Wk 6 Fontaine PrepU
A patient with Parkinson's disease is undergoing a swallowing assessment because she has recently developed adventitious lung sounds. The patient's nutritional needs should be met by what method? a) Semisolid food with thick liquids b) Total parenteral nutrition (TPN) c) Provision of a low-residue diet d) Minced foods and a fluid restriction
a) Semisolid food with thick liquids
Which of the following is a modifiable risk factor for transient ischemic attacks and ischemic strokes? a) Thyroid disease b) Advanced age c) History of smoking. d) Social drinking
c) History of smoking.
A client diagnosed with Parkinson's disease has developed slurred speech and drooling. The nurse knows that these symptoms indicate which of the following? a) The client is having an exacerbation. b) Medication needs to be adjusted to higher doses. c) The client is exhibiting signs of medication overdose. d) The disease has entered the late stages.
d) The disease has entered the late stages.
A nurse suspects an older adult is experiencing heat stroke based on which assessment findings? Select all that apply. a) Increased thirst b) Weakness c) Bradypnea d) Temperature 105 degrees F (40.6 degrees C) e) Delirium f) Lack of sweating
• Temperature 105 degrees F (40.6 degrees C) • Lack of sweating • Delirium
An elderly, confused client, is going to be treated with donepezil (Aricept). This drug is effective in treating clients: a) With delirium. b) With early-stage Alzheimer's disease. c) Who are confused because of depression. d) With age-related neurologic changes.
b) With early-stage Alzheimer's disease.
Which of the following states is characterized by a decline in intellectual functioning? a) Delirium b) Depression c) Dementia d) Delusion
c) Dementia
Which nursing diagnosis takes the highest priority for a client with parkinsonian crisis? a) Impaired urinary elimination b) Imbalanced nutrition: Less than body requirements c) Ineffective airway clearance d) Risk for injury
c) Ineffective airway clearance
Which type of gait correlates with Parkinson's disease? a) Steppage b) Scissors c) Shuffling d) Spastic hemiparesis
c) Shuffling
A nurse is planning care for a client who experienced a stroke in the right hemisphere of his brain. What should the nurse do? a) Support the right arm with a sling or pillow to prevent subluxation. b) Place the wheelchair on the client's left side when transferring him into a wheelchair. c) Provide close supervision because of the client's impulsiveness and poor judgment. d) Anticipate the client will exhibit some degree of expressive or receptive aphasia.
Provide close supervision because of the client's impulsiveness and poor judgment.
Which of the following is a drug-related cause of delirium? a) Sepsis b) Alcohol withdrawal c) Electrolyte imbalance d) Encephalitis
b) Alcohol withdrawal
The nurse is educating a patient about the risks of stroke related to the new prescription for a COX-2 inhibitor and what symptoms they should report. Which COX-2 inhibitor is the nurse educating the patient about? a) Piroxicam (Feldene) b) Celecoxib (Celebrex) c) Ibuprofen (Motrin) d) Tolmetin sodium (Tolectin)
b) Celecoxib (Celebrex)
An 82-year-old man is admitted for observation after a fall. Due to his age, the nurse knows that the patient is at increased risk for what complication of his injury? a) Embolus b) Hematoma c) Skull fracture d) Stroke
b) Hematoma
Which of the following is the most common motor dysfunction seen in patients diagnosed with stroke? a) Diplopia b) Hemiplegia c) Ataxia d) Hemiparesis
b) Hemiplegia
You are providing care for an 82-year-old man whose signs and symptoms of Parkinson disease have become more severe over the past several months. The man tells you that he can no longer do as many things for himself as he used to be able to do. What factor should you recognize as impacting your patient's life most significantly? a) Neurologic deficits b) Tremors and decreased mobility c) Loss of independence d) Age-related changes
c) Loss of independence
The nurse knows that symptoms associated with a TIA, usually a precursor of a future stroke, usually subside in what period of time? a) 3 to 6 hours b) 24 to 36 hours c) 12 hours d) 1 hour
d) 1 hour
A patient is in the acute phase of an ischemic stroke. How long does the nurse know that this phase may last? a) Up to 2 weeks b) Up to 24 hours c) Up to 1 week d) 1 to 3 days
d) 1 to 3 days
If warfarin is contraindicated as a treatment for stroke, which of the following medication is the best option? a) Dipyridamole (Persantine) b) Ticlodipine (Ticlid) c) Clopidogrel (Plavix) d) Aspirin
d) Aspirin
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) Occipital b) Parietal c) Temporal d) Frontal
d) Frontal
A patient has expressive speaking aphasia after having a stroke. Which portion of the brain does the nurse know has been affected? a) Posterior frontal area b) Parietal-occipital area c) Temporal lobe d) Inferior posterior frontal areas
d) Inferior posterior frontal areas
A client with end-stage dementia is admitted to the orthopedic unit after undergoing internal fixation of the right hip. How should the nurse manage the client's postoperative pain? a) Administer oral opioids as needed. b) Administer analgesics around the clock. c) Administer pain medication through a transdermal patch. d) Provide patient-controlled analgesia.
