N136- EXAM #4 QUESTIONS &
ACCURATE COMPLETE SOLUTIONS
100%
In promoting health maintenance for the prevention of strokes, the nurse understands
that the highest risk for the most common type of stroke is present in
a. African Americans
b. women who smoke
c. individuals with hypertension and diabetes
d. those who are obese with high dietary fat intake - CORRECT ANSWER C:
Individuals with hypertension and diabetes- The highest risk factors for thrombotic
stroke are hypertension and diabetes. African Americans have a higher risk for stroke
than do white persons but probably because they have a greater incidence of
hypertension. Factors such as obesity, diet high in saturated fats and cholesterol,
cigarette smoking, and excessive alcohol use are also risk factors but carry less risk
than hypertension.
A thrombus that develops in a cerebral artery does not always cause a loss of
neurologic function because
a. the body can dissolve the atherosclerotic plaques as they form
b. some tissues of the brain do not require constant blood supply to prevent damage
c. circulation through the circle of Willis may provide blood supply to the affected area
of the brain
d. neurologic deficits occur only when major arteries are occluded by thrombus
formation around an atherosclerotic plaque - CORRECT ANSWER C: Circulation
through the circle of Willis may provide blood supply to the affected area of the brain.
The communication between cerebral arteries in the circle of Willing provides a
collateral circulation, which may maintain circulation to an area of the brain if its original
blood supply is obstructed. ALl areas of the brain require constant blood supply, and
atherosclerotic plaques are not readily reversed. Neurologic deficits can result from
ischemia cause by many factors.
A patient comes to the emergency department immediately after experiencing
numbness of the face and an inability to speak, but while the patient awaits
examination, the symptoms disappear and the patient request discharge. The nurse
stresses that it is important for the patient to be evaluated primarily because
a. the patient has probably experienced an asymptomatic lacunar stroke
, b. the symptoms are likely to return and progress to worsening neurologic deficit in the
next 24 hours
c. neurologic deficits that are transient occur most often as a result of small
hemorrhages that clot off
d. the patient has probably experienced a transient ischemic attack (TIA), which is a
sign of progressive cerebral vascular disease - CORRECT ANSWER D: The patient
has probably experienced a transient ischemic attack (TIA), which is a sign of
progressive cerebral vascular disease- A TIA is a temporary focal loss of neurologic
function caused by ischemia of an area of the brain, usually lasting only about 3 hours.
TIAs may be due to microemboli from heart disease or carotid or cerebral thrombi and
are a warning of progressive disease. Evaluation is necessary to determine the cause of
the neurologic deficit and provide prophylactic treatment if possible.
The neurologic functions that are affected by a stroke are primarily related to
a. the amount of tissue area involved
b. the rapidity of onset of symptoms
c. the brain area perfused by the affected artery
d. the presence or absence of collateral circulation - CORRECT ANSWER C: The
brain area perfused by the affected artery- clinical manifestation of altered neurologic
function differ, depending primarily on the specific cerebral artery involved and the area
of the brain that is perfused by the artery. The degree of impairment depends on rapidity
of onset, the size of the lesion, and the presence of collateral circulation.
A patient is admitted to the hospital with a left hemiplegia. To determine the size and
location and to ascertain whether a stroke is ischemic or hemorrhagic, the nurse
anticipates that the health care provider will request a
a. CT scan
b. lumbar puncture
c. cerebral arteriogram
d. positron emission tomography (PET) - CORRECT ANSWER A: CT scan- A CT scan
is the most commonly used diagnostic test to determine the size and location of the
lesion and to differentiate a thrombotic stroke from a hemorrhagic stroke. Positron
emission tomography (PET) will show the metabolic activity of the brain and provide a
depiction of the extent of tissue damage after a stroke. Lumbar punctures are not
performed routinely because of the chance of increased intracranial pressure causing
herniation. Cerebral arteriograms are invasive and may dislodge an embolism or cause
further hemorrhage; they are performed only when no other test can provide the needed
information.
