age 1 of 37
CRITICAL CARE EXAM 2 - PRACTICE QUESTIONS AND
ANSWERS WITH RATIONALES
ischemic stroke ......ANSWER........a type of stroke that occurs
when the flow of blood to the brain is blocked due to plaque or
emboli
examples of ischemic stroke ......ANSWER........Large Artery
Atherosclerosis, Cardioembolic, Lacunar stroke, Crytogenic
stroke.
TIA ......ANSWER........signs and symptoms of a stroke are present
due to decreased cerebral blood flow, but symptoms resolve
within 24 hours. found with CT scan
TIA time frame ......ANSWER........5-10 mins symptoms less than
24 hours
-decrease in cerebral perfusion
What causes a TIA? ......ANSWER........carotid artery stenosis
,age 2 of 37
s/s of a TIA ......ANSWER........monocular blindness, temp focal
neurologic deficit, no permanent deficits
TIA treatment ......ANSWER........carotid endarterectomy (cleaning
out the arteries)
intracerebral stroke ......ANSWER........-most common type of
hemorrhagic stroke
-Rupture of small vessels inside the brain, most deadly type of
stroke (bleeding of the brain tissue)
ruptured cerebral aneurysm ......ANSWER........dilation of a
section of an artery that causes the vessel wall to weaken (circle
of willis). seizures can occur within the first 12 hours of rupture.
risk of vasospasm.
hemorrhagic stroke ......ANSWER........uncontrolled bleeding into
intracerebral or subarachnoid space or both
,age 3 of 37
arteriovenous malformation (AVM)
......ANSWER........miscommunication between the artery and the
vein.
-blood is being shunted to the veins w/o capillary use
-can present as tumor. Put the vesicles at risk for rupturing
NIHSS ......ANSWER........National Institutes of Health Stroke Scale
What is the NIHSS used for? ......ANSWER........To determine
severity of stroke:
LOC, orientation, CN, speech, motor, visual
physical assessment of a stroke ......ANSWER........-neuro checks
and knowing where the stroke is in the brain will help with the
assessment
-weakness or numbness of one side of body, slurred speech,
visual disturbance, dizziness, incoordination, ataxia, vertigo,
sudden onset of severe headache /assess airway, breathing,
circulation
, age 4 of 37
stroke diagnostics ......ANSWER........CT without contrast, EKG,
NIH, CBC, MRI, PT/INR, BMP, cardiac enzymes.
ischemic stroke treatment ......ANSWER........tPA can be given as
treatment within 4.5 hrs of symptom onset. permissive HTN with
tPA is SBP<185.when tPA cannot be given permissive HTN is
<220. need to maintain glycemic control, anticoagulants, NPO
until swallow screen is complete.
-thrombectomy
when is the nurse able to give TPA? ......ANSWER........less than
4.5 hours from the onset, pt must be older than 18, CT scan
shows ischemia, measurable deficits, the pt cannot have
hemorrhage or bleeding, recent head trauma or surgery
when is the nurse NOT able to give TPA? ......ANSWER........more
than 4.5 hrs from onset, rapidly moving, current hemorrhage or
bleeding, recent head trauma, recent cns surgery, severe HTN
CRITICAL CARE EXAM 2 - PRACTICE QUESTIONS AND
ANSWERS WITH RATIONALES
ischemic stroke ......ANSWER........a type of stroke that occurs
when the flow of blood to the brain is blocked due to plaque or
emboli
examples of ischemic stroke ......ANSWER........Large Artery
Atherosclerosis, Cardioembolic, Lacunar stroke, Crytogenic
stroke.
TIA ......ANSWER........signs and symptoms of a stroke are present
due to decreased cerebral blood flow, but symptoms resolve
within 24 hours. found with CT scan
TIA time frame ......ANSWER........5-10 mins symptoms less than
24 hours
-decrease in cerebral perfusion
What causes a TIA? ......ANSWER........carotid artery stenosis
,age 2 of 37
s/s of a TIA ......ANSWER........monocular blindness, temp focal
neurologic deficit, no permanent deficits
TIA treatment ......ANSWER........carotid endarterectomy (cleaning
out the arteries)
intracerebral stroke ......ANSWER........-most common type of
hemorrhagic stroke
-Rupture of small vessels inside the brain, most deadly type of
stroke (bleeding of the brain tissue)
ruptured cerebral aneurysm ......ANSWER........dilation of a
section of an artery that causes the vessel wall to weaken (circle
of willis). seizures can occur within the first 12 hours of rupture.
risk of vasospasm.
hemorrhagic stroke ......ANSWER........uncontrolled bleeding into
intracerebral or subarachnoid space or both
,age 3 of 37
arteriovenous malformation (AVM)
......ANSWER........miscommunication between the artery and the
vein.
-blood is being shunted to the veins w/o capillary use
-can present as tumor. Put the vesicles at risk for rupturing
NIHSS ......ANSWER........National Institutes of Health Stroke Scale
What is the NIHSS used for? ......ANSWER........To determine
severity of stroke:
LOC, orientation, CN, speech, motor, visual
physical assessment of a stroke ......ANSWER........-neuro checks
and knowing where the stroke is in the brain will help with the
assessment
-weakness or numbness of one side of body, slurred speech,
visual disturbance, dizziness, incoordination, ataxia, vertigo,
sudden onset of severe headache /assess airway, breathing,
circulation
, age 4 of 37
stroke diagnostics ......ANSWER........CT without contrast, EKG,
NIH, CBC, MRI, PT/INR, BMP, cardiac enzymes.
ischemic stroke treatment ......ANSWER........tPA can be given as
treatment within 4.5 hrs of symptom onset. permissive HTN with
tPA is SBP<185.when tPA cannot be given permissive HTN is
<220. need to maintain glycemic control, anticoagulants, NPO
until swallow screen is complete.
-thrombectomy
when is the nurse able to give TPA? ......ANSWER........less than
4.5 hours from the onset, pt must be older than 18, CT scan
shows ischemia, measurable deficits, the pt cannot have
hemorrhage or bleeding, recent head trauma or surgery
when is the nurse NOT able to give TPA? ......ANSWER........more
than 4.5 hrs from onset, rapidly moving, current hemorrhage or
bleeding, recent head trauma, recent cns surgery, severe HTN