b) Administer analgesics around the clock.
A client is diagnosed with amyotrophic lateral sclerosis (ALS) in the early stages. Which medication would the nurse most likely expect to be prescribed as treatment? a) Bromocriptine b) Riluzole c) Amantadine d) Benztropine meslyate
b) Riluzole
Which of the following is indicative of a right hemisphere stroke? a) Altered intellectual ability b) Spatial-perceptual deficits c) Slow, cautious behavior d) Aphasia
b) Spatial-perceptual deficits
A patient having an acute stroke with no other significant medical disorders has a blood glucose level of 420 mg/dL. What significance does the hyperglycemia have for this patient? a) The patient has developed diabetes insipidus due to the location of the stroke. b) The patient has new onset diabetes. c) This is significant for poor neurologic outcomes. d) The patient has liver failure.
c) This is significant for poor neurologic outcomes.
A client with a medical diagnosis of dementia of Alzheimer's type (DAT) has been increasingly agitated in recent days. As a result, the nurse has identified the nursing diagnosis of "risk for injury related to agitation and confusion" and an outcome of "the client will remain free from injury." What intervention should the nurse use in order to facilitate this outcome? a) Explain to the client the relationship between agitation and injury. b) Apply restraints and place the client in seclusion as necessary. c) Use the least restrictive devices if necessary. d) Set limits with the client around behavior.
c) Use the least restrictive devices if necessary.
Your grandmother is 72 years old and is a feisty, independent matriarch to your family. She developed influenza and was quite ill for several days. Three days into her illness she became disoriented, confused and didn't recognize family members. Because she is not improving, you take her to the local ED for treatment. What would you expect the physician to prescribe as treatment? a) Treat the underlying condition. b) Admission to a psychiatric unit c) No treatment is available. d) Antipsychotic medications
a) Treat the underlying condition.
A patient with a new diagnosis of ischemic stroke is deemed to be a candidate for treatment with tissue plasminogen activator (t-PA) and has been admitted to the ICU. In addition to closely monitoring the patient's cardiac and neurologic status, the nurse monitors the patient for signs of what complication? a) Septicemia b) Acute pain c) Bleeding d) Seizures
c) Bleeding
Within 8 hours of her last drink, a client with alcoholism experiences tremors, loss of appetite, and disordered thinking. The nurse believes this client is in withdrawal. What should the nurse do next? a) Provide the client with constant one-on-one monitoring. b) Help the client engage in progressive muscle-relaxation techniques. c) Obtain a physician's order for lorazepam (Ativan). d) Give disulfiram (Antabuse) as prescribed.
c) Obtain a physician's order for lorazepam (Ativan).
