Stroke

If warfarin is contraindicated as a treatment for stroke, which medication is the best option? Aspirin Clopidogrel Ticlodipine Dipyridamole

Aspirin

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? Hemorrhage due to an aneurysm Subarachnoid hemorrhage Intracerebral hemorrhage Arteriovenous malformation

Intracerebral hemorrhage

Which terms refers to blindness in the right or left half of the visual field in both eyes? Nystagmus Diplopia Scotoma Homonymous hemianopsia

Homonymous hemianopsia

Which are contraindications for the administration of tissue plasminogen activator (t-PA)? Select all that apply. Ischemic stroke Systolic BP less than or equal to 185 mm Hg Intracranial hemorrhage Age 18 years or older Major abdominal surgery within 10 days

Intracranial hemorrhage

A client has been diagnosed as having global aphasia. The nurse recognizes that the client will be unable to do perform which action? Form understandable words Comprehend spoken words Speak at all Form understandable words and comprehend spoken words

Form understandable words

What is the expected outcome of thrombolytic drug therapy for stroke? increased vascular permeability prevention of hemorrhage vasoconstriction dissolved emboli

dissolved emboli

The results of which serologic test should the nurse have on the medical record before a client is started on tissue plasminogen activator or alteplase recombinant? Lee-White clotting time potassium level fibrin split product partial thromboplastin time

partial thromboplastin time

What is a priority nursing assessment in the first 24 hours after admission of the client with a thrombotic stroke? bowel sounds pupil size and pupillary response echocardiogram cholesterol level

pupil size and pupillary response

Which of the following statements reflects nursing management of the patient with expressive aphasia? Speak clearly and in simple sentences; use gestures or pictures when able. Frequently reorient the patient to time, place, and situation. Speak slowly and clearly to assist the patient in forming the sounds. Encourage the patient to repeat sounds of the alphabet.

Encourage the patient to repeat sounds of the alphabet.

A physician orders several drugs for a client with hemorrhagic stroke. Which drug order should the nurse question? Dexamethasone (Decadron) Methyldopa (Aldomet) Phenytoin (Dilantin) Heparin sodium

Heparin sodium

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? "Emotional lability is common after a stroke, and it usually improves with time." "You seem upset, and it may be hard for you to focus on the teaching, I'll come back later." "This behavior is common in clients with stroke. Which does your spouse do more often? Laugh or cry?" "You sound stressed; maybe using some stress management techniques will help."

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

Which term refers to the inability to perform previously learned purposeful motor acts on a voluntary basis? Perseveration Apraxia Agnosia Agraphia

Apraxia

Aneurysm rebleeding occurs most frequently during which time frame after the initial hemorrhage? First month First week First 48 hours First 2 weeks

First 48 hours...i think

Which is a modifiable risk factor for transient ischemic attacks and ischemic strokes? Advanced age Social drinking Thyroid disease Smoking

Smoking

A client with atrial fibrillation is receiving coumadin to prevent clots from forming in the atria. The order is for Coumadin (warfarin) 2.5 mg orally daily. The medication is supplied in 1 mg tabs. How many tabs will the nurse administer to the client? Enter the correct number ONLY

2.5

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? Surgical wound infection A thrombus formation at the site of the endarterectomy Bleeding from the endarterectomy site This is a normal occurrence after an endarterectomy and would not be a concern.

A thrombus formation at the site of the endarterectomy

Which term refers to the failure to recognize familiar objects perceived by the senses? Agraphia Perseveration Agnosia Apraxia

Agnosia

Which nursing interventions would be useful for a client with ICP related to bleeding in the brain? Select all that apply. Avoid any activities that cause a Valsalva maneuver. Follow the physician's orders to increase fluid volume. Report changes in neurologic status as soon as a worsening trend is identified. Use the Glasgow Coma Scale to assess neurologic status at least every 2 hours.

Avoid any activities that cause a Valsalva maneuver. Report changes in neurologic status as soon as a worsening trend is identified.

