Chapter 28: Cerebrovascular Accident

Chapter 28: Cerebrovascular Accident

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A patient has weakness on the right side and impaired reasoning after having a cerebrovascular accident (CVA). What part of the brain is affected?

a.	Left hemisphere of the cerebrum
b.	Right hemisphere of the cerebrum
c.	Left cerebellum
d.	Right cerebellum

 

 

ANS:  A

Impaired motor strength on the right side in conjunction with impaired reasoning indicates a lesion in the left hemisphere of the cerebrum. The cerebellum controls balance and is not contralateral.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 481-482      OBJ:   3

TOP:   Symptoms of a CVA                       KEY:  Nursing Process Step: Assessment

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

2. Which patient is at the greatest risk for a CVA?

a.	A 20-year-old obese Latin woman who is taking birth control pills
b.	A 40-year-old athletic white man with a family history of CVA
c.	A 60-year-old Asian woman who smokes occasionally
d.	A 65-year-old African American man with hypertension

 

 

ANS:  D

Older African Americans have a higher incidence of CVA than occasional smokers, young persons, or athletes. Hypertension increases the risk.

 

DIF:    Cognitive Level: Analysis                REF:   p. 483             OBJ:   1

TOP:   CVA Risk Factors                           KEY:  Nursing Process Step: Assessment

MSC:  NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

 

3. A patient experienced a period of momentary confusion, dizziness, and slurred speech but recovered in 2 hours. Which assessment in the diagnosis of this episode would be most helpful?

a.	Patient’s complaint of nausea
b.	Blood pressure (BP) of 140/90 mm Hg
c.	Patient’s complaint of headache
d.	Auscultation of a bruit over the carotid artery

 

 

ANS:  D

A carotid bruit is evidence of a narrowing in that vessel, a symptom of a possible CVA or transient ischemic attack (TIA). BP of 140/90 mm Hg, although at the high end, is considered within normal limits. Headache and nausea alone are too common to be definitive.

 

DIF:    Cognitive Level: Application           REF:   p. 485             OBJ:   2

TOP:   TIA Diagnosis                                 KEY:  Nursing Process Step: Assessment

MSC:  NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

 

4. A nurse is updating a teaching plan for a patient who sustained a TIA. What should the nurse be sure to include?

a.	Daily aspirin dose
b.	Long rest periods daily
c.	Reduction of fluid intake to 800 mL/day
d.	High-carbohydrate diet

 

 

ANS:  A

Daily aspirin reduces platelet aggregation and may prevent another attack. Reductions of fluid and long rest periods encourage clot formation.

 

DIF:    Cognitive Level: Application           REF:   p. 485             OBJ:   3

TOP:   Post-TIA Teaching                          KEY:  Nursing Process Step: Planning

MSC:  NCLEX: Physiological Integrity: Pharmacological Therapies

 

5. A patient recovering from a CVA asks the purpose of the warfarin (Coumadin). What is the best response by the nurse regarding the purpose of Coumadin?

a.	Dissolves the clot.
b.	Prevents the formation of new clots.
c.	Dilates the vessels to improve blood flow.
d.	Suppresses the formation of platelets.

 

 

ANS:  B

Coumadin and heparin prevent more clots rather than dissolving them. Coumadin has no effect on vasodilation or blood cell production.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 486             OBJ:   3

TOP:   Coumadin Therapy                          KEY:  Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity: Pharmacological Therapies