After a major ischemic stroke, a possible complication is cerebral edema. Nursing care during the immediate recovery period from an ischemic stroke should include which of the following? a) Maximizing PaCO2 b) Administering hypertonic IV solution c) Positioning to avoid hypoxia d) Initiating early mobilization
c) Positioning to avoid hypoxia
Target organ damage from untreated/undertreated hypertension includes which of the following? Select all that apply. a) Retinal damage b) Diabetes c) Heart failure d) Stroke e) Hyperlipidemia
• Stroke • Retinal damage • Heart failure
Which of the following insults or abnormalities can cause an ischemic stroke? a) Trauma b) Arteriovenous malformation c) Intracerebral aneurysm rupture d) Cocaine use
d) Cocaine use
An 82-year-old client has pernicious anemia and has been receiving treatment for several years. Which symptom may be confused with another condition in older adults? a) Glossitis b) Ataxia c) Stomatitis d) Dementia
d) Dementia
Lillian Anderson, a 73-year-old retired dancer, is being seen by a neurologist in the group where you practice nursing. She reports light-headedness, speech disturbance, and left-sided weakness, which lasted for several hours. The neurologist diagnosed a transient ischemic attack, which caused Ms. Anderson great concern. During your client education with Ms. Anderson, you would include which of the following? a) Two thirds of people that experience a TIA will go on to develop a stroke. b) When symptoms cease, she will return to her presymptomatic state. c) A TIA is an insidious, often chronic episode of neurologic impairment. d) Symptoms of a TIA may linger for up to a week.
b) When symptoms cease, she will return to her presymptomatic state.
A patient with Alzheimer's disease becomes agitated while the nurse is attempting to take vital signs. What action by the nurse is most appropriate? a) Document the inability to assess vital signs due to patient's agitation. b) Continue taking the vital signs. c) Place the patient in a secluded room until calm. d) Distract the patient with a familiar object or music.
d) Distract the patient with a familiar object or music.
Choice Multiple question - Select all answer choices that apply. During a patient's recovery from stroke, the nurse should be aware of predictors of stroke outcome in order to help patients and families set realistic goals. What are the predictors of stroke outcome? Select all that apply. a) Gender b) Race c) LOC at time of admission d) Age e) National Institutes of Health Stroke Scale (NIHSS) score
• LOC at time of admission • Age • National Institutes of Health Stroke Scale (NIHSS) score
A client is diagnosed with a brain angioma. When providing care to this client, the nurse would be especially vigilant in monitoring for signs and symptoms of which of the following? a) Hemorrhagic stroke b) Hydrocephalus c) Infection d) Seizures
a) Hemorrhagic stroke
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) The antiseizure medication lamotrigine (Lamictal) has been found to be effective for post-stroke pain.
Low levels of the neurotransmitter serotonin lead to which of the following disease processes? a) Parkinson's disease b) Depression c) Myasthenia gravis d) Seizures
b) Depression
The nurse working on a cardiac care unit is caring for a patient whose stroke volume has increased. The nurse is aware that afterload influences a patient's stroke volume. The nurse recognizes that afterload is increased when there is what? a) Venous vasodilation b) Arterial vasodilation c) Arterial vasoconstriction d) Venous vasoconstriction
c) Arterial vasoconstriction
Which medication is indicated for the patient with atrial fibrillation who is at high risk for stroke? a) Plavix b) Aspirin c) Coumadin d) Lovenox
c) Coumadin
The nurse is admitting the older adult to the PACU. Which information about this client would be most important for the PACU nurse to obtain? a) Are family members available? b) What procedure was performed? c) Does the client have a history of dementia? d) What was estimated blood loss?
c) Does the client have a history of dementia?
A 55-year-old man newly diagnosed with hypertension returns to his physician's office for a routine follow-up appointment after several months of treatment with Lopressor (metoprolol). During the nurse's initial assessment the patient's blood pressure (BP) is recorded as 180/90 mm Hg. The patient states he does not take his medication as prescribed. The best response by the nurse is which of the following? a) "The medication you were prescribed may cause sexual dysfunction; are you experiencing this side effect?" b) "Be certain to discuss your noncompliance with your medication regimen with the physician." c) "Your hypertension must be treated with medications; you need to take your Lopressor every day." d) "It is very important for you to take your medication as prescribed, or you could experience a stroke."
a) "The medication you were prescribed may cause sexual dysfunction; are you experiencing this side effect?"
