MULTIPLE CHOICE
1. Which topic would the nurse anticipate teaching a patient who had a brief episode of tinnitus, diplopia, and dysarthria with no residual effects?
a. Cerebral aneurysm clipping
b. Heparin intravenous infusion
c. Oral low-dose aspirin therapy
d. Tissue plasminogen activator ...
Harding: Lewis’s Medical -Surgical Nursing, 12th Edition MULTIPLE CHOICE 1. Which topic would the nurse anticipate teaching a patient who had a brief episode of tinnitus, diplopia, and dysarthria with no residual effects? a. Cerebral aneurysm clipping b. Heparin intravenous infusion c. Oral low -dose aspirin therapy 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 i s used only for acute ischemic stroke, not for TIA. DIF: Cognitive Level : Apply (Application) TOP: Nursing Process : Planning MSC: NCLEX: Physiological Integrity 2. A patient is being admitted with a possible stroke. Which information from the nursing assessment indicates that the patient is more likely to be having a hemorrhagic stroke than a thromboembolic stroke? a. The patient has intermittent bouts of atrial fibrillation. b. The patient has had brief episodes of right -sided hemiplegia. c. The patient has a history of treatment for infective endocarditis. d. The patient reports that the symptoms began with a severe headache. ANS: D A sudden onset headache is typical of a subarachnoid hemorrhage. Atrial fibrillation and infective endocarditis are a risk factors for thrombot ic or embolic stroke. Brief episodes of right -sided hemiplegia are consistent with transient ischemic attack and risk for embolic stroke. DIF: Cognitive Level : Analyze (Analysis) TOP: Nursing Process : Assessment MSC: NCLEX: Physiological Integrity 3. A patient being admitted with a stroke has right -sided facial drooping and right -sided arm and leg paralysis. Which other finding would the nurse expect? a. Impulsive behavior b. Right -sided neglect c. Hyperactive left -sided tendon reflexes d. Difficulty comprehending instructi ons ANS: D Right -sided paralysis indicates a left -brain stroke, which is also associated with difficulty in comprehension and use of language: the left hemisphere is dominant for language skills in right -handed persons and in most left -handed persons. Impu lsive behavior and neglect are more likely with a right -side stroke. The left -side reflexes are likely to be intact. DIF: Cognitive Level : Apply (Application) TOP: Nursing Process : Assessment MSC: NCLEX: Physiological Integrity 4. The health record indicates tha t a patient has an occluded left posterior cerebral artery. Which finding would the nurse anticipate? 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 : Apply (Application) TOP: Nursing Process : Assessment MSC: NCLEX: Physiological Integrity
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