Medical Surgical Nursing Assessment and Management of Clinical Problems, 10th Edition by Sharon L. Lewis
Medical Surgical Nursing Assessment and Management of Clinical Problems, 10th Edition by Sharon L. Lewis
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Chapter 57: Stroke
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
MULTIPLE CHOICE
| 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
| 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
| 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
| 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
| 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
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