Chapter 11 Flashcards
When assessing a patient with a possible stroke, the priority of care is:
a. identifying risk factors for stroke.
b. determining if there is a family history of stroke.
c. recognizing the signs of a stroke.
d. determining the type of stroke.
a. identifying risk factors for stroke.
b. determining if there is a family history of stroke.
c. recognizing the signs of a stroke.
d. determining the type of stroke.
Answer: c
Objective: 11-5
Reference: 375
Which of the following is the best answer to the question, “Are all stroke patients paralyzed on one side of their bodies?”
a. “Yes. Both the arm and leg on the same side is always be paralyzed.”
b. “No. Some patients suffering a stroke will show no signs of paralysis at all.”
c. “No. Paralysis can occur on both sides of the body of different limbs.”
d. “No. Some stroke patients may have only slight weakness on one side of their bodies.”
a. “Yes. Both the arm and leg on the same side is always be paralyzed.”
b. “No. Some patients suffering a stroke will show no signs of paralysis at all.”
c. “No. Paralysis can occur on both sides of the body of different limbs.”
d. “No. Some stroke patients may have only slight weakness on one side of their bodies.”
Answer: d
Objective: 11-4
Reference: 375
When assessing a patient for abnormal speech, you should:
a. ask the patient stick his tongue straight out.
b. ask the patient to repeat a common phrase.
c. see if one side of the patient’s mouth is drooping.
d. write questions on note cards for the patient to read.
a. ask the patient stick his tongue straight out.
b. ask the patient to repeat a common phrase.
c. see if one side of the patient’s mouth is drooping.
d. write questions on note cards for the patient to read.
Answer: b
Objective: 11-4
Reference: 375
When assessing a patient for a facial droop, you should:
a. palpate the face one side at a time.
b. gently lift and then let go of the skin over the cheeks.
c. ask the patient to show you his teeth or to smile.
d. observe the patient’s ability to turn his head to the right and then to the left.
a. palpate the face one side at a time.
b. gently lift and then let go of the skin over the cheeks.
c. ask the patient to show you his teeth or to smile.
d. observe the patient’s ability to turn his head to the right and then to the left.
Answer: c
Objective: 11-5
Reference: 375
Which of the following instructions to a possible stroke patient describes the proper procedure for assessing an arm drift?
a. “Hold your arms up over your head for 20 seconds.”
b. “Grab my fingers with both hands and squeeze as hard as you can.”
c. “Raise your hands above your head and close your eyes.”
d. “Hold your arms straight out for 10 to 15 seconds.”
a. “Hold your arms up over your head for 20 seconds.”
b. “Grab my fingers with both hands and squeeze as hard as you can.”
c. “Raise your hands above your head and close your eyes.”
d. “Hold your arms straight out for 10 to 15 seconds.”
Answer: d
Objective: 11-5
Reference: 374
Which of the following questions is critical for establishing a window of treatment for a patient who is weak and dizzy and may have suffered a stroke?
a. “Does your father have a history of heart problems or stroke?”
b. “What time did the weakness and dizziness start?”
c. “What medications do you take?”
d. “Do you have any pain in your arms or legs?”
a. “Does your father have a history of heart problems or stroke?”
b. “What time did the weakness and dizziness start?”
c. “What medications do you take?”
d. “Do you have any pain in your arms or legs?”
Answer: b
Objective: 11-5
Reference: 373, 376
Which of the following pieces of information is assessed by the Cincinnati Prehospital Stroke Scale?
a. Blood glucose level
b. Presence or absence of facial droop
c. Duration of symptoms
d. Age of the patient
a. Blood glucose level
b. Presence or absence of facial droop
c. Duration of symptoms
d. Age of the patient
Answer: b
Objective: 11-5
Reference: 376
You have assessed a patient and found a patent airway, adequate breathing, and a strong radial pulse. The patient is having no difficulty speaking and no facial droop, but exhibits a slight left arm drift. You should interpret these findings as:
a. not suggestive of a stroke.
b. suggestive of a stroke only if the patient’s blood pressure is also elevated.
c. suggestive of a stroke only if the patient’s pupils are not equal.
d. suggestive that a stroke may be occurring.
a. not suggestive of a stroke.
b. suggestive of a stroke only if the patient’s blood pressure is also elevated.
c. suggestive of a stroke only if the patient’s pupils are not equal.
d. suggestive that a stroke may be occurring.
Answer: d
Objective: 11-5
Reference: 375
Which of the following statements shows that the speaker has an accurate understanding of assessment findings related to stroke?
a. “For a stroke to be suspected, both arms must be equally weak.”
b. “If one arm is weak, a stroke should be suspected.”
c. “A stroke should be suspected only when one arm is paralyzed, not just weak.”
d. “If one arm is weak, stroke should be suspected only if the patient’s blood pressure is also elevated.”
a. “For a stroke to be suspected, both arms must be equally weak.”
b. “If one arm is weak, a stroke should be suspected.”
c. “A stroke should be suspected only when one arm is paralyzed, not just weak.”
d. “If one arm is weak, stroke should be suspected only if the patient’s blood pressure is also elevated.”
