PUCH62CerebrovascularDisorders PartII
A 64-year-old client reports symptoms consistent with a transient ischemic attack (TIA) to the health care provider in the emergency department. Which is the origin of the client's symptoms? A. impaired cerebral circulation B. cardiac disease C. diabetes insipidus D. hypertension
A
A client has experienced an ischemic stroke that has damaged the frontal lobe of his brain. Which of the following deficits does the nurse expect to observe during assessment? A. Limited attention span and forgetfulness B. Hemiplegia or hemiparesis C. Lack of deep tendon reflexes D. Visual and auditory agnosia
A
A healthcare provider orders several drugs for a client with hemorrhagic stroke. Which drug order should the nurse question? A. Heparin sodium B. Dexamethasone C. Methyldopa D. Phenytoin
A
The nurse is providing information about strokes to a community group. Which of the following would the nurse identify as the primary initial symptoms of an ischemic stroke? A. Weakness on one side of the body and difficulty with speech B. Severe headache and early change in level of consciousness C. Foot drop and external hip rotation D. Vomiting and seizures
A
The provider diagnoses the patient as having had an ischemic stroke. The etiology of an ischemic stroke would include which of the following? A. Cardiogenic emboli B. Cerebral aneurysm C. Arteriovenous malformation D. Intracerebral hemorrhage
A
Which term refers to the failure to recognize familiar objects perceived by the senses? A. Agnosia B. Agraphia C. Apraxia D. Perseveration
A
A diagnostic test has determined that the appropriate diet for the client with a left cerebrovascular accident (CVA) should include thickened liquids. Which of the following is the priority nursing diagnosis for this client? A. Decreased Fluid Volume Risk B. Aspiration Risk C. Impaired Swallowing D. Malnutrition Risk
C
A client reports light-headedness, speech disturbance, and left-sided weakness lasting for several hours. The neurologist diagnosed a transient ischemic attack, which caused the client great concern. What would the nurse include during client education? A. When symptoms cease, the client will return to presymptomatic state. B. A TIA is an insidious, often chronic episode of neurologic impairment. C. Symptoms of a TIA may linger for up to a week. D. Two thirds of people that experience a TIA will go on to develop a stroke.
A
A nurse is instructing the spouse of a client who suffered a stroke about the use of eating devices the client will be using. During the teaching, the spouse starts to cry and states, "One minute he is laughing, and the next he's crying; I just don't understand what's wrong with him." Which statement is the best response by the nurse? A. "Emotional lability is common after a stroke, and it usually improves with time." B. "You sound stressed; maybe using some stress management techniques will help." C. "You seem upset, and it may be hard for you to focus on the teaching, I'll come back later." D. "This behavior is common in clients with stroke. Which does your spouse do more often? Laugh or cry?"
A
A nurse is providing care to a client who has had a stroke. Which symptoms are consistent with left-sided stroke? A. expressive aphasia, defects in the right visual fields, problems with abstract thinking B. impulsive behavior, poor judgment, deficits in left visual fields C. problems with abstract thinking, impairment of short-term memory, poor judgment D. cautious behavior, deficits in left visual fields, misjudgment of distances
A
A nurse practitioner provides health teaching to a patient who has difficulty managing hypertension. This patient is at an increased risk of which type of stroke? A. Intracerebral hemorrhage B. Subarachnoid hemorrhage C. Hemorrhage due to an aneurysm D. Arteriovenous malformation
A
A patient had a carotid endarterectomy yesterday and when the nurse arrived in the room to perform an assessment, the patient states, "All of a sudden, I am having trouble moving my right side." What concern should the nurse have about this complaint? A. A thrombus formation at the site of the endarterectomy B. This is a normal occurrence after an endarterectomy and would not be a concern. C. Bleeding from the endarterectomy site D. Surgical wound infection
A
A stroke victim is experiencing memory loss and impaired learning capacity. The nurse knows that brain damage has most likely occurred in which lobe? A. Frontal B. Occipital C. Parietal D. Temporal
A
An emergency department nurse is interviewing a client who is presenting with signs of an ischemic stroke that began 2 hours ago. The client reports a history of a cholecystectomy 6 weeks ago and is taking digoxin, warfarin, and labetalol. What factor poses a threat to the client for thrombolytic therapy? A. International normalized ratio greater than 2 B. Two hour time period of the stroke C. Taking digoxin D. Surgery 6 weeks ago
A
While caring for clients who have suffered neurologic deficits from causes such as cerebrovascular accident and closed head injury, an important nursing goal that motivates nurses to offer the best care possible is preventing: A. complications. B. falls. C. choking. D. infection.
