Exam (elaborations)
VN 304 Med Surg 2 Quiz 9: CVA & Spinal Cord Injury Exam
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- VN 304 Med Surg 2
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- Unitek
VN 304 Med Surg 2 Quiz 9: CVA & Spinal Cord Injury Exam
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Unitek UniversityVN 304 Med Surg 2 Quiz 9: CVA &
Spinal Cord Injury Exam
Course Title and Number: VN 304 Med Surg 2
Exam Title:
Exam Date:
Instructor:
Student Name:
Student ID:
Examination
180 minutes
Instructions:
1. Read each question carefully.
2. Answer all questions.
3. Use the provided answer sheet to mark your responses.
4. Ensure all answers are final before submitting the exam.
Good Luck!
,Med-Surg 2 Quiz 9 CVA and Spinal Cord
Injury
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?
Answer: Left hemisphere of the cerebrum.
Explanation: Impaired motor strength on the right
side combined with impaired reasoning suggests a
lesion in the left hemisphere of the cerebrum. The
cerebellum, which controls balance, does not
typically cause contralateral symptoms.
2. Which patient is at the greatest risk for a CVA?
Answer: A 65-year-old African-American man with
hypertension.
Explanation: Older African Americans have a
higher incidence of CVA compared to other groups.
Hypertension is a significant risk factor for stroke.
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?
Answer: Results of MRI.
Explanation: A Transient Ischemic Attack (TIA) is
often suspected based on the patient's history and
physical exam. An MRI is the preferred imaging
study to confirm the diagnosis.
4. A nurse is updating a teaching plan for a
patient who sustained a TIA. What should the
nurse be sure to include?
, Answer: Daily aspirin dose.
Explanation: Daily aspirin therapy reduces
platelet aggregation and may help prevent future
TIAs or strokes.
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?
Answer: Prevents the formation of new clots.
Explanation: Warfarin (Coumadin) is an
anticoagulant that helps prevent the formation of
new blood clots, reducing the risk of another
stroke.
6. A patient has had a complete stroke as a
result of a ruptured vessel in the left
hemisphere. How should this patient's CVA be
classified?
Answer: Hemorrhagic, intracerebral.
Explanation: A ruptured vessel within the brain
hemisphere classifies the stroke as a hemorrhagic
intracerebral CVA. This is different from ischemic
strokes, which are caused by occlusions.
7. What should a nurse ensure as a priority for a
patient immediately after a CVA?
Answer: Airway maintenance.
Explanation: Maintaining the airway is crucial to
ensure adequate oxygenation, which helps prevent
hypoxemia and further brain injury after a stroke.
8. When should a nurse recognize that the acute
phase of a CVA has ended?
Answer: Vital signs and neurologic signs stabilize.
, Explanation: The acute phase of a CVA is
considered over when the patient's vital signs and
neurologic status have stabilized.
9. A patient in the acute phase of a CVA who has
been speaking distinctly begins to speak
indistinctly and only with great effort but still
coherent. What should this nurse determine
when assessing this patient?
Answer: Stroke in evolution with dysarthria.
Explanation: The worsening of symptoms,
including speech difficulties, suggests that the
stroke is still evolving. Dysarthria refers to slurred
or difficult speech.
10. Several days after a CVA, a patient's family
asks a nurse if tissue plasminogen activator (tPA)
is a drug therapy option now. The nurse's
response is based on the knowledge that this
drug must be used within how many hours after
the onset of symptoms?
Answer: 3 hours.
Explanation: tPA is most effective when
administered within 3 hours of symptom onset.
Some specialized centers may extend this window
to 6 hours, but the FDA guidelines recommend the
3-hour timeframe.
11. A nurse explains that a lumbar puncture is
most helpful as a diagnostic tool for a new
patient who has had a CVA. What would this
diagnostic test help determine regarding the
stroke?
Answer: It is hemorrhagic or embolic.
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