Answer: b
Objective: 11-5
Reference: 374, 375
You have been called for a 63-year-old woman with slurred speech and right arm weakness. On arrival, the patient informs you that the slurred speech and weakness have resolved. Since your assessment reveals no deficits, you would tell the patient:
a. “It would be best to start taking one baby aspirin every day; this will decrease the chance of this happening again.”
b. “Sometimes seizures present this way; call your doctor in the morning to schedule an appointment.”
c. “If this happens again, wait 10 minutes to see if you are okay. If the symptoms don’t go away, call 911.”
d. “You really need to be evaluated in the hospital. You could be at risk for a future stroke.”
a. “It would be best to start taking one baby aspirin every day; this will decrease the chance of this happening again.”
b. “Sometimes seizures present this way; call your doctor in the morning to schedule an appointment.”
c. “If this happens again, wait 10 minutes to see if you are okay. If the symptoms don’t go away, call 911.”
d. “You really need to be evaluated in the hospital. You could be at risk for a future stroke.”
Answer: d
Objective: 11-5
Reference: 375, 380
Your assessment reveals a drooling 48-year-old male to have gurgling speech and left arm paralysis. Which of the following would be your priority?
a. Suction the patient’s airway.
b. Protect the patient’s left arm.
c. Determine the patient’s risk factors for stroke.
d. Monitor the patient’s blood pressure.
a. Suction the patient’s airway.
b. Protect the patient’s left arm.
c. Determine the patient’s risk factors for stroke.
d. Monitor the patient’s blood pressure.
Answer: a
Objective: 11-5
Reference: 377
Which of the following events best describes an ischemic stroke?
a. An artery in the brain has ruptured.
b. Blood has collected throughout the brain tissue.
c. A heart attack has occurred at the same time as a stroke.
d. A blood clot has obstructed a blood vessel in the brain.
a. An artery in the brain has ruptured.
b. Blood has collected throughout the brain tissue.
c. A heart attack has occurred at the same time as a stroke.
d. A blood clot has obstructed a blood vessel in the brain.
Answer: d
Objective: 11-5
Reference: 370
Which of the following statements indicates that the speaker understands hemorrhagic strokes?
a. “They occur when clots form in blood vessels in the brain.”
b. “They occur when a blood vessel in the brain ruptures.”
c. “Their signs and symptoms generally resolve within 24 hours.”
d. “They can sometimes be treated by clot-destroying medications.”
a. “They occur when clots form in blood vessels in the brain.”
b. “They occur when a blood vessel in the brain ruptures.”
c. “Their signs and symptoms generally resolve within 24 hours.”
d. “They can sometimes be treated by clot-destroying medications.”
Answer: b
Objective: 11-5
Reference: 371
The signs and symptoms of a transient ischemic attack (TIA):
a. are temporary and resolve within 24 hours.
b. can persist for a few days before they resolve.
c. are mild but permanent.
d. are severe and permanent.
a. are temporary and resolve within 24 hours.
b. can persist for a few days before they resolve.
c. are mild but permanent.
d. are severe and permanent.
Answer: a
Objective: 11-5
Reference: 371
Which of the following statements indicates that the speaker an accurate understanding of altered mental status?
a. “It describes any abnormal change in a person’s level of awareness.”
b. “It occurs only when a patient is not responsive to verbal or painful stimuli.”
c. “It should be suspected only when a patient is on medications that can cause confusion.”
d. “It is any mental state in a person with diabetes.”
a. “It describes any abnormal change in a person’s level of awareness.”
b. “It occurs only when a patient is not responsive to verbal or painful stimuli.”
c. “It should be suspected only when a patient is on medications that can cause confusion.”
d. “It is any mental state in a person with diabetes.”
Answer: a
Objective: 11-1
Reference: 356
Your patient is a 78-year-old male who was found lying on the beginner slope. The patient is unresponsive with unequal pupils and vital signs as follows: pulse 78, respirations 20 and deep. The patient has a hematoma on the back of his head. Which one of the following would you do first?
a. Find a witness to tell you how the person got there.
b. Apply a cervical collar.
c. Ensure an open airway using the jaw-thrust maneuver.
d. Look for a medic alert tag.
a. Find a witness to tell you how the person got there.
b. Apply a cervical collar.
c. Ensure an open airway using the jaw-thrust maneuver.
d. Look for a medic alert tag.
Answer: c
Objective: Supplemental
Reference: 373
Your patient is unresponsive. Which piece of information given to you by the patient’s family is most important in relation to the treatment of a possible stroke?
a. “He forgot to take his blood thinner last night.”
b. “We think he had too much to drink last night.”
c. “We noticed him acting oddly about 7 p.m. last night.”
d. “He took some ibuprofen last night for a fever and cough.”
a. “He forgot to take his blood thinner last night.”
b. “We think he had too much to drink last night.”
c. “We noticed him acting oddly about 7 p.m. last night.”
d. “He took some ibuprofen last night for a fever and cough.”
Answer: c
Objective: 11-6
Reference: 373
The benefit of the Cincinnati Prehospital Stroke Scale is that it:
a. enables you to identify patients at risk for stroke.
b. enables you to identify the type of stroke a patient is having.
c. helps you predict the likelihood a patient will die from a stroke.
d. helps you identify the probability that your patient is having a stroke.
a. enables you to identify patients at risk for stroke.
b. enables you to identify the type of stroke a patient is having.
c. helps you predict the likelihood a patient will die from a stroke.
d. helps you identify the probability that your patient is having a stroke.
Answer: d
Objective: 11-6
Reference: 376