A home care nurse makes a visit to a client with Parkinson's disease who is being cared for by his spouse. During the visit, the spouse says, "I'm just so tired. I have to do just about everything for him." Which response by the nurse would be most appropriate? a) "You sound a bit overwhelmed. Tell me more about what's happening." b) "Are you upset about how your husband is doing?" c) "You're doing a great job. Just keep it up." d) "It must be difficult for you to see your husband like this."
a) "You sound a bit overwhelmed. Tell me more about what's happening."
A 43-year-old female literature teacher with a neurologic deficit is feeling frustrated because since her stroke, she can no longer pronounce words without great difficulty. Which of the following is the client struggling with? a) Dysarthria b) Dysphasia c) Dysphagia d) Ataxia
a) Dysarthria Dysarthria is characterized by poor articulation of words due to muscle weakness or loss of muscle control.
A nurse is caring for a client who had a stroke. Which nursing intervention promotes urinary continence? a) Encouraging intake of at least 2 L of fluid daily b) Consulting with a dietitian c) Taking the client to the bathroom twice per day d) Giving the client a glass of soda before bedtime
a) Encouraging intake of at least 2 L of fluid daily
Which of the following is a chronic, degenerative, progressive disease of the central nervous system characterized by the occurrence of small patches of demyelination in the brain and spinal cord? a) Multiple sclerosis b) Parkinson's disease c) Huntington disease d) Creutzfeldt-Jakob disease
a) Multiple sclerosis
Which of the following clinical manifestations would be exhibited by a patient following a hemorrhagic stroke of the right hemisphere? a) Neglect of the left side b) Inability to move the right arm c) Expressive aphasia d) Neglect of the side opposite to the hemisphere affected
a) Neglect of the left side
Which of the following is a disorder due to a lesion in the basal ganglia? a) Parkinson's disease b) Multiple sclerosis c) Guillain-Barré d) Myasthenia gravis
a) Parkinson's disease
Atrial fibrillation is common in patients with atrial septal defects (ASDs) and further increases the risk of which of the following? a) Stroke b) Cardiomegaly c) Heart failure d) Splenomegaly
a) Stroke
Harriet Wilson, an 82-year-old retired hairdresser, is a resident at the long-term care facility where you practice nursing. Other than her urinary incontinence which causes her embarrassment, she is active and independent. Harriet is typically alert and oriented but has begun to display confusion and disorientation. What do you suspect is the problem? a) UTI b) Dementia c) Alzheimer's disease d) Normal aging
a) UTI
An older adult develops sudden onset of confusion and is hospitalized. The family expresses concern that their loved one is developing Alzheimer's disease. What response by the nurse is most appropriate? a) "Once the underlying cause of the confusion is found and treated, your loved one will be better than ever." b) "There are several possible underlying factors that can be causing the confusion. Alzheimer's usually does not present with sudden confusion." c) "What concerns you most about Alzheimer's disease?" d) "Alzheimer's disease can be a great burden on the family. What community resources do you know about?"
b) "There are several possible underlying factors that can be causing the confusion. Alzheimer's usually does not present with sudden confusion."
During a health history, a client explains that he was just diagnosed with Parkinson's disease and wants to know what to expect. What should the nurse include during client teaching? a) Over time, the client's eyesight will diminish, especially at night. b) Abnormal body movements such as tremors may occur at rest along with asymmetry of movement. c) Whole-body convulsive movements will occur as the disease progresses. d) Eventually there will be paralysis of the extremities on one side of the body.
b) Abnormal body movements such as tremors may occur at rest along with asymmetry of movement.
