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What should be included in the patients care plan when establishing an exercise program for a patient affected by a stroke?
- A. Schedule passive range of motion every other day.
- B. Keep activity limited, as the patient may be over stimulated.
- C. Have the patient perform active range-of-motion (ROM) exercises once a day.
- D. Exercise the affected extremities passively four or five times a day.
Correct Answer: D
Rationale: Passive ROM four to five times daily prevents contractures and maintains mobility. Active ROM should be more frequent, and limited activity is not ideal.
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The nurse is caring for a patient diagnosed with an ischemic stroke and knows that effective positioning of the patient is important. Which of the following should be integrated into the patients plan of care?
- A. The patients hip joint should be maintained in a flexed position.
- B. The patient should be in a supine position unless ambulating.
- C. The patient should be placed in a prone position for 15 to 30 minutes several times a day.
- D. The patient should be placed in a Trendelenberg position two to three times daily to promote cerebral perfusion.
Correct Answer: C
Rationale: Prone positioning with pelvic support promotes hip extension, preventing contractures. Flexed hips, supine-only positioning, and Trendelenberg are inappropriate.
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 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.
When caring for a patient who has had a stroke, a priority is reduction of ICP. What patient position is most consistent with this goal?
- A. Head turned slightly to the right side
- B. Elevation of the head of the bed
- C. Position changes every 15 minutes while awake
- D. Extension of the neck
Correct Answer: B
Rationale: HOB elevation promotes venous drainage, reducing ICP. Neck extension or frequent position changes may increase ICP, and head turning is less effective.
The nurse is preparing health education for a patient who is being discharged after hospitalization for a hemorrhagic stroke. What content should the nurse include in this education?
- A. Mild, intermittent seizures can be expected.
- B. Take ibuprofen for complaints of a serious headache.
- C. Take antihypertensive medication as ordered.
- D. Drowsiness is normal for the first week after discharge.
Correct Answer: C
Rationale: Antihypertensive therapy is critical to manage hypertension, a key risk factor for hemorrhagic stroke. Seizures, ibuprofen use, and drowsiness are not normal or advised.