NUR 138 LATEST 2026 EXAM UPDATED QUESTIONS AND
SOLUTIONS RATED A+
✔✔Types of strokes - ✔✔Ischemic- results in blockage or stenosis of cerebral artery,
decreasing or stopping blood flow. Can be caused by a clot, or plaque.
Transient Ischemic Attack- brief period of localized cerebral ischemia that cause neuro
defecits that don't last more than 24 hrs. They are often a warning sign for and ischemic
stroke.
Hemorrhagic- occurs when cerebral blood vessel ruptures. Most often with individules
who have sustained high bp. It can also occur due to an aneurysm. Most common for
poor outcomes
✔✔Manifestations Stoke - ✔✔Manifestation are sudden in onset, focal and usually one
sided. Weakness of face or limbs, numbness on one side, loss of vision, speech
difficulties, sudden severe headache, and difficulty with balance are common. Women
are more likely to have atypical symptoms like confusion, disorientation, and loss of
consciousness.
Complications: seizure, visual disturbances, neglect syndrome, increased ICP,
congnative changes, airway obstruciton, dysphasia, incontinence, sensory changes
✔✔Collaboration stroke - ✔✔Diagnostic tests: stroke scale, CT scan, MRI, transcranial
doppler ultrasound, lumbar puncture.
Pharm: prevention: antiplatelet/anticoag, antihypertensives, and cholestrol lowering
drugs. Fibrinolytic therapy like tPA is gold standard for acute ischemia stroke,
corticosteriods
Sugery: carotid endarterectomy, intracranial bipass, and carotid angioplasty with
stenting
Rehabilitation: PT, OT, speech and language therapy
✔✔Nursing Process: stroke - ✔✔Assessment: observe visible signs of a stroke
including paralysis or weakness of one side of the body, facial dropping, and difficulty
speaking or understanding speech. Ask about family history, risk factors, previous
stroke, drug use, smoking history. Assess LOC, motor strength, cooridination,
communication, cranial nerve function, sensory function, stoke scale, vital signs, skin
integrity, and mobility status
Diagnosis: Risk for ineffective cerebral tissue perfusion, impaired mobility, impaired
communication, risk for constipation, impaired swallowing
, Planning: BP within normal range, understand importance of cardiac rehabilitaition,
ambulate and increase activity as tolerated, therapies will maximize communication
Implementation: maintain cerebral perfusion, monitor respiratory status, suction PRN,
O2 PRN, monitor LOC and strength, monitor VS, seizure precautions, encourage ROM
and ambulation, high fiber diet, turn Q2, encourage use of unaffected side for ADLs,
encourage bladder training, positive reinforcement, maintain safety
Evaluation: participates in therapy, communicates effectivly, family participates in care,
experiences minimal complication
✔✔Manifestations of stress - ✔✔Fear, anger, anxiety, depression, supression, lack of
self control, fight or flight response.
✔✔Nursing assessment: Stress - ✔✔Collect information about current and past illness,
specific physical complaints, general health history, stressors or stressful incidences,
manifestation of stress, and coping strategies. GI- constipation, diarrhea, dry mouth,
nausea. Skin- sweating and pale. Neuro-insomnia, fatigue, headaches, restlessness.
Cardio- tachycardia, hyperpnea. Observe for nail biting, cutting, or excessive crying
✔✔cognitive-behavioral therapy (CBT) - ✔✔Combines cognitive techniques and
behavior modifications to change detrimental behavior and thought patterns. It
enhances problem solving an coping skills.
✔✔Medications for stress - ✔✔Benzodiazepines- Short term treatment for anxiety
disorders
Antidepressent- SSRIs are helpful for phobias, symptoms of OCD, and panic
symptoms. Prozac, paxil, and zoloft are used.
MAOI's- atypical antidepressents
Betablockers- used to block the effects of sympathetic nervous system stimulation and
reduce manifestations of anxiety
✔✔SSRIs consideration - ✔✔Monitor for development of suicidal ideation or worsening
symptoms. Assess for dizziness or drowsiness. Do not drink alcohol. Periodically obtain
CBC with differencial, serum elecrolytes, and kidney and liver function studies. Do not
start within 14 days of stopping MAOI. Do not take if pregnant or breastfeeding.
✔✔obsessive-compulsive disorder (OCD) - ✔✔Disabling disorder characterized by
obsessive thoughts and compulsive, repetitive behaviors that dominate one's life. An
obsession is recurrent, unwanted, often distressing though or image that leads to
anxiety. A compulsion is a repetitive behavior or mental activity used in attempt to deal
with the obsessive thought. To be diagnosed one must exprience distress or lose time
more than one hour due to repetative behaviors.