Which of the following is the result of progressive deterioration of the brain? a) Meningitis b) Alzheimer's disease c) Encephalitis d) Delirium
b) Alzheimer's disease
A patient in a hypertensive emergency is admitted to the ICU. The nurse anticipates that the patient will be treated with IV vasodilators, and that the primary goal of treatment is what? a) Lower the BP to reduce onset of neurologic symptoms, such as headache and vision changes. b) Decrease the mean arterial pressure between 20% and 25% in the first hour of treatment. c) Reduce the BP to ≤ 120/75 mm Hg as quickly as possible. d) Decrease the BP to a normal level based on the patient's age.
b) Decrease the mean arterial pressure between 20% and 25% in the first hour of treatment.
A patient is brought by ambulance to the ED after suffering what the family thinks is a stroke. The nurse caring for this patient is aware that an absolute contraindication for thrombolytic therapy is what? a) Blood pressure of ≥ 180/110 mm Hg b) Evidence of hemorrhagic stroke c) Evidence of stroke evolution d) Previous thrombolytic therapy within the past 12 months
b) Evidence of hemorrhagic stroke
A nurse is providing care for a patient with a diagnosis of late-stage Alzheimer's disease. The patient has just returned to the medical unit to begin supplemental feedings through an NG tube. Which of the nurse's assessments addresses this patient's most significant potential complication of feeding? a) Vigilant monitoring of the frequency and character of bowel movements b) Frequent lung auscultation c) Frequent assessment of the patient's abdominal girth d) Assessment for hemorrhage from the nasal insertion site
b) Frequent lung auscultation
A nurse is teaching about ischemic stroke prevention to a community group and emphasizes that control of hypertension, which is the major risk factor for stroke, is key to prevention. Ways to control hypertension include the Dietary Approaches to Stop Hypertension (DASH) diet. This diet includes which of the following? a) Moderate amounts of animal protein b) Moderate amounts of low-fat dairy products c) Moderate amounts of fruits and vegetables d) High amounts of low-fat dairy products
b) Moderate amounts of low-fat dairy products (The DASH diet is high in fruits and vegetables, moderate in low-fat dairy products, and low in animal protein.)
A nurse is preparing a presentation for a local community group about familial Alzheimer's disease. As part of the presentation, the nurse is planning to discuss the possible genetic basis for this condition. The nurse would describe the inheritance as which of the following? a) Autosomal recessive b) Multifactoral c) Autosomal dominant d) X-linked
b) Multifactoral
You are caring for a patient with late-stage Alzheimer's disease. The patient's wife tells you that the patient has now become completely dependent and that she feels guilty if she takes any time for herself. What outcomes would be appropriate for the nurse to develop to assist the patient's wife? a) The caregiver learns to explain to the patient why she needs time for herself. b) The caregiver distinguishes essential obligations from those that can be controlled or limited. c) The caregiver prioritizes her own health over that of the patient. d) The caregiver leaves the patient at home alone for short periods of time to encourage independence.
b) The caregiver distinguishes essential obligations from those that can be controlled or limited.
The client with hemiplegia is at risk for impaired walking. Which nursing intervention would best assist this client in preventing complications associated with lower extremity impairment? a) Whirlpool tub baths and massage therapy b) Use of high-top tennis shoes throughout the day c) Use of walker for ambulation d) Occupational therapy daily
b) Use of high-top tennis shoes throughout the day
The nurse is performing stroke risk screenings at a hospital open house. The nurse has identified four patients who might be at risk for a stroke. Which patient is likely at the highest risk for a hemorrhagic stroke? a) White female, age 60, with history of excessive alcohol intake b) White male, age 60, with history of uncontrolled hypertension c) Black male, age 60, with history of diabetes d) Black male, age 50, with history of smoking
b) White male, age 60, with history of uncontrolled hypertension
A client with Alzheimer's disease is being treated for malnutrition and dehydration. The nurse decides to place him closer to the nurses' station because of his tendency to: a) exhibit acquiescent behavior. b) wander. c) forget to eat. d) not change his position often.
b) wander.
