NSG 252 Exam 3 – Intracranial Regulation, Inflammation, Mobility,
& Nursing Process | Complete Q&A with Bold Answers & Italic
Rationales | Latest 2026
.
Exam Overview
Feature Details
Course NSG 252 – Advanced Medical-Surgical Nursing II
Exam Exam 3
Primary Intracranial Regulation (Stroke, ICP, Meningitis), Inflammation, Mobility, Nursing
Focus Process
Format Multiple choice, select all that apply
Latest 2026-2027 Academic Year
Update
SECTION 1: INTRACRANIAL REGULATION – STROKE (CVA)
Q1. The nursing student knows that which type of stroke is caused by a rupture of a blood vessel in
the brain?
A) TIA
B) Ischemic stroke
C) Hemorrhagic stroke
D) Embolic stroke
Hemorrhagic stroke occurs when a blood vessel in the brain ruptures, causing bleeding into surrounding
brain tissue. This differs from ischemic stroke, which is caused by a blockage (clot) .
Q2. A nurse is assessing a patient who is suspected of having a CVA. The nurse knows that all of these
are signs of a right-sided stroke EXCEPT:
A) Impulsive behavior
B) Rapid movement
C) Impaired judgement
D) Right-sided weakness
,In right-sided strokes, the patient presents with visual/spatial awareness deficits and proprioception
deficits affecting the OPPOSITE side of the body. Right-sided weakness would indicate a LEFT-sided stroke
.
Q3. A client arrives in the emergency department with an ischemic stroke. What should the nurse do
BEFORE the client receives tissue plasminogen activator (t-PA)?
A) Ask what medications the client is taking
B) Complete a history and health assessment
C) Identify the time of onset of the stroke
D) Determine if the client is scheduled for any surgical procedures
Studies show that clients who receive recombinant tPA treatment within 3 hours after the onset of a
stroke have better outcomes. The time from onset to tPA treatment is critical .
Q4. A client is admitted with a possible ischemic stroke, has been aphasic for 3 hours, and has a blood
pressure of 220/120 mmHg. Which prescription by the health care provider should the nurse
question?
A) Labetalol infusion to keep the BP lower than 120/80 mmHg
B) Tissue plasminogen activator per protocol
C) Normal saline intravenously at 75 ml/hr
D) Bed elevated 30 degrees
*For patients who are candidates for tPA, blood pressure must be carefully controlled (maintained
below 185/110 mmHg before tPA and below 180/105 for 24 hours after). Aggressively lowering BP to
120/80 could reduce cerebral perfusion pressure and worsen outcomes .*
Q5. A client with a possible ischemic stroke has been aphasic for 3 hours. The nurse knows that tPA
can be administered up to what time window after symptom onset?
A) 1 hour
B) 3 to 4.5 hours
C) 6 hours
D) 12 hours
The standard window for IV tPA administration is within 3 hours of symptom onset, with some patients
eligible up to 4.5 hours based on specific criteria. The patient described has been symptomatic for 3
hours and is still within this window .
Q6. The nurse is caring for a patient who has just been admitted after suffering a cerebrovascular
accident (CVA). When prioritizing care for the patient, which actions should the nurse take? (Select all
that apply)
, A) Prepare the patient for a CT scan with contrast to confirm the diagnosis
B) Draw APTT and INR levels before starting fibrinolytic therapy
C) Draw APTT and INR levels only after starting fibrinolytic therapy
D) Administer aspirin PO initially before the patient receives fibrinolytic therapy
*You first do CT WITHOUT contrast in suspected CVA patients because if it is a hemorrhagic stroke, the
dye can worsen bleeding. Fibrinolytic therapy requires PT/INR and aPTT results BEFORE administration.
Aspirin should be avoided before tPA and delayed for 24 hours after tPA is started .*
Q7. The test used to confirm the type of stroke (ischemic vs. hemorrhagic) is:
A) MRI with contrast
B) CT without contrast
C) EEG
D) PET scan
A non-contrast CT scan is the initial imaging study of choice to differentiate between ischemic and
hemorrhagic stroke. Contrast is avoided initially because it can worsen hemorrhagic strokes .
Q8. A patient presented to the ED with a headache, slurred speech, and right-sided arm weakness that
began 30 minutes ago. Which findings require immediate follow-up? (Select all that apply)
A) Right-sided arm weakness
B) Slurred speech
C) Heart rate of 89 bpm
D) Headache
E) Confusion
F) Respiration rate of 22 breaths/min
*Right-sided arm weakness, headache, slurred speech, and confusion indicate the patient may be having
a stroke. Heart rate (89 bpm) and respiration rate (22 breaths/min) are within normal limits .*
Q9. The nurse determines that the client is at risk for ____________ if the client were to be
administered tissue plasminogen activator (t-PA) when experiencing a(n) ____________ stroke.
