MS2- EXAM 3- STROKE | CHAPTER 57:
STROKE (LEWIS BOOK) {LATEST 2026 -
2027} QUESTIONS AND ANSWERS 100%
CORRECT
A patient arrives in the emergency department with hemiparesis and dysarthria that
started 2 hours previously. Health records show a history of several transient
ischemic attacks (TIAs). What should the nurse anticipate for this patient?
A. Surgical endarterectomy
B. Transluminal angioplasty
C. Intravenous heparin drip administration
D. Tissue plasminogen activator (tPa) infusion - correct answer ANS: D
Rationale:
The patient's history and clinical manifestations suggest an acute ischemic stroke, and
a patient who is seen within 4.5 hours of stroke onset is likely to receive tPA (after
screening with a CT scan). Heparin administration in the emergency phase is not
indicated. Emergent carotid transluminal angioplasty or endarterectomy is not
indicated for the patient who is having an acute ischemic stroke.
,A female patient who had a stroke 24 hours ago has expressive aphasia. What is an
appropriate nursing intervention to help the patient communicate?
A. Ask questions that the patient can answer with "yes" or "no."
B. Develop a list of words that the patient can read and practice reciting.
C. Have the patient practice her facial and tongue exercises with a mirror.
D. Prevent embarrassing the patient by answering for her if she does not respond. -
correct answer ANS: A
Rationale:
Communication will be facilitated and less frustrating to the patient when questions
that require a "yes" or "no" response are used. When the language areas of the brain
are injured, the patient might not be able to read or recite words, which will frustrate
the patient without improving communication. Expressive aphasia is caused by damage
to the language areas of the brain, not by the areas that control the motor aspects of
speech. The nurse should allow time for the patient to respond.
,What concern should the nurse anticipate for a patient who had a right hemisphere
stroke?
A. Right-sided hemiplegia
B. Speech-language deficits
C. Denial of deficits and impulsiveness
D. Depression and distress about disability - correct answer ANS: C
Rationale:
The patient with right-sided brain damage typically denies any deficits and has poor
impulse control, leading to risk for injury when the patient attempts activities such as
transferring from a bed to a chair. Right-sided brain damage causes left hemiplegia.
Left-sided brain damage typically causes language deficits. Left-sided brain damage is
associated with depression and distress about the disability.
Which intervention should the nurse include in the plan of care for a patient with new
right-sided homonymous hemianopsia after a stroke?
A. Apply an eye patch to the right eye.
, B. Approach the patient from the right side.
C. Place needed objects on the patient's left side.
D. Teach the patient that the left visual deficit will resolve. - correct answer ANS: C
Rationale:
During the acute period, the nurse should place objects on the patient's unaffected
side. Because there is a visual defect in the right half of each eye, an eye patch is not
appropriate. The patient should be approached from the left side. The visual deficit may
not resolve, although the patient can learn to compensate for the defect.
A left-handed patient with left-sided hemiplegia has difficulty feeding himself. Which
intervention should the nurse include in the plan of care?
A. Provide a wide variety of food choices.
B. Provide oral care before and after meals.
C. Assist the patient to eat with the right hand.
STROKE (LEWIS BOOK) {LATEST 2026 -
2027} QUESTIONS AND ANSWERS 100%
CORRECT
A patient arrives in the emergency department with hemiparesis and dysarthria that
started 2 hours previously. Health records show a history of several transient
ischemic attacks (TIAs). What should the nurse anticipate for this patient?
A. Surgical endarterectomy
B. Transluminal angioplasty
C. Intravenous heparin drip administration
D. Tissue plasminogen activator (tPa) infusion - correct answer ANS: D
Rationale:
The patient's history and clinical manifestations suggest an acute ischemic stroke, and
a patient who is seen within 4.5 hours of stroke onset is likely to receive tPA (after
screening with a CT scan). Heparin administration in the emergency phase is not
indicated. Emergent carotid transluminal angioplasty or endarterectomy is not
indicated for the patient who is having an acute ischemic stroke.
,A female patient who had a stroke 24 hours ago has expressive aphasia. What is an
appropriate nursing intervention to help the patient communicate?
A. Ask questions that the patient can answer with "yes" or "no."
B. Develop a list of words that the patient can read and practice reciting.
C. Have the patient practice her facial and tongue exercises with a mirror.
D. Prevent embarrassing the patient by answering for her if she does not respond. -
correct answer ANS: A
Rationale:
Communication will be facilitated and less frustrating to the patient when questions
that require a "yes" or "no" response are used. When the language areas of the brain
are injured, the patient might not be able to read or recite words, which will frustrate
the patient without improving communication. Expressive aphasia is caused by damage
to the language areas of the brain, not by the areas that control the motor aspects of
speech. The nurse should allow time for the patient to respond.
,What concern should the nurse anticipate for a patient who had a right hemisphere
stroke?
A. Right-sided hemiplegia
B. Speech-language deficits
C. Denial of deficits and impulsiveness
D. Depression and distress about disability - correct answer ANS: C
Rationale:
The patient with right-sided brain damage typically denies any deficits and has poor
impulse control, leading to risk for injury when the patient attempts activities such as
transferring from a bed to a chair. Right-sided brain damage causes left hemiplegia.
Left-sided brain damage typically causes language deficits. Left-sided brain damage is
associated with depression and distress about the disability.
Which intervention should the nurse include in the plan of care for a patient with new
right-sided homonymous hemianopsia after a stroke?
A. Apply an eye patch to the right eye.
, B. Approach the patient from the right side.
C. Place needed objects on the patient's left side.
D. Teach the patient that the left visual deficit will resolve. - correct answer ANS: C
Rationale:
During the acute period, the nurse should place objects on the patient's unaffected
side. Because there is a visual defect in the right half of each eye, an eye patch is not
appropriate. The patient should be approached from the left side. The visual deficit may
not resolve, although the patient can learn to compensate for the defect.
A left-handed patient with left-sided hemiplegia has difficulty feeding himself. Which
intervention should the nurse include in the plan of care?
A. Provide a wide variety of food choices.
B. Provide oral care before and after meals.
C. Assist the patient to eat with the right hand.