A
A client diagnosed with a stroke is ordered to receive warfarin. Later, the nurse learns that the warfarin is contraindicated and the order is canceled. The nurse knows that the best alternative medication to give is A. dipyridamole. B. aspirin. C. clopidogrel. D. ticlopidine.
B
A client who's paralyzed on the left side has been receiving physical therapy and attending teaching sessions about safety. Which behavior indicates that the client accurately understands safety measures related to paralysis? A. The client leaves the side rails down. B. The client uses a mirror to inspect the skin. C. The client repositions only after being reminded to do so. D. The client hangs the left arm over the side of the wheelchair.
B
A female client who reports recurring headaches, accompanied by increased irritability, photophobia, and fatigue is asked to track the headache symptoms and occurrence on a calendar log. Which is the best nursing rationale for this action? A. Cluster headaches can cause severe debilitating pain. B. Migraines often coincide with menstrual cycle. C. Tension headaches are easier to treat. D. Headaches are the most common type of reported pain.
B
A patient who has suffered a stroke begins having complications regarding spasticity in the lower extremity. What ordered medication does the nurse administer to help alleviate this problem? A. Diphenhydramine (Benadryl) B. Lioresal (Baclofen) C. Heparin D. Pregabalin (Lyrica)
B
While providing information to a community group, the nurse tells them the primary initial symptoms of a hemorrhagic stroke are: A. Weakness on one side of the body and difficulty with speech B. Severe headache and early change in level of consciousness C. Foot drop and external hip rotation D. Confusion or change in mental status
B
A client is following up after a visit to the emergency department where testing indicated that the client had suffered a transient ischemic attack. What lifestyle changes would the nurse include in teaching to prevent further reoccurrence? Select all that apply. A. High-dose aspirin B. Blood pressure control C. Weight loss D. Physical activity limitations E. Smoking cessation
B C E
A client has been diagnosed as having global aphasia. The nurse recognizes that the client will be unable to perform which action? A. Comprehend spoken words B. Form words that are understandable C. Form words that are understandable or comprehend spoken words D. Speak at all
C
A client is receiving an IV infusion of mannitol (Osmitrol) after undergoing intracranial surgery to remove a brain tumor. To confirm that this drug is producing its therapeutic effect, the nurse should consider which finding most significant? A. Decreased level of consciousness (LOC) B. Elevated blood pressure C. Increased urine output D. Decreased heart rate
C
A nurse is reading a journal article about stroke and the underlying causes associated with this condition. The nurse demonstrates understanding of the information when identifying which subtype of stroke as being due to atrial fibrillation? A. large-artery thrombotic B. small, penetrating artery thrombotic C. cardio embolic D. cryptogenic
C
A patient is admitted via ambulance to the emergency room of a stroke center at 1:30 p.m. with symptoms that the patient said began at 1:00 p.m. Within 1 hour, an ischemic stroke had been confirmed and the doctor ordered tPA. The nurse knows to give this drug no later than what time? A. 2:00 p.m. B. 3:00 p.m. C. 4:00 p.m. D. 7:00 p.m.
C
A 76-year-old client is brought to the clinic by his daughter. The daughter states that her father has had two transient ischemic attacks (TIAs) in the past week. The physician orders carotid angiography, and the report reveals that the carotid artery has been narrowed by atherosclerotic plaques. What treatment option does the nurse expect the physician to offer this client to increase blood flow to the brain? A. Stent placement B. Removal of the carotid artery C. Percutaneous transluminal coronary artery angioplasty D. Carotid endarterectomy
D
A client has experienced an ischemic stroke that has damaged the temporal (lateral and superior portions) lobe. Which of the following deficits would the nurse expect during assessment of this client? A. Limited attention span and forgetfulness B. Hemiplegia or hemiparesis C. Lack of deep tendon reflexes D. Auditory agnosia
D
A client is hospitalized when presenting to the emergency department with right-sided weakness. Within 6 hours of being admitted, the neurologic deficits had resolved and the client was back to his presymptomatic state. The nurse caring for the client knows that the probable cause of the neurologic deficit was what? A. Left-sided stroke B. Right-sided stroke C. Cerebral aneurysm D. Transient ischemic attack
D
The nurse is caring for a client diagnosed with a hemorrhagic stroke. The nurse recognizes that which intervention is most important? A. Elevating the head of the bed to 30 degrees B. Monitoring for seizure activity C. Administering a stool softener D. Maintaining a patent airway
D