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A family member brings the patient to the clinic for a follow-up visit after a stroke. The family member asks the nurse what he can do to decrease his chance of having another stroke. What would be the nurses best answer?
- A. Have your heart checked regularly.
- B. Stop smoking as soon as possible.
- C. Get medication to bring down your sodium levels.
- D. Eat a nutritious diet.
Correct Answer: B
Rationale: Smoking cessation significantly reduces stroke risk. Heart checks, sodium medication, and diet are less directly impactful.
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As a member of the stroke team, the nurse knows that thrombolytic therapy carries the potential for benefit and for harm. The nurse should be cognizant of what contraindications for thrombolytic therapy? Select all that apply.
- A. INR above 1.0
- B. Recent intracranial pathology
- C. Sudden symptom onset
- D. Current anticoagulation therapy
- E. Symptom onset greater than 3 hours prior to admission
Correct Answer: B,D,E
Rationale: Recent intracranial pathology, anticoagulation (INR >1.7), and symptom onset >3 hours are thrombolytic contraindications. INR above 1.0 is too low, and sudden onset is not a contraindication.)
A nurse is caring for a patient diagnosed with a hemorrhagic stroke. When creating this patients plan of care, what goal should be prioritized?
- A. Prevent complications of immobility.
- B. Maintain and improve cerebral tissue perfusion.
- C. Relieve anxiety and pain.
- D. Relieve sensory deprivation.
Correct Answer: B
Rationale: Cerebral perfusion is a priority physiologic need for survival in hemorrhagic stroke. Other goals are important but secondary.
The public health nurse is planning a health promotion campaign that reflects current epidemiologic trends. The nurse should know that hemorrhagic stroke currently accounts for what percentage of total strokes in the United States?
- A. 43%
- B. 33%
- C. 23%
- D. 13%
Correct Answer: D
Rationale: Hemorrhagic strokes account for 13% of total strokes, with ischemic strokes comprising 87%.
A community health nurse is giving an educational presentation about stroke and heart disease at the local senior citizens center. What nonmodifiable risk factor for stroke should the nurse cite?
- A. Female gender
- B. Asian American race
- C. Advanced age
- D. Smoking
Correct Answer: C
Rationale: Advanced age is a nonmodifiable stroke risk factor, with incidence doubling per decade after 55. Male gender, not female, and African American race are risks; smoking is modifiable.
A patient with a cerebral aneurysm exhibits signs and symptoms of an increase in intracranial pressure (ICP). What nursing intervention would be most appropriate for this patient?
- A. Range-of-motion exercises to prevent contractures
- B. Encouraging independence with ADLs to promote recovery
- C. Early initiation of physical therapy
- D. Absolute bed rest in a quiet, nonstimulating environment
Correct Answer: D
Rationale: Absolute bed rest minimizes BP elevation, reducing bleeding risk in cerebral aneurysms. Activity-based interventions increase ICP and are contraindicated.