A white female client is admitted to an acute care facility with a diagnosis of stroke. Her history reveals bronchial asthma, exogenous obesity, and iron-deficiency anemia. Which history finding is a risk factor for stroke? Having bronchial asthma Being white Being obese Being female

Being obese

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? Cerebral aneurysm Cardiogenic emboli Large artery thrombosis Small artery thrombosis

Cerebral aneurysm

After a stroke, a client is admitted to the facility. The client has left-sided weakness and an absent gag reflex. He's incontinent and has a tarry stool. His blood pressure is 90/50 mm Hg, and his hemoglobin is 10 g. Which nursing intervention is a priority for this client? Checking stools for occult blood Keeping skin clean and dry Elevating the head of the bed to 30 degrees Performing range-of-motion (ROM) exercises on the left side

Elevating the head of the bed to 30 degrees

A client has been diagnosed as having global aphasia. The nurse recognizes that the client will be unable to perform which action? Form words that are understandable Comprehend spoken words Speak at all Form words that are understandable or comprehend spoken words

Form words that are understandable or Comprehend spoken words...i put formed words are understandable

A physician orders several drugs for a client with hemorrhagic stroke. Which drug order should the nurse question? Phenytoin Heparin sodium Dexamethasone Methyldopa

Heparin sodium

A nurse is caring for an older client who has had a hemorrhagic stroke. The client has exhibited impulsive behavior and, despite reminders from the nurse, doesn't recognize his limitations. Which priority measure should the nurse implement to prevent injury? Ask a physician to order a vest and wrist restraints. Encourage the client to do as much as possible without assistance, and to use the call light only in emergencies. Encourage the family to reprimand the client if he doesn't ask for help with transfers and mobility. Install a bed alarm to remind the client to ask for assistance and to alert staff that the client is getting out of bed.

Install a bed alarm to remind the client to ask for assistance and to alert staff that the client is getting out of bed.

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? Completed Stroke Left-sided cerebrovascular accident (CVA) Transient ischemic attack (TIA) Right-sided cerebrovascular accident (CVA)

Left-sided cerebrovascular accident (CVA)

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? Lioresal (Baclofen) Diphenhydramine (Benadryl) Pregabalin (Lyrica) Heparin

Lioresal (Baclofen)

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

Maintaining a patent airway

A transcranial Doppler ultrasonography detects cerebral vasospasms in a client experiencing lethargy 8 days following a subarachnoid hemorrhage. The nurse anticipates which therapeutic intervention? Nitroprusside IV Fluid restriction Nimodipine PO Phenytoin IV

Nimodipine PO

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

Noncontrast computed tomography (CT)

The nurse is caring for a client with dysphagia. Which intervention would be contraindicated while caring for this client? Allowing ample time to eat Placing food on the affected side of the mouth Testing the gag reflex before offering food or fluids Assisting the client with meals

Placing food on the affected side of the mouth

A nurse is planning care for a client who experienced a stroke in the right hemisphere of his brain. What should the nurse do? Anticipate the client will exhibit some degree of expressive or receptive aphasia. Provide close supervision because of the client's impulsiveness and poor judgment. Support the right arm with a sling or pillow to prevent subluxation. Place the wheelchair on the client's left side when transferring him into a wheelchair.

Provide close supervision because of the client's impulsiveness and poor judgment.

The geriatric advanced practice nurse (APN) is doing client teaching with a client who has had a cerebrovascular accident (CVA) and the client's family. One concern the APN addresses is a potential for falls related to the CVA and resulting muscle weakness. What would be most important for the APN to include in teaching related to this concern? Leg exercises to strengthen muscle weakness. Use of tripod cane. Remove throw rugs and electrical cords from home environment. Need for support group due to decreased self image related to restricted mobility.

Remove throw rugs and electrical cords from home environment.

An emergency department nurse is interviewing a client with signs of an ischemic stroke that began 2 hours ago. The client reports that she had a cholecystectomy 6 weeks ago and is taking digoxin, coumadin, and labetelol. This client is not eligible for thrombolytic therapy for which of the following reasons? She is taking digoxin. She had surgery 6 weeks ago. She is not within the treatment time window. She is taking coumadin.

She is taking coumadin.

The nurse has just received report on a client in the ED being transferred to the acute stroke unit with a diagnosis of a right hemispheric stroke. Which findins does the nurse understand is indicative of a right hemispheric stroke? Aphasia Spatial-perceptual deficits Slow, cautious behavior Altered intellectual ability

Spatial-perceptual deficits

Which statements reflect the nursing management of a client with receptive aphasia? Speak clearly to the client in simple sentences; use gestures or pictures. Frequently reorient the client to time, place, and situation. Speak slowly and clearly to assist the client in forming the sounds. Encourage the client to repeat sounds of the alphabet.

