PrepU: Stroke

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) Heparin sodium

A patient presents to the emergency room with complaints of having an "exploding headache" for the last 2 hours. The patient is immediately seen by a triage nurse who suspects the patient is experiencing a stroke. Which of the following is a possible cause based on the characteristic symptom? A) Large artery thrombosis B) Cerebral aneurysm C) Cardiogenic emboli D) Small artery thrombosis

B) Cerebral aneurysm

A nurse who provides care at a community clinic is in contact with a diverse group of patients. Which of the following individuals most clearly displays risk factors for stroke? A) A man who is receiving oral antibiotics for the treatment of a chlamydial infection B) A woman who has osteoporosis, a history of fractures, and a family history of stroke C) An obese woman with a history of atrial fibrillation and type 2 diabetes D) A 70-year-old man who has benign prostatic hyperplasia and early stage Alzheimer's disease

C) An obese woman with a history of atrial fibrillation and type 2 diabetes

A client's emergency magnetic resonance imaging (MRI) has been examined by the physician and tissue plasminogen activator (tPA) has been administered to the client. What was this client's most likely diagnosis? A) Status epilepticus B)Subarachnoid hemorrhage C) Ischemic stroke D) Encephalitis

C) Ischemic stroke

The nurse working in an emergency room is caring for a client who is exhibiting signs and symptoms of a stroke. What does the nurse anticipate that the physician's orders will include? A) CT scan B) MRI C) Intravenous antibiotics D) Pain medication

A) CT scan

A client has experienced an ischemic stroke that has damaged the lower motor neurons of the brain. Which of the following deficits would the nurse expect during assessment? A) Limited attention span and forgetfulness B) Visual agnosia C) Lack of deep tendon reflexes D) Auditory agnosia

C) Lack of deep tendon reflexes

The most common cause of an ischemic stroke is which of the following? A) Intracerebral arterial vasculitis B) Cardiogenic embolus C) Thrombosis D) Vasospasm

C) Thrombosis

A community health nurse is conducting a workshop for unlicensed care providers who work in a chain of long-term care facilities. The nurse is teaching the participants about the signs and symptoms of stroke. What signs and symptoms should the nurse identify? Select all that apply. A) Epistaxis (nosebleed) B) Confusion C) Sudden numbness D) Sudden ear pain E) Visual disturbances

B, C, E

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

A) Intracranial hemorrhage

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) Lioresal (Baclofen)

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) Severe headache and early change in level of consciousness

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) aspirin.

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) Limited attention span and forgetfulness

Which of the following is accurate regarding a hemorrhagic stroke? A) Main presenting symptom is an "exploding headache." B) Functional recovery usually plateaus at 6 months. C) One of the main presenting symptoms is numbness or weakness of the face. D) It is caused by a large-artery thrombus.

A) Main presenting symptom is an "exploding headache."

When developing a care plan for a client who has recently suffered a stroke, a nurse includes the nursing diagnosis Risk for imbalanced body temperature. What is the rationale for this diagnosis? A) The stroke may have impacted the body's thermoregulation centers. B) A decreased body temperature will signal the need to cover the client. C) An elevated temperature indicated cerebellum malfunction. D) An elevated body temperature indicated infection.

A) The stroke may have impacted the body's thermoregulation centers.

A client suffering a thrombotic stroke is brought into the emergency department by ambulance and the health care team is preparing to administer a synthetic tissue plasminogen activator for which purpose? A) Thrombolysis B) Thrombogenesis C) Hemolysis D) Hemostasis

A) Thrombolysis

A teenager has been in a car accident and experienced an acceleration-deceleration head injury. Initially, the client was stable but then started to develop neurological signs/symptoms. The nurse caring for this client should be assessing for which type of possible complication? A)Brain contusions and hematomas B) TIAs and cerebrovascular infarction C) Momentary unconsciousness D) Status epilepticus

A)Brain contusions and hematomas

A nurse is assisting with a community screening for people at high risk for stroke. To which of the following clients would the nurse pay most attention? A) A 60-year-old Black Man B) A 40-year-old White woman C) a 62-year-old White woman D) A 28-year-old pregnant Black woman

A) A 60-year-old Black Man

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

B) Left-sided cerebrovascular accident (CVA)

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) "Emotional lability is common after a stroke, and it usually improves with time."

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

D) Semi-Fowler's

The nurse is participating in a health fair for stroke prevention. Which will the nurse say is a modifiable risk factor for ischemic stroke? A) Thyroid disease B) Social drinking C) Advanced age D) Smoking

D) Smoking

Which of the following antiseizure medication has been found to be effective for post-stroke pain? A) Lamotrigine (Lamictal) B) Phenytoin (Dilantin) C) Carbamazepine (Tegretol) D) Topiramate (Topamax)

A) Lamotrigine (Lamictal)

What clinical manifestations does the nurse recognize when a patient has had a right hemispheric stroke? A) Left visual field deficit B) Aphasia C) Slow, cautious behavior D) Altered intellectual ability

A) Left visual field deficit

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) International normalized ratio greater than 2

The nurse is caring for a client admitted with a stroke. Imaging studies indicate an embolus partially obstructing the right carotid artery. What type of stroke does the nurse know this client has? A) Ischemic B) Hemorrhagic C) Right-sided D) Left-sided

A) Ischemic

An emergency department nurse is awaiting the arrival of a client with signs of an ischemic stroke that began 1 hour ago, as reported by emergency medical personnel. The treatment window for thrombolytic therapy is which of the following? A) Three hours B) One hour C) Two hours D) Six hours

A) Three hours

A family member comes to the clinic to talk to the nurse about a client who has had a stroke on the right side of the brain. The family member is concerned because of the deficits the client is exhibiting. The nurse knows that when a client experiences a stroke on the right side of the brain, common deficits include what? Select all that apply. A) Left-sided hemiplegia B) Tendency to distractibility C) Impairment of long-term memory D) Hyperaware of deficits E) Neglect of objects and people on the left side

A, B, E

The MRA scan of a client with a suspected stroke reports ruptured berry aneurysm. The nurse plans care for a client with: A) Encephalitis B) Subarachnoid hemorrhage C) Lacunar infarct D) Thrombotic stroke

B) Subarachnoid hemorrhage