Question 1

When should a nurse recognize that the acute phase of a CVA has ended?

Accepted Answer

A)  Forty-eight hours has passed from its onset. 
B)  The patient begins to respond verbally. 
C)  BP drops. 
D)  Vital signs and neurologic signs stabilize. 
A)  Forty-eight hours has passed from its onset. 
B)  The patient begins to respond verbally. 
C)  BP drops. 
D)  Vital signs and neurologic signs stabilize.

Question 2

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?

Accepted Answer

A)  It is lacunar. 
B)  It is hemorrhagic or embolic. 
C)  It is complete or in evolution. 
D)  It will result in paralysis. 
A)  It is lacunar. 
B)  It is hemorrhagic or embolic. 
C)  It is complete or in evolution. 
D)  It will result in paralysis.

Question 3

A nurse is updating a teaching plan for a patient who sustained a TIA.What should the nurse be sure to include?

Accepted Answer

A)  Daily aspirin dose 
B)  Long rest periods daily 
C)  Reduction of fluid intake to 800 mL/day 
D)  High-carbohydrate diet 
A)  Daily aspirin dose 
B)  Long rest periods daily 
C)  Reduction of fluid intake to 800 mL/day 
D)  High-carbohydrate diet

Question 4

A patient who has sustained a hemorrhagic stroke is placed on a protocol of 60 mg of calcium channel blocker (nimodipine)every 4 hours.The patient's pulse is 82 beats/min before the administration of the prescribed dose.Which action should the nurse implement?

Accepted Answer

A)  Give the full dose as prescribed without further assessment. 
B)  Omit the dose, recording the pulse rate as the rationale. 
C)  Delay the dose until the pulse is below 60 beats/min. 
D)  Give half of the prescribed dose (30 mg). 
A)  Give the full dose as prescribed without further assessment. 
B)  Omit the dose, recording the pulse rate as the rationale. 
C)  Delay the dose until the pulse is below 60 beats/min. 
D)  Give half of the prescribed dose (30 mg).

Question 5

Pneumonia is the most frequent cause of death after a stroke.Which intervention would be contraindicated in the acute care of a patient with a hemorrhagic CVA?

Accepted Answer

A)  Thicken liquids to ease swallowing and prevent aspiration. 
B)  Change position every 30 to 60 minutes. 
C)  Maintain adequate fluid intake, orally or IV. 
D)  Encourage forceful coughing to stimulate deep breathing. 
A)  Thicken liquids to ease swallowing and prevent aspiration. 
B)  Change position every 30 to 60 minutes. 
C)  Maintain adequate fluid intake, orally or IV. 
D)  Encourage forceful coughing to stimulate deep breathing.

Question 6

What purposes exist for a stent in the carotid artery of a person with a TIA?

Accepted Answer

A)  Capture circulating clots. 
B)  Help with subsequent angioplasties. 
C)  Keep the artery open. 
D)  Prevent hemorrhage. 
E)  Measure the pressure in the artery. 
A)  Capture circulating clots. 
B)  Help with subsequent angioplasties. 
C)  Keep the artery open. 
D)  Prevent hemorrhage. 
E)  Measure the pressure in the artery.

Question 7

What should a nurse ensure as a priority for a patient immediately after a CVA?

Accepted Answer

A)  Preservation of motor function 
B)  Airway maintenance 
C)  Adequate hydration 
D)  Control of elimination 
A)  Preservation of motor function 
B)  Airway maintenance 
C)  Adequate hydration 
D)  Control of elimination

Question 8

What signs and symptoms characterize expressive aphasia?

Accepted Answer

A)  Speech that sounds normal but makes no sense 
B)  Total inability to communicate 
C)  Difficulty understanding the written and spoken word 
D)  Stuttering and spitting 
E)  Difficulty initiating speech 
A)  Speech that sounds normal but makes no sense 
B)  Total inability to communicate 
C)  Difficulty understanding the written and spoken word 
D)  Stuttering and spitting 
E)  Difficulty initiating speech

Question 9

Which assessment indicates that a patient with a CVA is in transition to the rehabilitation phase?

Accepted Answer

A)  BP has been within normal limits for 24 hours. 
B)  Patient makes positive statements about his condition. 
C)  No further neurologic deficits are observed. 
D)  Successful attempts are made at independent function. 
A)  BP has been within normal limits for 24 hours. 
B)  Patient makes positive statements about his condition. 
C)  No further neurologic deficits are observed. 
D)  Successful attempts are made at independent function.

Question 10

The wife of a husband who has had a CVA asks why he is being treated with insulin since he has no history of diabetes.What is the best response by the nurse as to why hyperglycemia occurs after a stroke?

