Management of Patients with Cerebrovascular Disorders

A client with hypercholesterolemia is receiving Lipitor (atorvastatin) to prevent high cholesterol and stroke. The order is for Lipitor 40 mg PO daily. The medication is supplied in 80 mg tabs. How many tabs will the nurse administer to the client? A. 0.25 tab B. 0.5 tab C. 1 tab D. 2 tabs

B. 0.5 tab

A nurse is teaching a community group about modifiable and nonmodifiable disk factors for ischemic strokes. Which of the following is a risk factor that cannot be modified? A. Hypertension B. Atrial fibrillation C. Advanced age D. Obesity

C. Advanced age

A client reports light-headedness, speech disturbance, and left-sided weakness that have lasted for several hours. In the examination, an abnormal sound is auscultated in an artery leading to the brain. What is the term for the auscultated discovery? A. TIA B. Diplopia C. Bruit D. Atherosclerotic plaque

C. Bruit

How often should neurologic assessments and vital signs be taken initially for the patient receiving tissue plasminogen activator (t-PA)? A. Every 30 minutes B. Every 45 minutes C. Every 15 minutes D. Every hour

C. Every 15 minutes

The nurse practitioner is able to correlate a patient's neurologic deficits with the location in the brain affected by ischemia or hemorrhage. For a patient with a left hemispheric stroke, the nurse would expect to see: A.Left visual field deficit B. Impulsive behavior C. Right-sided paralysis D. Spatial-perceptual deficits

C. Right-sided paralysis

Which is a contraindication for the administration of tissue plasminogen activator (t-PA)? A. Ischemic stroke B. Age 18 years or older C. Systolic blood pressure less than or equal to 185 mmHg D. Intracranial hemorrhage

D. Intracranial hemorrhage

A client is admitted with weakness, expressive aphasia, and right hemianopia. The brain MRI reveals an infarct. The nurse understands these sy,proms to be suggestive of which of the following findings? A. Transient ischemic attack B. Completed Stroke C. Right-sided cerebrovascular accident (CVA) D. Left-sided cerebrovascular accident (CVA)

D. Left-sided cerebrovascular accident (CVA)

Which of the following is the initial diagnostic in suspected stroke? A. Cerebral angiography B. Magnetic resonance imaging (MRI) C. CT with contrast D. Noncontrast computed tomography

D. Noncontrast computed tomography

Which of the following is the chief cause of intracerebral hemorrhage (ICH)? A. Diabetes B. Hypercholesterolemia C. Migraine headaches D. Uncontrolled hypertension

D. Uncontrolled hypertension

A patient is brought to the emergency department with a possible stroke. What initial diagnostic test for a stroke, usually performed in the emergency department, would the nurse prepare the patient for? A. 12-lead echocardiogram B. Noncontrast computed tomography C. Carotid ultrasound study D. Transcranial Doppler flow study

B. Noncontrast computed tomography

A nurse is teaching a community class that those experiencing symptoms of ischemic stroke need to enter the medical system early. The primary reason for this is which of the following? A. A ruptured intracranial aneurysm must quickly be repaired B. A ruptured arteriovenous malformation will cause deficits until it is stopped C. Thrombolytic therapy has a time window of only 3 hours D. Intracranial pressure is increased by a space-occupying bleed

C. Thrombolytic therapy has a time window of only 3 hours

A nurse is working with a student who is caring for a client with an acute bleeding cerebral aneurysm. Which action by the student nurse requires further intervention? A. Maintaining the client in a quiet environment B. Keeping the client in one position to decrease bleeding C. Positioning the client to prevent airway obstruction D. Administering I.V. fluids as ordered and monitoring for client for signs of fluid volume excess

B. Keeping the client in one position to decrease bleeding

A client admitted to the emergency department is being evaluated for the possibility of a stroke. Which assessment finding would lead the nurse to suspect that the client is experiencing a hemorrhagic stroke? A. Slurred speech B. Severe exploding headache C. Left-sided weakness D. Difficulty finding appropriate words

B. Severe exploding headache

The nurse is caring for a client diagnosed with a hemorrhagic stroke. The nurse recognizes a that which intervention is most important? A. Elevating the head of the bed to 30 degrees B. Monitoring for seizure activity C. Maintaining a patent airway D. Administering a stool softener

C. Maintaining a patent airway

A 154-pound woman has been prescribed t-PA (0.9 mg/kg) for an ischemic stroke. The nurse knows to give how many mg initially? A. 7.5 mg B. 6.3 mg C. 8.3 mg D. 10 mg

B. 6.3 mg

A client with a history of atrial fibrillation has experienced a TIA. In an effort to reduce the risk of cerebrovascular accident (CVA), the nurse anticipates the priority medical treatment to include which of the following? A. Anticoagulant therapy B. Cholesterol-lowering drugs C. Carotid endarterectomy D. Monthly prothrombin levels

A. Anticoagulant therapy

While making your initial rounds after coming on shift, you find a client thrashing about in bed complaining of a severe headache. The client tells you the pain is behind his right eye which is red and tearing. What type of headache would you suspect this client of having? A. Cluster B. Sinus C. Migraine D. Tension

A. Cluster

The nurse is caring for a client with aphasia. Which strategy will the nurse use to facilitate communication with the client? A. Establishing eye contact B. Speaking loudly C. Avoiding the use of hand gestures D. Speaking in complete sentences

A. Establishing eye contact

The nurse is caring for a patient having a hemorrhagic stroke. What position in the bed will the nurse maintain this patient? A. Semi-Fowler's B. Supine C. Prone D. High-Fowler's

A. Semi-Fowler's

Which interventions would be recommended for a client with dysphagia? (Select all that apply.) A. Test the gag reflex before offering food or liquids B. Assist the client with meals C. Pace food on the affected side of the mouth D. Allow ample time to eat

A. Test the gag reflex before offering food or liquids B. Assist the client with meals D. Allow ample time to eat