Speak slowly and clearly to assist the client in forming the sounds.

Which interventions would be recommended for a client with dysphagia? Select all that apply. Test the gag reflex before offering food or fluids. Place food on the affected side of the mouth. Assist the client with meals. Allow ample time to eat.

Test the gag reflex before offering food or fluids. Assist the client with meals. Allow ample time to eat.

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? Weakness on one side of the body and difficulty with speech Footdrop and external hip rotation Vomiting and seizures Severe headache and early change in level of consciousness

Weakness on one side of the body and difficulty with speech

The nurse is performing stroke risk screenings at a hospital open house. Identification of high-risk individuals is the goal of the screenings. The nurse has identified four patients who might be at risk for a stroke. Which patient is likely at highest risk for a stroke? White man, age 60 with history of uncontrolled hypertension Black man, age 50 with history of smoking White woman, age 60 with history of excessive alcohol intake Black man, age 60, with history of diabetes

White man, age 60 with history of uncontrolled hypertension

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 ticlodipine. dipyridamole. aspirin. clopidogrel.

aspirin

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? TIA bruit atherosclerotic plaque diplopia

bruit

The nurse is assisting a client with a stroke who has homonymous hemianopia. The nurse should understand that the client will: forget the names of foods. have a preference for foods high in salt. eat food on only half of the plate. not be able to swallow liquids.

eat food on only half of the plate.

A client arrives in the emergency department with an ischemic stroke. Because the health care team is considering administering tissue plasminogen activator (t-PA) administration, the nurse should first: ask what medications the client is taking. identify the time of onset of the stroke. determine if the client is scheduled for any surgical procedures. complete a history and health assessment.

identify the time of onset of the stroke.

A physician orders aspirin, 325 mg P.O. daily for a client who has experienced a transient ischemic attack (TIA). The nurse should teach the client that the physician has ordered this medication to: control headache pain. enhance the immune response. reduce the chance of blood clot formation. prevent intracranial bleeding.

reduce the chance of blood clot formation

When helping the client who has had a cerebrovascular accident (CVA) learn self-care skills, the nurse should: teach the client to put on clothing on the affected side first. dress the client, explaining each step of the process as it is completed. encourage the client to wear clothing designed especially for people who have had a CVA. advise the client to ask for help when dressing.

teach the client to put on clothing on the affected side first.

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 man who is receiving oral antibiotics for the treatment of a chlamydial infection An obese woman with a history of atrial fibrillation and type 2 diabetes A woman who has osteoporosis, a history of fractures, and a family history of stroke A 70-year-old man who has benign prostatic hyperplasia and early stage Alzheimer's disease

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

A 76-year-old male 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? Select all that apply. Carotid endarterectomy Percutaneous transluminal coronary artery angioplasty Removal of the carotid artery Administration of tissue plasminogen activator Balloon angioplasty of the carotid artery followed by stent placement

Balloon angioplasty of the carotid artery followed by stent placement Carotid endarterectomy

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? When symptoms cease, the client will return to presymptomatic state. A TIA is an insidious, often chronic episode of neurologic impairment. Symptoms of a TIA may linger for up to a week. Two thirds of people that experience a TIA will go on to develop a stroke.

When symptoms cease, the client will return to presymptomatic state.

During the first 24 hours after thrombolytic treatment for an ischemic stroke, the primary goal is to control the client's: temperature. respirations. pulse. blood pressure.

blood pressure.

A nurse is providing care to a client who has had a stroke. Which symptoms are consistent with right-sided hemiplegia? short retention of information, deficits in left visual fields, misjudgement of distances problems with abstract thinking, impairment of short-term memory, poor judgment expressive aphasia, defects in the right visual fields, problems with abstract thinking impulsive behavior, poor judgment, deficits in left visual fields

expressive aphasia, defects in the right visual fields, problems with abstract thinking

A client is admitted for evaluation of cerebral aneurysm. Which assessment finding is of greatest importance in prioritizing nursing care to this client? Nausea Frequent voiding Complaint of headache off and on for past month No bowel movement since yesterday

nausea