A nurse on a busy medical unit provides care for many patients who require indwelling urinary catheters at some point during their hospital care. The nurse should recognize a heightened risk of injury associated with indwelling catheter use in which patient? a) A patient whose diagnosis of chronic kidney disease requires a fluid restriction b) A patient who is on bed rest following a recent episode of venous thromboembolism c) A patient who has Alzheimer's disease and who is acutely agitated d) A patient who has decreased mobility following a transmetatarsal amputation
c) A patient who has Alzheimer's disease and who is acutely agitated
Which of the following is a disease in which there is a loss of motor neurons in the anterior horns of the spinal cord and motor nuclei of the lower brain stem? a) Alzheimer's disease b) Huntington disease c) Amyotrophic lateral sclerosis (ALS) d) Parkinson's disease (PD)
c) Amyotrophic lateral sclerosis (ALS)
A client has been newly diagnosed with delirium. The nurse knows that the primary sign of delirium includes which of the following? a) Inability to fulfill role b) Impaired socialization c) An altered level of consciousness d) Disturbed sleep-wake cycles
c) An altered level of consciousness
A 45-year-old male patient presents to the ED complaining of trouble speaking and numbness of the right arm and leg. The nurse suspects an ischemic stroke. Which of the following insults or abnormalities can cause an ischemic stroke? a) Arteriovenous malformation b) Intracerebral aneurysm rupture c) Cocaine use d) Trauma
c) Cocaine use
A nurse is providing care to a client who had a stroke. Which of the following symptoms are consistent with right-sided hemiplegia? a) Short retention of information, deficits in left visual fields, misjudge distances b) Impulsive behavior, poor judgment, deficits in left visual fields c) Expressive aphasia, defects in the right visual fields, problems with abstract thinking d) Problems with abstract thinking, impairment of short-term memory, poor judgment
c) Expressive aphasia, defects in the right visual fields, problems with abstract thinking
The nurse is participating in a health fair for stroke prevention. Which of the following will the nurse say is a modifiable risk factor for ischemic stroke? a) Advanced age b) Social drinking c) History of smoking d) Thyroid disease
c) History of smoking
Which topic is most important for the nurse to include in the teaching plan for a client newly diagnosed with Parkinson's disease? a) Establishing balanced nutrition b) Involvement with diversion activities c) Maintaining a safe environment d) Enhancement of the immune system
c) Maintaining a safe environment
Which is a chronic, degenerative, progressive disease of the central nervous system characterized by the occurrence of demyelination in the brain and spinal cord? a) Parkinson's disease b) Creutzfeldt-Jakob disease c) Multiple sclerosis (MS) d) Huntington disease
c) Multiple sclerosis (MS)
The nurse is caring for an 82-year-old female patient in the PACU. The woman begins to awaken and responds to her name, but is confused, restless, and agitated. What principle should guide the nurse's subsequent assessment? a) Postoperative confusion in older adults is an indication of impaired oxygenation or possibly a stroke during surgery. b) Confusion, restlessness, and agitation are expected postoperative findings in older adults and they will diminish in time. c) Postoperative confusion is common in the older adult patent, but it could also indicate a significant blood loss. d) Confusion, restlessness, and agitation indicate an underlying cognitive deficit such as dementia.
c) Postoperative confusion is common in the older adult patent, but it could also indicate a significant blood loss.
