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Chapter 41: Critical Care of Patients With
Neurologic Emergencies Ignatavicius:
Medical-Surgical Nursing, 10th Edition
Verified and Updated Questions and
Answers (100% Correct Answers)
1. A client is in the emergency department reporting a brief episode during which he
was dizzy, unable to speak, and felt numbness in his left leg. Currently the client's
neurologic examination is normal. About what drug would the nurse plan to teach the
patient?
a. Alteplase
b. Clopidogrel
c. Heparin sodium
d. Mannitol
Answer: ANS: B
This client's signs and symptoms are consistent with a transient ischemic attack, and
the client would likely be prescribed aspirin or clopidogrel to prevent platelet
aggregation on discharge. Alteplase is used for ischemic stroke. Heparin and
mannitol are not used for this condition.
2. The nurse is preparing a client for discharge from the emergency department after
experiencing a transient ischemic attack (TIA). Before discharge, which factor would
the nurse identify as placing the client at high risk for a stroke?
a. Age greater than or equal to 75
b. Blood pressure greater than or equal to 160/95
c. Unilateral weakness during a TIA
d. TIA symptoms lasting less than a minute
Answer: ANS: C T
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he client who has a TIA is at risk for a stroke is he or she has one-sided (unilateral)
weakness during a TIA. Risk factors also include an age greater than or equal to 60,
blood pressure greater than or equal to 140/90 (either or both systolic and diastolic),
and/or a long duration of TIA symptoms. One minute is not a very long time for
symptoms to occur.
3. The nurse is taking a history from a daughter about her father's onset of stroke
signs and symptoms. Which statement by the daughter indicates that the client likely
had an embolic stroke?
a. Client's symptoms occurred slowly over several hours. b. Client because
increasingly lethargic and drowsy.
c. Client reported severe headache before other symptoms.
d. Client has a long history of atrial fibrillation.
Answer: ANS: D
The major cause of embolic strokes is a history of heart disease, especially atrial
fibrillation. Most clients who have an embolic stroke have acute sudden neurologic
symptoms but stay alert rather than lethargic. Decreasing level of consciousness and
severe headache are more common in clients who have hemorrhagic strokes.
4. A client is admitted with a sudden decline in level of consciousness. What is the
nursing action at this time?
a. Assess the client for hypoglycemia and hypoxia.
b. Place the client on his or her side.
c. Prepare for administration of a fibrinolytic agent.
d. Start a continuous IV heparin sodium infusion.
Answer: ANS: A
The cause of a sudden decline in level of consciousness may or may not be related to
a neurologic health problem. Therefore, the client must be evaluated for other
common causes, especially hypoglycemia and hypoxia. Placing the client on his or
her side may be helpful to prevent aspiration in case the client experiences vomiting,
but the clinical situation does not indicate that the client has nausea or vomiting.
Administering either an anticoagulant like heparin or a fibrinolytic agent assumes
that the client has an acute ischemic stroke, which has not been confirmed through
imaging tests
Chapter 41: Critical Care of Patients With
Neurologic Emergencies Ignatavicius:
Medical-Surgical Nursing, 10th Edition
Verified and Updated Questions and
Answers (100% Correct Answers)
1. A client is in the emergency department reporting a brief episode during which he
was dizzy, unable to speak, and felt numbness in his left leg. Currently the client's
neurologic examination is normal. About what drug would the nurse plan to teach the
patient?
a. Alteplase
b. Clopidogrel
c. Heparin sodium
d. Mannitol
Answer: ANS: B
This client's signs and symptoms are consistent with a transient ischemic attack, and
the client would likely be prescribed aspirin or clopidogrel to prevent platelet
aggregation on discharge. Alteplase is used for ischemic stroke. Heparin and
mannitol are not used for this condition.
2. The nurse is preparing a client for discharge from the emergency department after
experiencing a transient ischemic attack (TIA). Before discharge, which factor would
the nurse identify as placing the client at high risk for a stroke?
a. Age greater than or equal to 75
b. Blood pressure greater than or equal to 160/95
c. Unilateral weakness during a TIA
d. TIA symptoms lasting less than a minute
Answer: ANS: C T
, Inquire through: | Professional | Confidential Support
he client who has a TIA is at risk for a stroke is he or she has one-sided (unilateral)
weakness during a TIA. Risk factors also include an age greater than or equal to 60,
blood pressure greater than or equal to 140/90 (either or both systolic and diastolic),
and/or a long duration of TIA symptoms. One minute is not a very long time for
symptoms to occur.
3. The nurse is taking a history from a daughter about her father's onset of stroke
signs and symptoms. Which statement by the daughter indicates that the client likely
had an embolic stroke?
a. Client's symptoms occurred slowly over several hours. b. Client because
increasingly lethargic and drowsy.
c. Client reported severe headache before other symptoms.
d. Client has a long history of atrial fibrillation.
Answer: ANS: D
The major cause of embolic strokes is a history of heart disease, especially atrial
fibrillation. Most clients who have an embolic stroke have acute sudden neurologic
symptoms but stay alert rather than lethargic. Decreasing level of consciousness and
severe headache are more common in clients who have hemorrhagic strokes.
4. A client is admitted with a sudden decline in level of consciousness. What is the
nursing action at this time?
a. Assess the client for hypoglycemia and hypoxia.
b. Place the client on his or her side.
c. Prepare for administration of a fibrinolytic agent.
d. Start a continuous IV heparin sodium infusion.
Answer: ANS: A
The cause of a sudden decline in level of consciousness may or may not be related to
a neurologic health problem. Therefore, the client must be evaluated for other
common causes, especially hypoglycemia and hypoxia. Placing the client on his or
her side may be helpful to prevent aspiration in case the client experiences vomiting,
but the clinical situation does not indicate that the client has nausea or vomiting.
Administering either an anticoagulant like heparin or a fibrinolytic agent assumes
that the client has an acute ischemic stroke, which has not been confirmed through
imaging tests
