Chapter 57: Stroke

Chapter 57: Stroke

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. After a patient experienced a brief episode of tinnitus, diplopia, and dysarthria with no residual effects, the nurse anticipates teaching the patient about

a.	cerebral aneurysm clipping.	c.	oral low-dose aspirin therapy.
b.	heparin intravenous infusion.	d.	tissue plasminogen activator (tPA).

 

 

ANS:  C

The patient’s symptoms are consistent with transient ischemic attack (TIA), and drugs that inhibit platelet aggregation are prescribed after a TIA to prevent a stroke. Continuous heparin infusion is not routinely used after TIA or with acute ischemic stroke. The patient’s symptoms are not consistent with a cerebral aneurysm. tPA is used only for acute ischemic stroke, not for TIA.

 

DIF:    Cognitive Level: Apply (application)           REF:               1353

TOP:   Nursing Process: Planning               MSC:  NCLEX: Physiological Integrity

 

2. A patient is being admitted with a possible stroke. Which information from the assessment indicates that the nurse should consult with the health care provider before giving the prescribed aspirin?

a.	The patient has dysphasia.
b.	The patient has atrial fibrillation.
c.	The patient reports that symptoms began with a severe headache.
d.	The patient has a history of brief episodes of right-sided hemiplegia.

 

 

ANS:  C

A sudden onset headache is typical of a subarachnoid hemorrhage, and aspirin is contraindicated. Atrial fibrillation, dysphasia, and transient ischemic attack are not contraindications to aspirin use.

 

DIF:    Cognitive Level: Apply (application)           REF:               1348

TOP:   Nursing Process: Assessment           MSC:  NCLEX: Physiological Integrity

 

3. A patient with a stroke experiences facial drooping on the right side and right-sided arm and leg paralysis. When admitting the patient, which clinical manifestation will the nurse expect to find?

a.	Impulsive behavior
b.	Right-sided neglect
c.	Hyperactive left-sided tendon reflexes
d.	Difficulty comprehending instructions

 

 

ANS:  D

Right-sided paralysis indicates a left-brain stroke, which will lead to difficulty with comprehension and use of language. The left-side reflexes are likely to be intact. Impulsive behavior and neglect are more likely with a right-side stroke.

 

DIF:    Cognitive Level: Apply (application)           REF:               1350

TOP:   Nursing Process: Assessment           MSC:  NCLEX: Physiological Integrity

 

4. During the change of shift report, a nurse is told that a patient has an occluded left posterior cerebral artery. The nurse will anticipate that the patient may have

a.	dysphasia.	c.	visual deficits.
b.	confusion.	d.	poor judgment.

 

 

ANS:  C

Visual disturbances are expected with posterior cerebral artery occlusion. Aphasia occurs with middle cerebral artery involvement. Cognitive deficits and changes in judgment are more typical of anterior cerebral artery occlusion.

 

DIF:    Cognitive Level: Apply (application)           REF:               1350

TOP:   Nursing Process: Assessment           MSC:  NCLEX: Physiological Integrity

 

5. When teaching about clopidogrel (Plavix), the nurse will tell the patient with cerebral atherosclerosis

a.	to monitor and record the blood pressure daily.
b.	to call the health care provider if stools are tarry.
c.	that clopidogrel will dissolve clots in the cerebral arteries.
d.	that clopidogrel will reduce cerebral artery plaque formation.

 

 

ANS:  B

Clopidogrel inhibits platelet function and increases the risk for gastrointestinal bleeding, so patients should be advised to notify the health care provider about any signs of bleeding. The medication does not lower blood pressure, decrease plaque formation, or dissolve clots.

 

DIF:    Cognitive Level: Apply (application)           REF:               1353

TOP:   Nursing Process: Implementation     MSC:  NCLEX: Physiological Integrity