Neuro NCLEX Questions and Answers

Neuro NCLEX Questions and Answers with Rationale 100% Pass

A patient comes to the emergency department immediately after experiencing numbness of the face and an inability to speak, but while the patient awaits examination, the symptoms disappear and the patient request discharge. The nurse stresses that it is important for the patient to be evaluated primarily because the patient has probably experienced a;

a.) Transient ischemic attack b.) Ischemic stroke c.) Hemorrhagic stroke d.) MI ✔✔a.) Transient ischemic stroke

Rationale:

The patient has probably experienced a transient ischemic attack (TIA), which is a sign of progressive cerebral vascular disease- (A TIA is a temporary focal loss of neurologic function caused by ischemia of an area of the brain, usually lasting only about 3 hours. TIAs may be due to microemboli from heart disease or carotid or cerebral thrombi and are a warning of progressive disease. Evaluation is necessary to determine the cause of the neurologic deficit and provide prophylactic treatment if possible.)

Aspirin is ordered for a patient who is admitted with a possible stroke. Which information obtained during the admission assessment indicates that the nurse should consult with the health care provider before giving the aspirin?

• The patient has dysphasia.
• The patient has atrial fibrillation.
• The patient states, "My symptoms started with a terrible headache."
• The patient has a history of brief episodes of right-sided hemiplegia. ✔✔c. The patient states,

"My symptoms started with a terrible headache."

Rationale:

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.

A patient with a stroke experiences right-sided arm and leg paralysis and facial drooping on the right side. When admitting the patient, which clinical manifestation will the nurse expect to find?

• Impulsive behavior
• Right-sided neglect

• Hyperactive left-sided reflexes
• Difficulty in understanding commands ✔✔d. Difficulty in understanding commands

Rationale:

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.

A patient with a history of several transient ischemic attacks (TIAs) arrives in the emergency department with hemiparesis and dysarthria that started 2 hours previously. The nurse anticipates the need to prepare the patient for

• surgical endarterectomy.
• transluminal angioplasty.
• intravenous heparin administration.
• tissue plasminogen activator (tPA) infusion. ✔✔d. tissue plasminogen activator (tPA)

infusion.

Rationale:

The patient's history and clinical manifestations suggest an acute ischemic stroke and a patient who is seen within 4.5 hours of stroke onset is likely to receive tPA (after screening with a CT scan). Heparin administration in the emergency phase is not indicated. Emergent carotid transluminal angioplasty or endarterectomy is not indicated for the patient who is having an acute ischemic stroke.

When caring for a patient with left-sided homonymous hemianopsia resulting from a stroke, which intervention should the nurse include in the plan of care during the acute period of the stroke?

• Apply an eye patch to the left eye.
• Approach the patient from the left side.
• Place objects needed for activities of daily living on the patient's right side.
• Reassure the patient that the visual deficit will resolve as the stroke progresses. ✔✔c. Place

objects needed for activities of daily living on the patient's right side.

Rationale:

During the acute period, the nurse should place objects on the patient's unaffected side. Since there is a visual defect in the left half of each eye, an eye patch is not appropriate. The patient