stroke nclex questions

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Stroke Questions: NCLEX Style

10 terms superCandace32 Preview NCLEX med surg stroke 36 terms Shauna_Wiberg Preview Spinal Cord Injury NCLEX 26 terms ET0003Preview Seizure 12 terms mur in promoting health maintenance for prevention of strokes, the nurse understands that the highest risk for the most common type of stroke is present in which people?

• blacks
• women who smoke
• persons with hypertension and diabetes
• those who are obese with high dietary fat intake

c a thrombus that develops in a cerebral artery does not always cause a loss of neurologic function because

• the body can dissolve atherosclerotic plaques as they

form

• some tissues of the brain do not require constant

blood supply to prevent damage

• circulation via the circle of willis may provide blood

supply to the affected area of the brain

• neurologic deficits occur only when major arteries are

occluded by thrombus formation around atherosclerotic plaque c

a patient comes to the ED with numbest of the face and an inability to speak. while the patient awaits examination, the symptoms disappear and the patient requests discharge. why should the nurse emphasize that it is important for the patient to be treated before leaving

• the patient has probably experience an asymptotic

lacunar stroke

• the symptoms are likely to return and progress to

worsening neurologic deficit in the next 24 hours

• neurologic deficits that are transient occur most often

as a result of small hemorrhages that clot off

• the patient has probably had a transient ischemic

attack (TIA) which is a sign of progressive cerebrovascular disease d which statement describe characteristics of a stroke caused by an intracerebral hemorrhage> (select all that apply)?

• carries poor prognosis
• caused by rupture of a vessel
• strong association with hypertension
• commonly occurs during or after sleep
• creates a mass that compresses the brain

a, b, c, e which type of stroke is associated with endocardial disorders, has a rapid onset and is likely to occur during activity?

• embolic
• thrombotic
• intracerebral hemorrhage
• subarachnoid hemorrhage

a what primarily determines the neurological functions that are affected by a stroke?

• the amount of tissue area involved
• the rapidity of the onset of symptoms
• the brain area perfused by the affected artery
• the presence or absence of collateral circulation

c right or left brain damage? aphasia, inability to remember words, hemiplegia of the right side of the body left right or left brain damage? impaired judgment, quick and impulse behavior, left homonymous hemianopsia, neglect of left side of body right the patient has a lack of comprehension of both verbal and written language. which type of communication difficulty does this patient. have?

• dysarthria
• fluent dysphasia
• receptive aphasia
• expressive aphasia

c

A patient is admitted to the hospital with a left hemiplegia. To determine the size and location and to ascertain whether a stroke is ischemic or hemorrhagic, the nurse anticipates that the health care provider will request a

• lumbar puncture
• cerebral angiography
• MRI
• CT scan with contrast

c A carotid endarterectomy is being considered as a treatment for a patient who has had several TIAs. The nurse explains to the patient that this surgery

• involves intracranial surgery to join a superficial

extracranial artery to an intracranial artery

• is used to restore blood to the brain following an

obstruction of a cerebral artery

• is used to open a stenosis in a carotid artery with a

balloon and stent to restore cerebral circulation

• involves removing an atherosclerotic plaque in the

carotid artery to prevent an impending stroke d The incidence of ischemic stroke in patients with TIAs and other risk factors is reduced with administration of

• nimodipine (Nimotop)
• furosemide (Lasix)
• warfarin (Coumadin)
• daily low dose aspirin

d what is the priority intervention in the ED for the patient with a stroke?

• IV fluid replacement
• giving osmotic diuretics to reduce cerebral edema
• starting hypothermia to decrease the oxygen needs of

the brain d.maintaining respiratory function with a patent airway and oxygen administration d A diagnosis of a ruptured cerebral aneurysm has been made in a patient with manifestations of a stroke. The nurse anticipates that treatment options that would be evaluated for the patient include

• hyperventilation therapy
• surgical clipping of the aneurysm
• administration of hyperosmotic agents
• administration of thrombolytic therapy

b

During the acute phase of a stroke, the nurse assesses the patient's vital signs and neurologic status every 4 hours. A cardiovascular sign that the nurse would see as the body attempts to increase cerebral blood flow is

• hypertension
• fluid overload
• cardiac dysrhythmias
• S3 and S4 heart sounds

a During the secondary assessment of a patient with a stroke, what should be included (select all that apply)?

• gaze
• sensation
• facial palsy
• proprioception
• current medications
• distal motor function

a, b, c, d, f what is a nursing intervention that is indicated for the patient with hemiplegia?

• the use of a footboard to prevent plantar flexion
• immobilization of the affected arm against the chest

with a sling

• positioning the patient in bed with each joint lower

than the joint proximal to it

• having the patient perform passive rang of motion

(ROM) of the affected limb with the unaffected limb d a newly admitted patient diagnosed with a right sided brain stroke has homonymous hemianopsia. early in the case of the patient what should the nurse do ?

• place objects on the right side within the patients field

of vision

• approach the patient from the left side to assess the

patients ability to compensate

• place objects on the left side to assess the patients

ability to compensate

• patch the affected eye to encourage patient to turn

the head to scan the environments a four days following a stroke, a patient is to start oral fluids and feedings. before feeding the patient, what should the nurse do first?

• check the patient's gag reflex
• order a soft diet for the paitnet
• raise the head of the bed to a sitting position
• assess the patients ability to swallow tiny amounts of

crushed ice a