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Stroke Questions: NCLEX Style
ScienceMedicineNursing superCandace32 Save NCLEX med surg stroke 36 terms Shauna_Wiberg Preview stroke nclex questions 27 terms grau002Preview ICP Nclex Questions, ICP NCLEX sty...120 terms Mariko_Roberts Preview Spinal 26 terms ET0 Regular oral hygiene is an essential intervention for the client who has had a stroke. Which of the following nursing measures is inappropriate when providing oral hygiene?
A: Placing client on back with small pillow under the head
B: Keeping portable suctioning equipment at the bedside
C: Opening the client's mouth with a padded tongue blade
D: Cleaning the clients mouth and teeth with toothbrush
Answer: A
A 78 year old client is admitted to the ED with numbness and weakness of the left arm and slurred speech. Which nursing intervention is priority?
A: Prepare to administer recombinant tissue plasminogen activator (rt-PA)
B: Discuss the precipitating factors that caused the symptoms
C: Schedule a STAT CT scan of head
D: Notify speech pathologist for emergency consult
Answer: C
A client arrives at the ED with ischemic stroke and receives tissue plasminogen activator (t-PA) administration. Which is priority nursing assessment?
A: Current medications
B: Complete physical and history
C: Time of onset of current stroke
D: Upcoming surgical procedures
Answer: C
During the first 24 hours after thrombolytic therapy for ischemic stroke, the primary goal is to control the clients:
A: Pulse
B: Respiration
C: BP
D: Temperature
Answer: C
What is a priority nursing assessment in the first 24 hours after admission of client with a thrombotic stroke?
A: Cholesterol level
B: Pupil size and papillary response
C: Vowel sounds
D: Echo
Answer: B
What is expected outcome of thrombolytic drug therapy?
A: Increased vascular permeability
B: Vasoconstriction
C: Dissolved emboli
D: Prevention of hemorrhage
Answer: C
The client diagnosed with A-fib, has experienced a TIA. Which medication would the nurse anticipate being ordered for the client on discharge?
A: PO anticoagulant medication
B: Beta-blocker medication
C: Anti-hyperuricemic medication
D: Thrombolytic medication
Answer: A
Which client would the nurse identify as being MOST at risk for experiencing a CVA?
A: 55yr. old African American Male
B: 84yr. old Japanese female
C: 67yr. old white male
D: 39yr. old prego female
Answer: A
Which assessment data would indicate to nurse that the client would be at risk for hemorrhagic stroke?
A: Blood glucose level of 480mg/dL
B: Right sided carotid bruit
C: BP of 220/120 mm Hg
D: Presence of bronchogenic carcinoma
Answer: C
The Nurse and UAP are caring for a client with right-sided paralysis. Which action by the UAP requires the nurse to intervene?
A: Place gait belt around client's waster prior to ambulating
B: Places client on back with client's head to the side
C: Places her hand under the client's right axilla to help them move up in bed
D: Praises the client for attempting to perform ADL's independently
Answer: C Terms (10)
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