with no
residual effects, the nurse anticipates teaching the patient about
a.
cerebral aneurysm clipping.
b.
heparin intravenous infusion.
c.
oral low-dose aspirin therapy.
d.
tissue plasminogen activator (tPA). - correct answer ✔✔ ANS: C
The patient's symptoms are consistent with transient ischemic attack (TIA), and drugs that
inhibit platelet aggregation are prescribed after a TIA to prevent 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.
2. A 68-year-old 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
the prescribed aspirin?
a.
The patient has dysphasia.
b.
The patient has atrial fibrillation.
c.
,The patient reports that symptoms began with a severe headache.
d.
The patient has a history of brief episodes of right-sided hemiplegia. - correct answer ✔✔ ANS:
C
A sudden onset headache is typical of a subarachnoid hemorrhage, and aspirin is
contraindicated. Atrial fibrillation, dysphasia, and transient ischemic attack (TIA) are not
contraindications to aspirin use, so the nurse can administer the aspirin.
3. A 73-year-old patient with a stroke experiences facial drooping on the right side and right-
sided arm and leg paralysis. When admitting the patient, which clinical manifestation will the
nurse expect to find?
a.
Impulsive behavior
b.
Right-sided neglect
c.
Hyperactive left-sided tendon reflexes
d.
Difficulty comprehending instructions - correct answer ✔✔ ANS: D
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.
4. During the change of shift report a nurse is told that a patient has an occluded left posterior
cerebral artery. The nurse will anticipate that the patient may have
a.
dysphasia.
b.
confusion.
, c.
visual deficits.
d.
poor judgment. - correct answer ✔✔ ANS: C
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.
5. When teaching about clopidogrel (Plavix), the nurse will tell the patient with cerebral
atherosclerosis
a.
to monitor and record the blood pressure daily.
b.
that Plavix will dissolve clots in the cerebral arteries.
c.
that Plavix will reduce cerebral artery plaque formation.
d.
to call the health care provider if stools are bloody or tarr - correct answer ✔✔ ANS: D
Clopidogrel (Plavix) inhibits platelet function and increases the risk for gastrointestinal bleeding,
so patients should be advised to notify the health care provider about any signs of bleeding. The
medication does not lower blood pressure, decrease plaque formation, or dissolve clots.
6. A patient with carotid atherosclerosis asks the nurse to describe a carotid endarterectomy.
Which response by the nurse is accurate?
a.
"The obstructing plaque is surgically removed from an artery in the neck."
b.
"The diseased portion of the artery in the brain is replaced with a synthetic graft."