A client was admitted to the hospital last night with a compound fracture of the femur, sustained in a fall while intoxicated. Her condition remains relatively stable; however, she is shaky, irritable, and anxious. She tells about having vivid nightmares for two nights. The next day when the nurse returns from lunch, she finds the client restless and perspiring. Her pulse is 130. She cries, "Bugs are crawling on my bed. I've got to get out of here," and begins to thrash about. What would be the most accurate assessment of the client's situation? a) The client may have sustained a head injury in the fall prior to admission b) The client is having a recurrence of a psychosis c) The client is experiencing symptoms consistent with withdrawal delirium d) The client is attempting to obtain attention by manipulating staff
c) The client is experiencing symptoms consistent with withdrawal delirium
When should the nurse plan the rehabilitation of a patient who is having an ischemic stroke? a) After the patient has passed the acute phase of the stroke b) After the nurse has received the discharge orders c) The day the patient has the stroke d) The day before the patient is discharged
c) The day the patient has the stroke
The PACU nurse is caring for an older adult who presents with clinical manifestations of delirium. Which short-term outcome would be most important for this client? The client: a) experiences pain within tolerable limits. b) resumes usual urinary elimination pattern. c) maintains adequate oxygenation status. d) exhibits wound healing without complications.
c) maintains adequate oxygenation status.
The nurse can distinguish delirium from dementia by knowing which of the following? a) Delirium has an acute onset and is progressive in course. b) Delirium has a gradual onset and can be resolved. c) Dementia has an acute onset and can be resolved. d) Dementia has a gradual onset and is progressive in course.
d) Dementia has a gradual onset and is progressive in course.
A patient diagnosed with a hemorrhagic stroke has been admitted to the neurologic ICU. The nurse knows that teaching for the patient and family needs to begin as soon as the patient is settled on the unit and will continue until the patient is discharged. What will family education need to include? a) Risk factors for ischemic stroke b) Techniques for adjusting the patient's medication dosages at home c) How to differentiate between hemorrhagic and ischemic stroke d) How to correctly modify the home environment
d) How to correctly modify the home environment
A patient is admitted to the hospital for management of an extrapyramidal disorder. Included in the physician's admitting orders are the medications levodopa, Cogentin, and Eldepryl. The nurse knows that most likely, the client has a diagnosis of ________. a) Huntington's disease b) Multiple sclerosis c) Seizure disorder d) Parkinson's disease
d) Parkinson's disease
A 70-year-old client with a diagnosis of left-sided stroke is admitted to the facility. To prevent the development of disuse osteoporosis, which objective is most appropriate? a) Maintaining protein levels b) Promoting range-of-motion (ROM) exercises c) Maintaining vitamin levels d) Promoting weight-bearing exercises
d) Promoting weight-bearing exercises
A client is transferred to a rehabilitation center after being treated in the hospital for a stroke. Because the client has a history of Cushing's syndrome (hypercortisolism) and chronic obstructive pulmonary disease, the nurse formulates a nursing diagnosis of: a) Decreased cardiac output related to hypotension secondary to Cushing's syndrome. b) Risk for imbalanced fluid volume related to excessive sodium loss. c) Ineffective health maintenance related to frequent hypoglycemic episodes secondary to Cushing's syndrome. d) Risk for impaired skin integrity related to tissue catabolism secondary to cortisol hypersecretion.
d) Risk for impaired skin integrity related to tissue catabolism secondary to cortisol hyper secretion. (Cushing's syndrome causes tissue catabolism, resulting in thinning skin and connective tissue loss; along with immobility related to stroke, these factors increase this client's risk for impaired skin integrity. The exaggerated glucocorticoid activity in Cushing's syndrome causes sodium and water retention which, in turn, leads to edema and hypertension.)
A patient diagnosed with a stroke would be expected to exhibit which type of gait? a) Steppage b) Shuffling c) Scissors d) Spastic hemiparesis
d) Spastic hemiparesis
A patient in the ICU has been orally intubated and on mechanical ventilation for 2 weeks after having a severe stroke. What action does the nurse anticipate the physician will take now that the patient has been intubated for this length of time? a) The patient will begin the weaning process. b) The patient will be extubated and another endotracheal tube will be inserted. c) The patient will be extubated and a nasotracheal tube will be inserted. d) The patient will have an insertion of a tracheostomy tube.
d) The patient will have an insertion of a tracheostomy tube.
