Stroke, TIA, Parkinson's disease UPDATED Exam Questions and CORRECT Answers
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Stroke, TIA, Parkinson\'s Disease
Stroke, TIA, Parkinson's disease
UPDATED Exam Questions and
CORRECT Answers
In promoting health maintenance for prevention of strokes, the nurse understands that the
highest risk for the most common type of stroke is present in
a. African Americans
b. women who smoke
iduals with hypertensi...
Stroke, TIA, Parkinson's disease
UPDATED Exam Questions and
CORRECT Answers
In promoting health maintenance for prevention of strokes, the nurse understands that the
highest risk for the most common type of stroke is present in
a. African Americans
b. women who smoke
c.individuals with hypertension and diabetes
d. those who are obese with high dietary fat intake - CORRECT ANSWER- ✔✔C:
Individuals with hypertension and diabetes- The highest risk factors for thrombotic stroke are
hypertension and diabetes. African Americans have a higher risk for stroke than do white
persons but probably because they have a greater incidence of hypertension. Factors such as
obesity, diet high in saturated fats and cholesterol, cigarette smoking, and excessive alcohol
use are also risk factors but carry less risk than hypertension.
A thrombus that develops in a cerebral artery does not always cause a loss of neurologic
function because
a. the body can dissolve the atherosclerotic plaques as they form
b. some tissues of the brain do not require constant blood supply to prevent damage
c. circulation through the circle of Willis may provide blood supply to the affected area of
the brain
d. neurologic deficits occur only when major arteries are occluded by thrombus formation
around an atherosclerotic plaque - CORRECT ANSWER- ✔✔C: Circulation through the
circle of Willis may provide blood supply to the affected area of the brain.
The communication between cerebral arteries in the circle of Willing provides a collateral
circulation, which may maintain circulation to an area of the brain if its original blood supply
is obstructed. ALl areas of the brain require constant blood supply, and atherosclerotic
plaques are not readily reversed. Neurologic deficits can result from ischemia cause by many
factors.
A patient comes to the emergency department immediately after experiencing numbness of
the face and an inability to speak, but while the patient awaits examination, the symptoms
disappear and the patient request discharge. The nurse stresses that it is important for the
patient to be evaluated primarily because
a. the patient has probably experienced an asymptomatic lacunar stroke
, b. the symptoms are likely to return and progress to worsening neurologic deficit in the next
24 hours
c. neurologic deficits that are transient occur most often as a result of small hemorrhages that
clot off
d. the patient has probably experienced a transient ischemic attack (TIA), which is a sign of
progressive cerebral vascular disease - CORRECT ANSWER- ✔✔D: The patient has
probably experienced a transient ischemic attack (TIA), which is a sign of progressive
cerebral vascular disease- A TIA is a temporary focal loss of neurologic function caused by
ischemia of an area of the brain, usually lasting only about 3 hours. TIAs may be due to
microemboli from heart disease or carotid or cerebral thrombi and are a warning of
progressive disease. Evaluation is necessary to determine the cause of the neurologic deficit
and provide prophylactic treatment if possible.
The neurologic functions that are affected by a stroke are primarily related to
a. the amount of tissue area involved
b. the rapidity of onset of symptoms
c. the brain area perfused by the affected artery
d. the presence or absence of collateral circulation - CORRECT ANSWER- ✔✔C: The brain
area perfused by the affected artery- clinical manifestation of altered neurologic function
differ, depending primarily on the specific cerebral artery involved and the area of the brain
that is perfused by the artery. The degree of impairment depends on rapidity of onset, the size
of the lesion, and the presence of collateral circulation.
A patient is admitted to the hospital with a left hemiplegia. To determine the size and location
and to ascertain whether a stroke is ischemic or hemorrhagic, the nurse anticipates that the
health care provider will request a
a. CT scan
b. lumbar puncture
c. cerebral arteriogram
d. positron emission tomography (PET) - CORRECT ANSWER- ✔✔A: CT scan- A CT scan
is the most commonly used diagnostic test to determine the size and location of the lesion and
to differentiate a thrombotic stroke from a hemorrhagic stroke. Positron emission tomography
(PET) will show the metabolic activity of the brain and provide a depiction of the extent of
tissue damage after a stroke. Lumbar punctures are not performed routinely because of the
chance of increased intracranial pressure causing herniation. Cerebral arteriograms are
invasive and may dislodge an embolism or cause further hemorrhage; they are performed
only when no other test can provide the needed information.
, The incidence of ischemic stroke in patients with TIAs and other risk factors is reduced with
administration of
a. furosemide (Lasix)
b. lovastatin (Mevacor)
c. daily low dose aspirin
d. nimodipine (Nimotop) - CORRECT ANSWER- ✔✔C: Daily low dose aspirin- the
administration of antiplatelet agents, such as aspirin, dipyridamole (Persantine), and
ticlopdipine (Ticlid), reduces the incidence of stroke in those at risk. Anticoagulants are also
used for prevention of embolic strokes but increase the risk for hemorrhage. Diuretics are not
indicated for stroke prevention other than for their role in controlling BP, and antilipemic
agents have bot been found to have a significant effect on stroke prevention. The calcium
channel blocker nimodipine is used in patients with subarachnoid hemorrhage to decrease the
effects of vasospasm and minimize tissue damage.
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The priority intervention in the emergency department for the patient with a stroke is
a. intravenous fluid replacement
b. administration of osmotic diuretics to reduce cerebral edema
c. initiation of hypothermia to decrease the oxygen needs of the brain
d. maintenance of respiratory function with a patent airway and oxygen administration -
CORRECT ANSWER- ✔✔D: Maintenance of respiratory function with a patent airway and
oxygen administration- the first priority in acute management of the patient with a stroke is
preservation of life. Because the patient with a stroke may be unconscious or have a reduced
gag reflex, it is most important to maintain a patent airway for the patient and provide oxygen
if respiratory effort is impaired. IV fluid replacement, treatment with osmotic diuretics, and
perhaps hypothermia may be used for further treatment.
During the acute phase of a stroke, the nurse assesses the patient's vital signs and neurologic
status every 4 hours. A cardiovascular sign that the nurse would see as the body attempts to
increase cerebral blood flow is
a. hypertension
b. fluid overload
c. cardiac dysrhythmias
d. S3 and S4 heart sounds - CORRECT ANSWER- ✔✔A: Hypertension- The body responds
to the vasopasm and a decreased circulation to the brain that occurs with a stroke by
increasing the BP, frequently resulting in hypertension. The other options are important
cardiovascular factors to assess, but they do not result from impaired cerebral blood flow.
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