Chapter 58: Nursing Management: Stroke

Chapter 58: Nursing Management: Stroke

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE
1. The nurse expects that management of the patient who experiences a brief episode of
tinnitus, diplopia, and dysarthria with no residual effects will include
a. prophylactic clipping of cerebral aneurysms.
b. heparin via continuous intravenous infusion.
c. oral administration of low dose aspirin therapy.
d. therapy with 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 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: Application REF: 1468-1469 TOP: Nursing Process:
Planning
MSC: NCLEX: Physiological Integrity
2. Aspirin is ordered for a patient who is admitted with a possible stroke. Which
information obtained during the admission assessment indicates that the nurse should
consult with the health care provider before giving the aspirin?
a. The patient has dysphasia.
b. The patient has atrial fibrillation.
c. The patient states, “My symptoms started with a terrible 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 (TIA) are not
contraindications to aspirin use, so the nurse can administer the aspirin.
DIF: Cognitive Level: Application REF: 1466
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
3. A patient with a stroke experiences right-sided arm and leg paralysis and facial drooping
on the right side. When admitting the patient, which clinical manifestation will the nurse
expect to find?
a. Impulsive behavior
b. Right-sided neglect
c. Hyperactive left-sided reflexes
Test Bank 58-2
d. Difficulty in understanding commands
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: Application REF: 1466-1468
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
4. The nurse receives a verbal report that a patient has an occlusion of the left posterior
cerebral artery. The nurse will anticipate that the patient may have
a. dysphasia.
b. confusion.
c. visual deficits.
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: Application REF: 1466
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
5. The health care provider prescribes clopidogrel (Plavix) for a patient with cerebral
atherosclerosis. When teaching about the new medication, the nurse will tell the patient
a. to monitor and record the blood pressure daily.
b. to call the health care provider if stools are tarry.
c. that Plavix will dissolve clots in the cerebral arteries.
d. that Plavix will reduce cerebral artery plaque formation.
ANS: B
Plavix 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: Application REF: 1468-1469
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity