NSG 3250 Exam 3 – Adult Health: Neurological
Disorders (Stroke, TIA, ICP, Aphasia & Nursing
Management)
Level 1 (Questions 1–25)
**1. ** What is the main difference between a TIA and an ischemic stroke?
**Answer: ** TIA is transient with complete resolution of symptoms (usually <1 hour,
max 24 hours) and **no irreversible brain damage**. Ischemic stroke causes permanent
infarction and cell death. Patients with TIA are at high risk for thrombotic stroke but
**not** hemorrhagic stroke.
**2. ** How is a stroke definitively diagnosed in the acute phase?
**Answer: ** Non-contrast CT scan of the head (rules out hemorrhage before giving
thrombolytic).
**3. ** A patient with a left-hemisphere stroke is most likely to exhibit which
communication deficit?
**Answer: ** Aphasia (expressive, receptive, or global). The left hemisphere is dominant
for language in most people.
**4. ** Patients with a left-hemisphere stroke typically show deficits on which side of the
body?
**Answer: ** Right side (hemiplegia, hemiparesis, hemianopia).
, **5. ** Patients with a right-hemisphere stroke typically show deficits on which side of
the body?
**Answer: ** Left side + left-sided neglect, spatial-perceptual deficits, and impulsivity.
**6. ** List three classic signs/symptoms a patient with TIA may experience.
**Answer: ** Aphasia, ataxia, hemiplegia, unilateral weakness, difficulty swallowing
(dysphagia), difficulty speaking (dysarthria), visual changes, severe headache.
**7. ** What is the critical time window for administering thrombolytic therapy
(alteplase/tPA) in acute ischemic stroke?
**Answer: ** Within **4.5 hours** of symptom onset (strict eligibility criteria apply). Some
centers use up to 9 hours with advanced imaging.
**8. ** What are the two major categories of stroke?
**Answer: ** Ischemic (87%) and Hemorrhagic (13%).
**9. ** Name the two main subtypes of ischemic stroke.
**Answer: ** Thrombotic (clot forms locally) and Embolic (clot travels from elsewhere,
often atrial fibrillation).
**10. ** What is hemianopsia?
**Answer:** Loss of half the visual field (often homonymous hemianopsia). Common in
left-hemisphere strokes affecting the right visual field.
**11.** Why do we avoid hypotonic IV solutions in patients with stroke or increased ICP?
**Answer:** They increase cerebral edema and raise intracranial pressure (ICP).
**12.** What is the priority nursing intervention when communicating with a patient who
has expressive aphasia?
Disorders (Stroke, TIA, ICP, Aphasia & Nursing
Management)
Level 1 (Questions 1–25)
**1. ** What is the main difference between a TIA and an ischemic stroke?
**Answer: ** TIA is transient with complete resolution of symptoms (usually <1 hour,
max 24 hours) and **no irreversible brain damage**. Ischemic stroke causes permanent
infarction and cell death. Patients with TIA are at high risk for thrombotic stroke but
**not** hemorrhagic stroke.
**2. ** How is a stroke definitively diagnosed in the acute phase?
**Answer: ** Non-contrast CT scan of the head (rules out hemorrhage before giving
thrombolytic).
**3. ** A patient with a left-hemisphere stroke is most likely to exhibit which
communication deficit?
**Answer: ** Aphasia (expressive, receptive, or global). The left hemisphere is dominant
for language in most people.
**4. ** Patients with a left-hemisphere stroke typically show deficits on which side of the
body?
**Answer: ** Right side (hemiplegia, hemiparesis, hemianopia).
, **5. ** Patients with a right-hemisphere stroke typically show deficits on which side of
the body?
**Answer: ** Left side + left-sided neglect, spatial-perceptual deficits, and impulsivity.
**6. ** List three classic signs/symptoms a patient with TIA may experience.
**Answer: ** Aphasia, ataxia, hemiplegia, unilateral weakness, difficulty swallowing
(dysphagia), difficulty speaking (dysarthria), visual changes, severe headache.
**7. ** What is the critical time window for administering thrombolytic therapy
(alteplase/tPA) in acute ischemic stroke?
**Answer: ** Within **4.5 hours** of symptom onset (strict eligibility criteria apply). Some
centers use up to 9 hours with advanced imaging.
**8. ** What are the two major categories of stroke?
**Answer: ** Ischemic (87%) and Hemorrhagic (13%).
**9. ** Name the two main subtypes of ischemic stroke.
**Answer: ** Thrombotic (clot forms locally) and Embolic (clot travels from elsewhere,
often atrial fibrillation).
**10. ** What is hemianopsia?
**Answer:** Loss of half the visual field (often homonymous hemianopsia). Common in
left-hemisphere strokes affecting the right visual field.
**11.** Why do we avoid hypotonic IV solutions in patients with stroke or increased ICP?
**Answer:** They increase cerebral edema and raise intracranial pressure (ICP).
**12.** What is the priority nursing intervention when communicating with a patient who
has expressive aphasia?
