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The nurse is performing stroke risk screenings at a hospital open house. The nurse has identified four patients who might be at risk for a stroke. Which patient is likely at the highest risk for a hemorrhagic stroke?
- A. White female, age 60, with history of excessive alcohol intake
- B. White male, age 60, with history of uncontrolled hypertension
- C. Black male, age 60, with history of diabetes
- D. Black male, age 50, with history of smoking
Correct Answer: B
Rationale: Uncontrolled hypertension is the primary risk factor for hemorrhagic stroke. Alcohol, diabetes, and smoking increase risk but are less significant than hypertension.
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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.
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.
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%.
After a subarachnoid hemorrhage, the patients laboratory results indicate a serum sodium level of less than 126 mEq/L. What is the nurses most appropriate action?
- A. Administer a bolus of normal saline as ordered.
- B. Prepare the patient for thrombolytic therapy as ordered.
- C. Facilitate testing for hypothalamic dysfunction.
- D. Prepare to administer 3% NaCl by IV as ordered.
Correct Answer: D
Rationale: Hyponatremia post-subarachnoid hemorrhage suggests SIADH or cerebral salt-wasting, treated with hypertonic 3% saline. Normal saline may worsen the issue, and other options are irrelevant.
A nurse in the ICU is providing care for a patient who has been admitted with a hemorrhagic stroke. The nurse is performing frequent neurologic assessments and observes that the patient is becoming progressively more drowsy over the course of the day. What is the nurses best response to this assessment finding?
- A. Report this finding to the physician as an indication of decreased metabolism.
- B. Provide more stimulation to the patient and monitor the patient closely.
- C. Recognize this as the expected clinical course of a hemorrhagic stroke.
- D. Report this to the physician as a possible sign of clinical deterioration.
Correct Answer: D
Rationale: Increasing drowsiness indicates possible deterioration in hemorrhagic stroke, requiring immediate physician notification. It is not expected or due to metabolism, and stimulation is contraindicated.