A carotid endarterectomy is being considered as a treatment for a patient who has had
several TIAs. The nurse explains to the patient that this surgery
a. is used to restore blood to the brain following an obstruction of a cerebral artery
ACCURATE COMPLETE SOLUTIONS
100%
In promoting health maintenance for the prevention of strokes, the nurse understands
that the highest risk for the most common type of stroke is present in
a. African Americans
b. women who smoke
c. individuals with hypertension and diabetes
d. those who are obese with high dietary fat intake - CORRECT ANSWER C:
Individuals with hypertension and diabetes- The highest risk factors for thrombotic
stroke are hypertension and diabetes. African Americans have a higher risk for stroke
than do white persons but probably because they have a greater incidence of
hypertension. Factors such as obesity, diet high in saturated fats and cholesterol,
cigarette smoking, and excessive alcohol use are also risk factors but carry less risk
than hypertension.
A thrombus that develops in a cerebral artery does not always cause a loss of
neurologic function because
a. the body can dissolve the atherosclerotic plaques as they form
b. some tissues of the brain do not require constant blood supply to prevent damage
c. circulation through the circle of Willis may provide blood supply to the affected area
of the brain
d. neurologic deficits occur only when major arteries are occluded by thrombus
formation around an atherosclerotic plaque - CORRECT ANSWER C: Circulation
through the circle of Willis may provide blood supply to the affected area of the brain.
The communication between cerebral arteries in the circle of Willing provides a
collateral circulation, which may maintain circulation to an area of the brain if its original
blood supply is obstructed. ALl areas of the brain require constant blood supply, and
atherosclerotic plaques are not readily reversed. Neurologic deficits can result from
ischemia cause by many factors.
A patient comes to the emergency department immediately after experiencing
numbness of the face and an inability to speak, but while the patient awaits
examination, the symptoms disappear and the patient request discharge. The nurse
stresses that it is important for the patient to be evaluated primarily because
a. the patient has probably experienced an asymptomatic lacunar stroke
, b. the symptoms are likely to return and progress to worsening neurologic deficit in the
next 24 hours
c. neurologic deficits that are transient occur most often as a result of small
hemorrhages that clot off
d. the patient has probably experienced a transient ischemic attack (TIA), which is a
sign of progressive cerebral vascular disease - CORRECT ANSWER D: The patient
has probably experienced a transient ischemic attack (TIA), which is a sign of
progressive cerebral vascular disease- A TIA is a temporary focal loss of neurologic
function caused by ischemia of an area of the brain, usually lasting only about 3 hours.
TIAs may be due to microemboli from heart disease or carotid or cerebral thrombi and
are a warning of progressive disease. Evaluation is necessary to determine the cause of
the neurologic deficit and provide prophylactic treatment if possible.
The neurologic functions that are affected by a stroke are primarily related to
a. the amount of tissue area involved
b. the rapidity of onset of symptoms
c. the brain area perfused by the affected artery
d. the presence or absence of collateral circulation - CORRECT ANSWER C: The
brain area perfused by the affected artery- clinical manifestation of altered neurologic
function differ, depending primarily on the specific cerebral artery involved and the area
of the brain that is perfused by the artery. The degree of impairment depends on rapidity
of onset, the size of the lesion, and the presence of collateral circulation.
A patient is admitted to the hospital with a left hemiplegia. To determine the size and
location and to ascertain whether a stroke is ischemic or hemorrhagic, the nurse
anticipates that the health care provider will request a
a. CT scan
b. lumbar puncture
c. cerebral arteriogram
d. positron emission tomography (PET) - CORRECT ANSWER A: CT scan- A CT scan
is the most commonly used diagnostic test to determine the size and location of the
lesion and to differentiate a thrombotic stroke from a hemorrhagic stroke. Positron
emission tomography (PET) will show the metabolic activity of the brain and provide a
depiction of the extent of tissue damage after a stroke. Lumbar punctures are not
performed routinely because of the chance of increased intracranial pressure causing
herniation. Cerebral arteriograms are invasive and may dislodge an embolism or cause
further hemorrhage; they are performed only when no other test can provide the needed
information.
A carotid endarterectomy is being considered as a treatment for a patient who has had
several TIAs. The nurse explains to the patient that this surgery
a. is used to restore blood to the brain following an obstruction of a cerebral artery