Choice Multiple question - Select all answer choices that apply. A patient has had a large ischemic stroke and is hospitalized in the neurologic intensive care unit. What interventions will be provided for this patient to decrease intracranial pressure? (Select all that apply.) a) Administering mannitol b) Administering supplemental oxygen if the oxygen saturation is below 88% c) Administering heparin to induce anticoagulation d) Elevating the head of the bed 30 degrees e) Maintaining the partial pressure of carbon dioxide (PaCO2) within a range of 30 to 35 mm Hg
• Administering mannitol • Maintaining the partial pressure of carbon dioxide (PaCO2) within a range of 30 to 35 mm Hg • Elevating the head of the bed 30 degrees
There are no diagnostic tests that are specific for Alzheimer's disease. However, the following is helpful in determining the diagnosis. Choose all that are correct. a) Positron emission tomography and magnetic resonance imaging provide structural and metabolic information. b) Electroencephalography detects slower-than-normal brain waves. c) All choices are correct. d) A computed tomography scan shows shrinking of the cerebral cortex in later stages. e) The diagnosis is made by excluding other causes for the client's symptoms.
• All choices are correct.
Choice Multiple question - Select all answer choices that apply. A nurse is preparing a presentation for a local senior center about the health status of older adults. Which of the following would the nurse include as the major causes of death in those older than 65 years? Select all that apply. a) Diabetes b) Cancer c) Stroke d) Heart disease e) Chronic obstructive pulmonary disease f) Renal disease
• Cancer • Heart disease
Choice Multiple question - Select all answer choices that apply. The following statements match nursing interventions with nursing diagnoses. Which statements are true for a patient with a stroke? Select all that apply. a) Self-care deficit: Instruct the patient on use of a walker. b) Impaired swallowing: Provide a pureed diet. c) Impaired verbal communication: Repeat words and instructions. d) Impaired physical mobility: Provide wide-grip utensils during meals. e) Disturbed sensory perception: Stand on the patient's unaffected side.
• Impaired verbal communication: Repeat words and instructions. • Impaired swallowing: Provide a pureed diet. • Disturbed sensory perception: Stand on the patient's unaffected side.
Which of the following are contraindications for the administration of tissue plasminogen activator (t-PA)? Select all that apply. a) Ischemic stroke b) Intracranial hemorrhage c) Systolic BP less than or equal to 185 mm Hg d) Age 18 years or older e) Major abdominal surgery within 10 days
• Intracranial hemorrhage • Major abdominal surgery within 10 days
Choice Multiple question - Select all answer choices that apply. 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) Neglect of objects and people on the left side c) Tendency to distractibility d) Hyperaware of deficits e) Impairment of long-term memory
• Neglect of objects and people on the left side • Left-sided hemiplegia • Tendency to distractibility
Choice Multiple question - Select all answer choices that apply. After having a stroke, a patient has cognitive deficits. What are the cognitive deficits the nurse recognizes the patient has as a result of the stroke? (Select all that apply.) a) Short- and long-term memory loss b) Decreased attention span c) Paresthesias d) Poor abstract reasoning e) Expressive aphasia
• Poor abstract reasoning • Decreased attention span • Short- and long-term memory loss
Nursing students are reviewing information about Parkinson's disease in preparation for class the next day. The students demonstrate understanding of the material when they identify which of the following as a cardinal sign of this disorder? Select all that apply. a) Rigidity b) Postural instability c) Tremor d) Intellectual decline e) Bradykinesia
• Postural instability • Rigidity • Bradykinesia • Tremor
As a member of the stroke team, the nurse knows that thrombolytic therapy carries the potential for benefit and for harm. The nurse should be cognizant of what contraindications for thrombolytic therapy? Select all that apply. a) Recent intracranial pathology b) Symptom onset greater than 3 hours prior to admission c) Sudden symptom onset d) INR above 1.0 e) Current anticoagulation therapy
• Recent intracranial pathology • Current anticoagulation therapy • Symptom onset greater than 3 hours prior to admission
