Question 1 of 10
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Which response would the nurse give when a patient asks, “What causes a stroke?”
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- “A stroke is cause by an untreated seizure disorder.”An untreated seizure disorder would not cause a stroke.
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- “A stroke is caused by a sudden increase in cardiac output.”A sudden increase in cardiac output would not cause a stroke.
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- “A stroke is caused by an interruption of blood flow to the brain.”A cerebrovascular accident (stroke) results when an interruption of blood flow to the brain occurs. This may be the result of hemorrhage or obstruction.
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- “A stroke is caused by a sudden change in electrolyte balance, especially sodium.”A sudden change in electrolyte balance, especially sodium, would not cause a stroke.
Question 2 of 10
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Which factor is a major cause of stroke?
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- Low blood pressureHigh blood pressure, not low blood pressure, is a risk factor for stroke.
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- AtherosclerosisAtherosclerosis is a major cause of stroke. It increases the patient’s risk for emboli as a result of a thrombus that forms in the brain vessels or plaque that can break off and become emboli in other arteries.
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- Absence seizureAbsence seizures are not a risk factor for emboli or stroke.
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- Cigarette smokingCigarette smoking is a risk factor for stroke, but it does not predispose the individual to developing emboli like atherosclerosis.
Question 3 of 10
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Which priority assessment would the nurse implement when a patient suspected of sustaining a stroke arrives at the emergency department?
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- Functional abilityFunctional ability is important; however, it is not a priority during the acute phase of a stroke. Once the patient is stable and the acute phase has passed, functional ability will be assessed.
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- Level of consciousness (LOC)During the examination, LOC would be assessed second.
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- HyperglycemiaThe nurse would assess hyperglycemia in a patient with diabetes.
- Correct
- AirwayDuring the examination, the nurse would assess the patient’s airway and respiratory rate first.
Question 4 of 10
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Which condition is a potential cause of a transient ischemic attack? Select all that apply. One, some, or all responses may be correct.
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- HypotensionHypotension leads to a widening of blood vessels, which promotes blood flow and reduces blood pressure.
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- Rheumatoid arthritisRheumatoid arthritis is an inflammatory condition that causes vasodilation of vessels. Vasodilation assists inflammation by increasing blood flow to damaged cells and body tissues.
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- AtherosclerosisAtherosclerosis is a buildup of plaque in the blood vessels that causes narrowing and an interruption in blood flow.
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- EmbolismAn embolism is an obstruction of an artery by a blood clot or air bubble and can impede blood flow.
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- VasospasmVasospasm occurs when a blood vessel in the brain is narrowed, blocking blood flow.
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- CocaineCocaine is a recreational drug that causes vasoconstriction.
Question 5 of 10
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How soon must thrombolytic therapy be initiated after arriving at the hospital for a patient suffering an ischemic stroke?
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- Within 1 hour of arrival at hospitalThrombolytic therapy must be administered within 1 hour of arrival at the hospital for a patient with an ischemic stroke.
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- Within 10 minutes of arrival at hospitalAmerican Hospital Association guidelines suggest an assessment utilizing the National Institutes of Health stroke scale should occur within 10 minutes of arriving at the hospital.
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- Within 25 minutes of arrival at hospitalAmerican Hospital Association guidelines suggest a computed tomography scan should be performed within 25 minutes of arrival and interpreted within 45 minutes.
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- Within 2 hours of arrival at hospitalWaiting 2 hours to administer thrombolytic therapy would be considered delaying life-saving treatment.
Question 6 of 10
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Which medical condition could lead to an intracerebral hemorrhage?
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- AtherosclerosisAtherosclerosis causes plaque buildup in the arteries and places the patient at risk for an ischemic stroke.
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- Arterial spasmsArterial spasms are a less common cause of embolic stroke.
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- Atrial fibrillation (AF)AF is a common cause of an embolic stroke.
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- Arteriovenous (AV) malformationAn AV malformation in the brain can leak or rupture causing an intracerebral hemorrhage.
Question 7 of 10
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Which condition would the nurse suspect when caring for a patient who complains of a sudden, severe headache, blurry vision, and significant neck stiffness?
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- HydrocephalusHydrocephalus is a buildup of fluid in the brain and presents with headache, weakness, nausea, cognitive difficulties, and loss of coordination.
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- EndocarditisEndocarditis is an infection of the heart’s inner lining and presents with fever, chills, malaise, and occasionally a heart murmur.
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- Subarachnoid hemorrhageA subarachnoid hemorrhage occurs when there is bleeding on the brain and causes a rapid onset of neurological deficits, including a sudden and severe headache, vision changes, and neck stiffness.
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- SepsisSepsis is a life-threatening infection that presents with fever, difficulty breathing, hypotension, and tachycardia.
Question 8 of 10
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Which statement by the patient about the use of aspirin after a stroke demonstrates a need for further education?
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- “I will crush the pill to put in my applesauce.”Aspirin is enteric-coated, and crushing could result in the drug being released too early, being destroyed by the stomach acid, or irritating the stomach lining.
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- “I will report any blood in my stool.”Aspirin is a blood thinner, so it is important to report any blood in the stool, bleeding gums, nosebleeds, or excessive bruising.
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- “I will take my medication sitting upright.”Aspirin can cause gastrointestinal irritation, so taking it with a full glass of water while sitting upright is highly recommended.
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- “I will report any ringing in my ears.”Tinnitus is a side effect of aspirin and should be reported immediately.
Question 9 of 10
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Which medication is used to prevent cerebral vasospasms?
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- AtorvastatinStatin medications are used to control cholesterol and prevent plaque formation.
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- WarfarinWarfarin is an anticoagulant, used for ischemic stroke prevention.
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- DiazepamDiazepam is an anticonvulsant that can be used to prevent seizures in patients after a cerebrovascular accident.
- Correct
- NimodipineNimodipine inhibits calcium ion influx across cellular membranes and decreases or prevents cerebral vasospasm.
Question 10 of 10
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Which statement about nutrition considerations by a stroke patient with dysphagia indicates a need for further education?
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- “I will only place one teaspoon of food in my mouth at a time.”This is correct and allows the patient ample time to chew and swallow the food before moving on.
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- “I will use a straw to drink from my cup.”The patient should sip from a cup or glass rather than use a straw as it could propel fluids into the back of the mouth too fast for the patient to swallow.
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- “I will remain upright for 45 minutes after each meal.”Sitting upright for 45 to 60 minutes after a meal allows it time to digest and decreases the risk for aspiration.
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- “I will place the food into the unaffected side of my mouth.”Placing the food on the unaffected side allows the patient to chew the food appropriately before swallowing, to decrease the risk of aspiration.