Accepted Answer

A)  Brain swelling 
B)  Hypertension 
C)  Immobility 
D)  Stress 
A)  Brain swelling 
B)  Hypertension 
C)  Immobility 
D)  Stress

Question 11

Which patient is at the greatest risk for a CVA?

Accepted Answer

A)  A 20-year-old obese Latin woman who is taking birth control pills 
B)  A 40-year-old athletic white man with a family history of CVA 
C)  A 60-year-old Asian woman who smokes occasionally 
D)  A 65-year-old African-American man with hypertension 
A)  A 20-year-old obese Latin woman who is taking birth control pills 
B)  A 40-year-old athletic white man with a family history of CVA 
C)  A 60-year-old Asian woman who smokes occasionally 
D)  A 65-year-old African-American man with hypertension

Question 12

How does a lacunar stroke differ from an ischemic CVA? (Select all that apply.)

Accepted Answer

A)  Causes a great deal of pain 
B)  Alters the personality 
C)  Affects small arteries 
D)  Nearly always results in blindness 
E)  Produces a small amount of neurologic damage 
A)  Causes a great deal of pain 
B)  Alters the personality 
C)  Affects small arteries 
D)  Nearly always results in blindness 
E)  Produces a small amount of neurologic damage

Question 13

Which home modifications will support rehabilitation for a patient who had a stroke? (Select all that apply.)

Accepted Answer

A)  Raised commode seat 
B)  Provision of a seat in the shower 
C)  Availability of soft, low chairs 
D)  Bathtub handrails 
E)  Bright-colored scatter rugs 
A)  Raised commode seat 
B)  Provision of a seat in the shower 
C)  Availability of soft, low chairs 
D)  Bathtub handrails 
E)  Bright-colored scatter rugs

Exam 23: Cerebrovascular Accident

When should a nurse recognize that the acute phase of a CVA has ended?

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?

A nurse is updating a teaching plan for a patient who sustained a TIA.What should the nurse be sure to include?

A patient who has sustained a hemorrhagic stroke is placed on a protocol of 60 mg of calcium channel blocker (nimodipine)every 4 hours.The patient's pulse is 82 beats/min before the administration of the prescribed dose.Which action should the nurse implement?

Pneumonia is the most frequent cause of death after a stroke.Which intervention would be contraindicated in the acute care of a patient with a hemorrhagic CVA?

What purposes exist for a stent in the carotid artery of a person with a TIA?

What should a nurse ensure as a priority for a patient immediately after a CVA?

What signs and symptoms characterize expressive aphasia?

Which assessment indicates that a patient with a CVA is in transition to the rehabilitation phase?

The wife of a husband who has had a CVA asks why he is being treated with insulin since he has no history of diabetes.What is the best response by the nurse as to why hyperglycemia occurs after a stroke?

Which patient is at the greatest risk for a CVA?

How does a lacunar stroke differ from an ischemic CVA? (Select all that apply.)

Which home modifications will support rehabilitation for a patient who had a stroke? (Select all that apply.)

Aspects of Medical-Surgical Nursing

Medical-Surgical Practice Settings

Medical-Surgical Patients: Individuals, Families, and Communities

Health, Illness, Stress, and Coping

Immunity, Inflammation, and Infection

Fluid, Electrolyte, and Acidbase Imbalance

The Patient With Cancer

Pain

Shock

The Older Adult Patient

Falls

Immobility

Delirium and Dementia

Incontinence

Nutrition

Intravenous Therapy

Surgery

The Patient With an Ostomy

Palliative and Hospice Care

Complementary and Alternative Therapies

Neurologic System Introduction

Neurologic Disorders

Spinal Cord Injury

Respiratory System Introduction

Upper Respiratory Disorders

Acute Lower Respiratory Tract Disorders

Chronic Lower Respiratory Tract Disorders

Hematologic System Introduction

Hematologic Disorders

Immunologic System Introduction

Immunologic Disorders

Cardiovascular System Introduction

Cardiac Disorders

Vascular Disorders

Hypertension

Digestive System Introduction

Upper Digestive Tract Disorders

Lower Digestive Tract Disorders

Liver, Gallbladder, and Pancreatic Disorders

Urologic System Introduction

Urologic Disorders

Musculoskeletal System Introduction

Connective Tissue Disorders

Fractures

Amputations

Endocrine System Introduction

Pituitary and Adrenal Disorders

Thyroid and Parathyroid Disorders

Diabetes and Hypoglycemia

Female Reproductive System Introduction

Female Reproductive Disorders

Male Reproductive System Introduction

Male Reproductive Disorders

Sexually Transmitted Infections

Integumentary System Introduction

Skin Disorders

Special Senses Introduction

Eye and Vision Disorders

Ear and Hearing Disorders

Psychobiological Disorders

Substance Abuse

First Aid, Emergency Care, and Disaster Management

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