Nokea
A patient who has experienced an ischemic stroke has been admitted to the medical unit. The patients family in adamant that she remain on bed rest to hasten her recovery and to conserve energy. What principle of care should inform the nurses response to the family?
- A. The patient should mobilize as soon as she is physically able.
- B. To prevent contractures and muscle atrophy, bed rest should not exceed 4 weeks.
- C. The patient should remain on bed rest until she expresses a desire to mobilize.
- D. Lack of mobility will greatly increase the patients risk of stroke recurrence.
Correct Answer: A
Rationale: Early mobilization prevents complications like contractures and DVT. Prolonged bed rest or waiting for patient initiative is not recommended.
You may also like to solve these questions
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.
The nurse is caring for a patient recovering from an ischemic stroke. What intervention best addresses a potential complication after an ischemic stroke?
- A. Providing frequent small meals rather than three larger meals
- B. Teaching the patient to perform deep breathing and coughing exercises
- C. Keeping a urinary catheter in situ for the full duration of recovery
- D. Limiting intake of insoluble fiber
Correct Answer: B
Rationale: Deep breathing and coughing prevent pneumonia, a common stroke complication. Frequent meals, prolonged catheters, and fiber limits are not indicated.
When preparing to discharge a patient home, the nurse has met with the family and warned them that the patient may exhibit unexpected emotional responses. The nurse should teach the family that these responses are typically a result of what cause?
- A. Frustration around changes in function and communication
- B. Unmet physiologic needs
- C. Changes in brain activity during sleep and wakefulness
- D. Temporary changes in metabolism
Correct Answer: A
Rationale: Emotional responses post-stroke often stem from frustration with functional and communication deficits. Other causes should be ruled out.
A preceptor is discussing stroke with a new nurse on the unit. The preceptor would tell the new nurse which cardiac dysrhythmia is associated with cardiogenic embolic strokes?
- A. Ventricular tachycardia
- B. Atrial fibrillation
- C. Supraventricular tachycardia
- D. Bundle branch block
Correct Answer: B
Rationale: Atrial fibrillation is strongly linked to cardiogenic embolic strokes due to thrombus formation. Other dysrhythmias are less associated.