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HESI RN EXIT CASE STUDY - STROKE 1. The Emergency Department (ED) nurse completes the admission assess- ment. Mr. Jones is alert but struggles to answer questions. When he attempts to talk, he slurs his speech and appears very frightened. Which additional clinical manifestations should the nurse expect to find if Mr. Jones' symptoms have been caused by a stroke ANS: carotid bruit elevated BP hyporeflexic DTR 2. Which assessment finding warrants immediate intervention by the RN? ANS: (Select all): Mr. Jones' Glasgow Coma Scale (GCS) score changes from 12 to 9 Mr. Jones has a positive Babinski's reflex bilaterally Mr. Jones is unable to verbalize responses to the nurse's questions 3. Due to his deteriorating condition, the neurologist is consulted to see Mr. Jones immediately. The nurse suspects that Mr. Jones has probably suffered a right-sided stroke. Which clinical manifestations further support this assess- ment ANS: increased distractibility visual deficit on left side spatial-perceptual deficits paresthesia on left side 4. The neurologist writes a diagnosis of "suspected stroke" and prescribes a computed tomography (CT) scan without contrast STAT. Which intervention should the nurse implement when preparing Mr. Jones and his son for this procedure ANS: Explain procedure requires client to lie completely still 5. The neurologist also prescribes a magnetic resonance imaging (MRI) of the head STAT. Which data warrants immediate intervention by the nurse concerning this diagnostic test ANS: left hip replacement 6. Which explanation by the nurse is the most therapeutic response ANS: "Your father has had a stroke, and the blood supply to the brain has been compromised." 7. Barry is visibly upset and states, "Dad has been fine all week. We even went out to dinner. I love him so much and I am scared." How should the nurse respond ANS: "I know this is scary for you. Would you like to sit and talk?" 8. The neurologist diagnoses an ischemic right-sided stroke. The neurologist
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