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  • August 11, 2024
  • 27
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers

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  • chapter 38 caring for clients with cerebrovascula
  • chapter 38 caring for clients with cerebrovascula

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STUVIA 2024/2025
Chapter 38: Caring for Clients with
Cerebrovascular Disorders
14

An exclusion criterion for therapy with tissue plasminogen activator is major surgery or invasive
procedure within the past 14 days. - ✔✔A physician orders therapy with tissue plasminogen activator
for a client. The nurse alerts the physician to a potential problem when reviewing the client's chart and
seeing that the client had major surgery within the last:

5.4 mg - ✔✔The nurse is preparing to administer tissue plasminogen activator (t-PA) to a patient
who weighs 132 lb. The order reads 0.9 mg/kg t-PA. The nurse understands that 10% of the
calculated dose is administered as an IV bolus over 1 minute, and the remaining dose (90%) is
administered IV over 1 hour via an infusion pump. How many milligrams IV bolus over 1 minute will
the nurse initially administer?

a
Migraine headaches, which are recurrent and severe and last for a day or more, have a vascular
origin. - ✔✔A client has a 12-year history of migraine headaches and is frustrated over how these
%


headaches impact lifestyle. What would the nurse indicate to the client is the origin of migraines?

a. vascular
b. muscular
c. light
d. endocrine

a
tPA is contraindicated in hemorrhagic stroke because it would greatly exacerbate cerebral bleeding.
Older age, previous stroke, hypertension, and diabetes do not necessarily contraindicate the use of
tPA. - ✔✔A woman has been brought to the emergency department (ED) by her distraught husband
who believes that she has had a stroke. A rapid assessment by the care team confirms that the
husband's suspicions are likely accurate, and the woman is being screened for the possible
administration of recombinant tissue plasminogen activator (r tPA). Which of the following factors
would contraindicate the use of tPA?

a. The woman's stroke has a hemorrhagic etiology.
b. The woman is older than 80 years of age.
c. The woman has previously had a stroke.
d. The woman has hypertension and type 1 diabetes.


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, STUVIA 2024/2025

a


A left visual field deficit is a common clinical manifestation of a right hemispheric stroke. Aphasia,
slow, cautious behavior, and altered intellectual ability are all clinical manifestations of a left
hemispheric stroke. - ✔✔What clinical manifestations does the nurse recognize when a patient has
had a right hemispheric stroke?

a. Left visual field deficit
b. Aphasia
c. Slow, cautious behavior
d. Altered intellectual ability

a


Administering heparin, an anticoagulant, could increase the bleeding associated with hemorrhagic
stroke. Therefore, the nurse should question this order to prevent additional hemorrhage in the brain.
In a client with hemorrhagic stroke, the healthcare provider may use dexamethasone (Decadron) to
%

decrease cerebral edema and pressure, methyldopa (Aldomet) to reduce blood pressure, and
phenytoin (Dilantin) to prevent seizures. - ✔✔A healthcare provider orders several drugs for a client
with hemorrhagic stroke. Which drug order should the nurse question?

a. Heparin sodium
b. Dexamethasone
c. Methyldopa
d. Phenytoin

a


Because of decreased physical mobility, a client with recent left-sided hemiparesis is at risk for falls in
the home setting. His ability to cope with the stroke is important, but investigating the home
environment doesn't provide information about this nursing diagnosis. Diarrhea and Noncompliance
aren't related to the client's home environment. - ✔✔A nurse is completing discharge teaching for the
client who has left-sided hemiparesis following a stroke. When investigating the client's home
environment, the nurse should focus on which nursing diagnosis?

a. Risk for injury


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, STUVIA 2024/2025
b. Ineffective coping
c. Noncompliance
d. Diarrhea

a


If damage has occurred to the frontal lobe, learning capacity, memory, or other higher cortical
intellectual functions may be impaired. Such dysfunction may be reflected in a limited attention span,
difficulties in comprehension, forgetfulness, and a lack of motivation. - ✔✔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. Frontal
b. Occipital
c. Parietal
d. Temporal

a
%


Interventions during this period include measures to reduce ICP, such as administering an osmotic
diuretic (e.g., mannitol) and positioning to avoid hypoxia. Hypertonic IV solutions are not used unless
sodium depletion is evident. PaCO2 must remain within an acceptable range, not maximized.
Mobilization would take place after the immediate threat of increased ICP has past. - ✔✔Nursing
care during the immediate recovery period from an ischemic stroke should include which of the
following?

a. Positioning to avoid hypoxia
b. Maximizing PaCO2
c. Administering hypertonic IV solution
d. Initiating early mobilization

a


Rapid diagnosis of stroke and initiation of thrombolytic therapy (within 3 hours) in clients with
ischemic stroke leads to a decrease in the size of the stroke and an overall improvement in functional
outcome after 3 months. - ✔✔An emergency department nurse is awaiting the arrival of a client with



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