Nokea
A patient diagnosed with transient ischemic attacks (TIAs) is scheduled for a carotid endarterectomy. The nurse explains that this procedure will be done for what purpose?
- A. To decrease cerebral edema
- B. To prevent seizure activity that is common following a TIA
- C. To remove atherosclerotic plaques blocking cerebral flow
- D. To determine the cause of the TIA
Correct Answer: C
Rationale: Carotid endarterectomy removes plaques to prevent stroke in patients with occlusive carotid disease. It does not address edema, seizures, or TIA causation.
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A patient is brought by ambulance to the ED after suffering what the family thinks is a stroke. The nurse caring for this patient is aware that an absolute contraindication for thrombolytic therapy is what?
- A. Evidence of hemorrhagic stroke
- B. Blood pressure of 180/110 mm Hg
- C. Evidence of stroke evolution
- D. Previous thrombolytic therapy within the past 12 months
Correct Answer: A
Rationale: Thrombolytic therapy is contraindicated in hemorrhagic stroke due to bleeding risk. High BP, stroke evolution, or prior thrombolytic use are not absolute contraindications.
A patient diagnosed with a hemorrhagic stroke has been admitted to the neurologic ICU. The nurse knows that teaching for the patient and family needs to begin as soon as the patient is settled on the unit and will continue until the patient is discharged. What will family education need to include?
- A. How to differentiate between hemorrhagic and ischemic stroke
- B. Risk factors for ischemic stroke
- C. How to correctly modify the home environment
- D. Techniques for adjusting the patients medication dosages at home
Correct Answer: C
Rationale: Home environment modifications support the patient's disability needs post-stroke. Stroke differentiation and medication adjustments are not family responsibilities.
A patient has had an ischemic stroke and has been admitted to the medical unit. What action should the nurse perform to best prevent joint deformities?
- A. Place the patient in the prone position for 30 minutes/day.
- B. Assist the patient in acutely flexing the thigh to promote movement.
- C. Place a pillow in the axilla when there is limited external rotation.
- D. Place patients hand in pronation.
Correct Answer: C
Rationale: A pillow in the axilla prevents shoulder adduction, reducing deformity risk. Prone positioning aids hip extension, not daily for 30 minutes. Acute thigh flexion may cause edema, and hand pronation is less functional than supination.
The nurse is assessing a patient with a suspected stroke. What assessment finding is most suggestive of a stroke?
- A. Facial droop
- B. Dysrhythmias
- C. Periorbital edema
- D. Projectile vomiting
Correct Answer: A
Rationale: Facial droop is a classic stroke sign. Dysrhythmias, edema, and vomiting are less specific or common in acute stroke.
Following diagnostic testing, a patient has been admitted to the ICU and placed on cerebral aneurysm precautions. What nursing action should be included in patients plan of care?
- A. Supervise the patients activities of daily living closely.
- B. Initiate early ambulation to prevent complications of immobility.
- C. Provide a high-calorie, low-protein diet.
- D. Perform all of the patient's hygiene and feeding.
Correct Answer: A
Rationale: Close supervision of ADLs prevents exertion that could elevate BP in aneurysm precautions. Ambulation and dietary restrictions are not indicated, and some ADLs may be allowed.