Stroke Flashcards
A nurse is caring for a client who has experienced a right‑hemispheric stroke. The nurse should expect the client to have difficulty with which of the following? (Select all that apply.)
A. Impulse control
B. Moving the left side
C. Depth perception
D. Speaking
E. Situational awareness
A. CORRECT: A client who has experienced a right‑hemispheric stroke can exhibit impulse control difficulty, such as the urgency to use the restroom.
B. CORRECT: A client who has experienced a right‑hemispheric stroke can exhibit left‑sided hemiplegia.
C. CORRECT: A client who has experienced a right‑hemispheric stroke can experience a loss in depth perception.
E. CORRECT: A client who has experienced a right‑hemispheric stroke can demonstrate a lack of awareness of surroundings.
A nurse is caring for a client who has left homonymous hemianopsia. Which of the following is an appropriate nursing intervention?
A. Teach the client to scan to the right to see objects on the right side of the body.
B. Place the bedside table on the right side of the bed.
C. Orient the client to the food on the plate using the clock method.
D. Place the wheelchair on the client’s left side
B. CORRECT: The client is unable to visualize to the left midline of their body. Placing the bedside table on the right side of the client’s bed will permit visualization of items on the table.
A nurse is planning care for a client who has dysphagia and a new dietary prescription. Which of the following should the nurse include in the plan of care? (Select all that apply.)
A. Have suction equipment available for use.
B. Feed the client thickened liquids.
C. Place food on the unaffected side of the client’s mouth.
D. Assign an assistive personnel to feed the client slowly.
E. Teach the client to swallow with the neck flexed.
A. CORRECT: Suction equipment should be available in case of choking and aspiration.
B. CORRECT: The client should be given liquids that are thicker than water to prevent aspiration.
C. CORRECT: Placing food on the unaffected side of the client’s mouth will allow them to have better control of the food and reduce the risk of aspiration.
E. CORRECT: The client should be taught to flex the neck, tucking the chin down and under to close the epiglottis during swallowing.
A nurse is caring for a client who has global aphasia (both receptive and expressive). Which of the following should the nurse include in the client’s plan of care? (Select all that apply.)
A. Speak to the client at a slower rate.
B. Assist the client to use cards with pictures.
C. Speak to the client in a loud voice.
D. Complete sentences that the client cannot finish.
E. Give instructions one step at a time
A. CORRECT: Clients who have global aphasia have difficulty with speaking and understanding speech. One strategy that can enhance client understanding is speaking to the client at a slower rate.
B. CORRECT: One strategy that can enhance understanding is the use of alternative forms of communication, such as cards with pictures or a computer.
E. CORRECT: One strategy that can enhance understanding is giving instructions one step at a time.
A nurse is assessing a client. Which of the following findings indicates that the client has experienced a left‑hemispheric stroke?
A. Impulse control difficulty
B. Poor judgment
C. Inability to recognize familiar objects
D. Loss of depth perception
C. CORRECT: A client who experienced a left‑hemispheric stroke will demonstrate the inability to recognize familiar objects, known as agnosia.
Who is at the highest risk for a cerebral vascular accident?
A) 19 yo Caucasian female who smokes and takes birth control
B) 42 yo Hispanic female with a history of A-Fib
C) 70 yo African American male who takes anti-hypertensive medication and smokes
D) 40 yo African American female with a history of acid reflux and smokes occasionally
C) 70 yo African American male who takes anti-hypertensive medication and smokes
The focus of this question is asking the nurse to identify the client who has the most risk factors for cerebral vascular accident (CVA). RIsk factors for CVA include smoking, advanced age, hypertension, obesity, sedentary lifestyle, African American race, and atrial fibrillation. The 70 year old African American client has the most risk factors for CVA of all the clients listed.
This answer is correct as this client has a total of four risk factors for CVA which is the most of any of the clients listed.
Which term refers to a classification of a type of stroke that can occur in a client that has a change in normal blood supply to the brain? Select all that apply.
A) transient ischemic attack
B) reversible ischemic neurologic deficit
C) arteriovenous malformation
D) ischemic stroke
E) hemorrhagic stroke
D) ischemic stroke
E) hemorrhagic stroke
Strokes are classified as two main types. These types are ischemic stroke and hemorrhagic stroke.
A change in blood supply to the brain can result in a stroke. Another term used to refer to a stroke is a cerebral vascular accident. The brain cannot store oxygen, so any interruption in blood flow to the brain can result in damage to the brain resulting in death to brain tissue (infarction). Strokes are classified as two main types: ischemic and hemorrhagic. Each has specific presentations.
What statement presented by the student regarding a transient ischemic attack requires further education?
A) a TIA is a warning sign for an ischemic stroke
B) a TIA is a brief interruption in the blood flow to the brain
C) a TIA manifests with visual, motor, sensory, and/or speech deficits
D) a TIA can last up to 1 week after the onset of symptoms
D) a TIA can last up to 1 week after the onset of symptoms
A transient ischemic attack (TIA) is considered a warning sign for an ischemic stroke. A TIA results from a brief interruption of blood flow to the brain. A TIA can last for just a few minutes but less than 24 hours. Usually the symptoms of a TIA resolve within 30 to 60 minutes. With the occurrence of a TIA there may be visual, motor, sensory, and speech deficits. Clinical manifestations may include: blurred vision, diplopia, arm/hand weakness, numbness of face/arm/hand and aphasia.
What statement made by a client is a primary indicator of a hemorrhagic stroke?
A) I have never been this dizzy before in my life
B) I have never had nausea this bad in my whole life
C) I have never had blurred vision this bad in my whole life
D) I have never had a headache this bad in my whole life
D) I have never had a headache this bad in my whole life
This answer is correct because the statement “I have never had a headache this bad in my whole life” is a primary indicator of a hemorrhagic stroke. Prior to the loss of consciousness, the client will report a headache that is worse than any other headache in the past. This is a key manifestation that presents in the event of a hemorrhagic stroke.
Which clinical manifestation by a client is reflective of right-sided brain hemisphere ischemic stroke? Select all that apply.
A) demonstrates problems with language
B) demonstrates problems with writing
C) demonstrates problems with logic
D) demonstrates problems with impulse control
E) demonstrates a change in behavior
D) demonstrates problems with impulse control
E) demonstrates a change in behavior
An ischemic stroke occurs when there is an occlusion to a blood vessel supplying the brain. This occlusion can occur as a result of a thrombus, which is a clot, or an embolus, which is a dislodged clot. The thrombotic stroke is gradual in onset, whereas the embolic stroke is sudden in onset. With each of these subtypes the client’s level of consciousness is preserved. With left-sided brain hemisphere ischemic stroke the client demonstrates problems with language and logic, as well as reading and writing problems. With the right-sided brain hemisphere ischemic stroke the client demonstrates lack of impulse control and behavioral changes. Hemiparesis occurs on the opposite side of the hemisphere injury (ex: right hemisphere injury = left-sided hemiparesis).
