MS2- EXAM 3- STROKE | CHAPTER 57: STROKE (LEWIS
BOOK) | 2026 UPDATE | QUESTIONS AND ANSWERS |
WITH COMPLETE SOLUTION
What topic should the nurse anticipate teaching a patient who had a brief
episode of tinnitus, diplopia, dysarthria with no residual effects?
A. Cerebral aneurysm clipping
B. Heparin intravenous infusion
C. Oral low-dose aspirin therapy
D. Tissue plasminogen activator (tPA) Answer - ANS: C
Rationale:
The patient's symptoms are consistent with transient ischemic attack (TIA), and
drugs that inhibit platelet aggregation are prescribed after a TIA to prevent a
stroke. Continuous heparin infusion is not routinely used after TIA or with
acute ischemic stroke. The patient's symptoms are not consistent with a
cerebral aneurysm. tPA is used only for acute ischemic stroke, not for TIA.
A patient is being admitted with a possible stroke. Which information from the
assessment indicates that the nurse should consult with the health care
provider before giving a prescribed dose of aspirin?
,A. The patient has dysphasia.
B. The patient has atrial fibrillation.
C. The patient reports that symptoms began with a severe headache.
D. The patient has a history of brief episodes of right-sided hemiplegia. Answer
- ANS: C
Rationale:
A sudden onset headache is typical of a subarachnoid hemorrhage, and aspirin
is contraindicated. Atrial fibrillation, dysphasia, and transient ischemic attack
are not contraindications to aspirin use.
A patient being admitted with a stroke has right-sided facial drooping and right-
sided arm and leg paralysis. Which finding should the nurse expect?
A. Impulsive behavior
B. Right-sided neglect
C. Hyperactive left-sided tendon reflexes
D. Difficulty comprehending instructions Answer - ANS: D
Rationale:
,Right-sided paralysis indicates a left-brain stroke, which will lead to difficulty
with comprehension and use of language. The left-side reflexes are likely to be
intact. Impulsive behavior and neglect are more likely with a right-side stroke.
During change of shift report, a nurse is told that a patient has an occluded left
posterior cerebral artery. What finding should the nurse anticipate?
A. Dysphasia
B. Confusion
C. Visual deficits
D. Poor judgment Answer - ANS: C
Rationale:
Visual disturbances are expected with posterior cerebral artery occlusion.
Aphasia occurs with middle cerebral artery involvement. Cognitive deficits and
changes in judgment are more typical of anterior cerebral artery occlusion.
What will the nurse tell the patient who has cerebral atherosclerosis about
taking clopidogrel (Plavix)?
A. Monitor and record the blood pressure daily.
B. Call the health care provider if stools are tarry.
C. Clopidogrel will dissolve clots in the cerebral arteries.
, D. Clopidogrel will reduce cerebral artery plaque formation. Answer - ANS: B
Rationale:
Clopidogrel inhibits platelet function and increases the risk for gastrointestinal
bleeding, so patients should be advised to notify the health care provider
about any signs of bleeding. The medication does not lower blood pressure,
decrease plaque formation, or dissolve clots.
A patient with carotid atherosclerosis asks the nurse to describe a carotid
endarterectomy. Which response by the nurse is accurate?
A. "The diseased portion of the artery is replaced with a synthetic graft."
B. "The obstructing plaque is surgically removed from inside an artery in the
neck."
C. "A wire is threaded through an artery in the leg to the clots in the carotid
artery, and clots are removed."
D. "A catheter with a deflated balloon is positioned at the narrow area, and the
balloon flattens the plaque." Answer - ANS: B
Rationale:
In a carotid endarterectomy, the carotid artery is incised, and the plaque is
removed. The response beginning, "The diseased portion of the artery is
replaced" describes an arterial graft procedure. The answer beginning, "A
catheter with a deflated balloon is positioned at the narrow area" describes an
angioplasty. The final response beginning, "A wire is threaded through the
BOOK) | 2026 UPDATE | QUESTIONS AND ANSWERS |
WITH COMPLETE SOLUTION
What topic should the nurse anticipate teaching a patient who had a brief
episode of tinnitus, diplopia, dysarthria with no residual effects?
A. Cerebral aneurysm clipping
B. Heparin intravenous infusion
C. Oral low-dose aspirin therapy
D. Tissue plasminogen activator (tPA) Answer - ANS: C
Rationale:
The patient's symptoms are consistent with transient ischemic attack (TIA), and
drugs that inhibit platelet aggregation are prescribed after a TIA to prevent a
stroke. Continuous heparin infusion is not routinely used after TIA or with
acute ischemic stroke. The patient's symptoms are not consistent with a
cerebral aneurysm. tPA is used only for acute ischemic stroke, not for TIA.
A patient is being admitted with a possible stroke. Which information from the
assessment indicates that the nurse should consult with the health care
provider before giving a prescribed dose of aspirin?
,A. The patient has dysphasia.
B. The patient has atrial fibrillation.
C. The patient reports that symptoms began with a severe headache.
D. The patient has a history of brief episodes of right-sided hemiplegia. Answer
- ANS: C
Rationale:
A sudden onset headache is typical of a subarachnoid hemorrhage, and aspirin
is contraindicated. Atrial fibrillation, dysphasia, and transient ischemic attack
are not contraindications to aspirin use.
A patient being admitted with a stroke has right-sided facial drooping and right-
sided arm and leg paralysis. Which finding should the nurse expect?
A. Impulsive behavior
B. Right-sided neglect
C. Hyperactive left-sided tendon reflexes
D. Difficulty comprehending instructions Answer - ANS: D
Rationale:
,Right-sided paralysis indicates a left-brain stroke, which will lead to difficulty
with comprehension and use of language. The left-side reflexes are likely to be
intact. Impulsive behavior and neglect are more likely with a right-side stroke.
During change of shift report, a nurse is told that a patient has an occluded left
posterior cerebral artery. What finding should the nurse anticipate?
A. Dysphasia
B. Confusion
C. Visual deficits
D. Poor judgment Answer - ANS: C
Rationale:
Visual disturbances are expected with posterior cerebral artery occlusion.
Aphasia occurs with middle cerebral artery involvement. Cognitive deficits and
changes in judgment are more typical of anterior cerebral artery occlusion.
What will the nurse tell the patient who has cerebral atherosclerosis about
taking clopidogrel (Plavix)?
A. Monitor and record the blood pressure daily.
B. Call the health care provider if stools are tarry.
C. Clopidogrel will dissolve clots in the cerebral arteries.
, D. Clopidogrel will reduce cerebral artery plaque formation. Answer - ANS: B
Rationale:
Clopidogrel inhibits platelet function and increases the risk for gastrointestinal
bleeding, so patients should be advised to notify the health care provider
about any signs of bleeding. The medication does not lower blood pressure,
decrease plaque formation, or dissolve clots.
A patient with carotid atherosclerosis asks the nurse to describe a carotid
endarterectomy. Which response by the nurse is accurate?
A. "The diseased portion of the artery is replaced with a synthetic graft."
B. "The obstructing plaque is surgically removed from inside an artery in the
neck."
C. "A wire is threaded through an artery in the leg to the clots in the carotid
artery, and clots are removed."
D. "A catheter with a deflated balloon is positioned at the narrow area, and the
balloon flattens the plaque." Answer - ANS: B
Rationale:
In a carotid endarterectomy, the carotid artery is incised, and the plaque is
removed. The response beginning, "The diseased portion of the artery is
replaced" describes an arterial graft procedure. The answer beginning, "A
catheter with a deflated balloon is positioned at the narrow area" describes an
angioplasty. The final response beginning, "A wire is threaded through the