SOLUTIONS RATED A+
✔✔Types of strokes - ✔✔Ischemic- results in blockage or stenosis of cerebral artery,
decreasing or stopping blood flow. Can be caused by a clot, or plaque.
Transient Ischemic Attack- brief period of localized cerebral ischemia that cause neuro
defecits that don't last more than 24 hrs. They are often a warning sign for and ischemic
stroke.
Hemorrhagic- occurs when cerebral blood vessel ruptures. Most often with individules
who have sustained high bp. It can also occur due to an aneurysm. Most common for
poor outcomes
✔✔Manifestations Stoke - ✔✔Manifestation are sudden in onset, focal and usually one
sided. Weakness of face or limbs, numbness on one side, loss of vision, speech
difficulties, sudden severe headache, and difficulty with balance are common. Women
are more likely to have atypical symptoms like confusion, disorientation, and loss of
consciousness.
Complications: seizure, visual disturbances, neglect syndrome, increased ICP,
congnative changes, airway obstruciton, dysphasia, incontinence, sensory changes
✔✔Collaboration stroke - ✔✔Diagnostic tests: stroke scale, CT scan, MRI, transcranial
doppler ultrasound, lumbar puncture.
Pharm: prevention: antiplatelet/anticoag, antihypertensives, and cholestrol lowering
drugs. Fibrinolytic therapy like tPA is gold standard for acute ischemia stroke,
corticosteriods
Sugery: carotid endarterectomy, intracranial bipass, and carotid angioplasty with
stenting
Rehabilitation: PT, OT, speech and language therapy
✔✔Nursing Process: stroke - ✔✔Assessment: observe visible signs of a stroke
including paralysis or weakness of one side of the body, facial dropping, and difficulty
speaking or understanding speech. Ask about family history, risk factors, previous
stroke, drug use, smoking history. Assess LOC, motor strength, cooridination,
communication, cranial nerve function, sensory function, stoke scale, vital signs, skin
integrity, and mobility status
Diagnosis: Risk for ineffective cerebral tissue perfusion, impaired mobility, impaired
communication, risk for constipation, impaired swallowing
, Planning: BP within normal range, understand importance of cardiac rehabilitaition,
ambulate and increase activity as tolerated, therapies will maximize communication
Implementation: maintain cerebral perfusion, monitor respiratory status, suction PRN,
O2 PRN, monitor LOC and strength, monitor VS, seizure precautions, encourage ROM
and ambulation, high fiber diet, turn Q2, encourage use of unaffected side for ADLs,
encourage bladder training, positive reinforcement, maintain safety
Evaluation: participates in therapy, communicates effectivly, family participates in care,
experiences minimal complication
✔✔Manifestations of stress - ✔✔Fear, anger, anxiety, depression, supression, lack of
self control, fight or flight response.
✔✔Nursing assessment: Stress - ✔✔Collect information about current and past illness,
specific physical complaints, general health history, stressors or stressful incidences,
manifestation of stress, and coping strategies. GI- constipation, diarrhea, dry mouth,
nausea. Skin- sweating and pale. Neuro-insomnia, fatigue, headaches, restlessness.
Cardio- tachycardia, hyperpnea. Observe for nail biting, cutting, or excessive crying
✔✔cognitive-behavioral therapy (CBT) - ✔✔Combines cognitive techniques and
behavior modifications to change detrimental behavior and thought patterns. It
enhances problem solving an coping skills.
✔✔Medications for stress - ✔✔Benzodiazepines- Short term treatment for anxiety
disorders
Antidepressent- SSRIs are helpful for phobias, symptoms of OCD, and panic
symptoms. Prozac, paxil, and zoloft are used.
MAOI's- atypical antidepressents
Betablockers- used to block the effects of sympathetic nervous system stimulation and
reduce manifestations of anxiety
✔✔SSRIs consideration - ✔✔Monitor for development of suicidal ideation or worsening
symptoms. Assess for dizziness or drowsiness. Do not drink alcohol. Periodically obtain
CBC with differencial, serum elecrolytes, and kidney and liver function studies. Do not
start within 14 days of stopping MAOI. Do not take if pregnant or breastfeeding.
✔✔obsessive-compulsive disorder (OCD) - ✔✔Disabling disorder characterized by
obsessive thoughts and compulsive, repetitive behaviors that dominate one's life. An
obsession is recurrent, unwanted, often distressing though or image that leads to
anxiety. A compulsion is a repetitive behavior or mental activity used in attempt to deal
with the obsessive thought. To be diagnosed one must exprience distress or lose time
more than one hour due to repetative behaviors.