A) Cranial hemorrhage; hemorrhagic
B) Clotting; ischemic
C) Paralysis; transient
D) Seizure; embolic
& Nursing Process | Complete Q&A with Bold Answers & Italic
Rationales | Latest 2026
.
Exam Overview
Feature Details
Course NSG 252 – Advanced Medical-Surgical Nursing II
Exam Exam 3
Primary Intracranial Regulation (Stroke, ICP, Meningitis), Inflammation, Mobility, Nursing
Focus Process
Format Multiple choice, select all that apply
Latest 2026-2027 Academic Year
Update
SECTION 1: INTRACRANIAL REGULATION – STROKE (CVA)
Q1. The nursing student knows that which type of stroke is caused by a rupture of a blood vessel in
the brain?
A) TIA
B) Ischemic stroke
C) Hemorrhagic stroke
D) Embolic stroke
Hemorrhagic stroke occurs when a blood vessel in the brain ruptures, causing bleeding into surrounding
brain tissue. This differs from ischemic stroke, which is caused by a blockage (clot) .
Q2. A nurse is assessing a patient who is suspected of having a CVA. The nurse knows that all of these
are signs of a right-sided stroke EXCEPT:
A) Impulsive behavior
B) Rapid movement
C) Impaired judgement
D) Right-sided weakness
,In right-sided strokes, the patient presents with visual/spatial awareness deficits and proprioception
deficits affecting the OPPOSITE side of the body. Right-sided weakness would indicate a LEFT-sided stroke
.
Q3. A client arrives in the emergency department with an ischemic stroke. What should the nurse do
BEFORE the client receives tissue plasminogen activator (t-PA)?
A) Ask what medications the client is taking
B) Complete a history and health assessment
C) Identify the time of onset of the stroke
D) Determine if the client is scheduled for any surgical procedures
Studies show that clients who receive recombinant tPA treatment within 3 hours after the onset of a
stroke have better outcomes. The time from onset to tPA treatment is critical .
Q4. A client is admitted with a possible ischemic stroke, has been aphasic for 3 hours, and has a blood
pressure of 220/120 mmHg. Which prescription by the health care provider should the nurse
question?
A) Labetalol infusion to keep the BP lower than 120/80 mmHg
B) Tissue plasminogen activator per protocol
C) Normal saline intravenously at 75 ml/hr
D) Bed elevated 30 degrees
*For patients who are candidates for tPA, blood pressure must be carefully controlled (maintained
below 185/110 mmHg before tPA and below 180/105 for 24 hours after). Aggressively lowering BP to
120/80 could reduce cerebral perfusion pressure and worsen outcomes .*
Q5. A client with a possible ischemic stroke has been aphasic for 3 hours. The nurse knows that tPA
can be administered up to what time window after symptom onset?
A) 1 hour
B) 3 to 4.5 hours
C) 6 hours
D) 12 hours
The standard window for IV tPA administration is within 3 hours of symptom onset, with some patients
eligible up to 4.5 hours based on specific criteria. The patient described has been symptomatic for 3
hours and is still within this window .
Q6. The nurse is caring for a patient who has just been admitted after suffering a cerebrovascular
accident (CVA). When prioritizing care for the patient, which actions should the nurse take? (Select all
that apply)
, A) Prepare the patient for a CT scan with contrast to confirm the diagnosis
B) Draw APTT and INR levels before starting fibrinolytic therapy
C) Draw APTT and INR levels only after starting fibrinolytic therapy
D) Administer aspirin PO initially before the patient receives fibrinolytic therapy
*You first do CT WITHOUT contrast in suspected CVA patients because if it is a hemorrhagic stroke, the
dye can worsen bleeding. Fibrinolytic therapy requires PT/INR and aPTT results BEFORE administration.
Aspirin should be avoided before tPA and delayed for 24 hours after tPA is started .*
Q7. The test used to confirm the type of stroke (ischemic vs. hemorrhagic) is:
A) MRI with contrast
B) CT without contrast
C) EEG
D) PET scan
A non-contrast CT scan is the initial imaging study of choice to differentiate between ischemic and
hemorrhagic stroke. Contrast is avoided initially because it can worsen hemorrhagic strokes .
Q8. A patient presented to the ED with a headache, slurred speech, and right-sided arm weakness that
began 30 minutes ago. Which findings require immediate follow-up? (Select all that apply)
A) Right-sided arm weakness
B) Slurred speech
C) Heart rate of 89 bpm
D) Headache
E) Confusion
F) Respiration rate of 22 breaths/min
*Right-sided arm weakness, headache, slurred speech, and confusion indicate the patient may be having
a stroke. Heart rate (89 bpm) and respiration rate (22 breaths/min) are within normal limits .*
Q9. The nurse determines that the client is at risk for ____________ if the client were to be
administered tissue plasminogen activator (t-PA) when experiencing a(n) ____________ stroke.
A) Cranial hemorrhage; hemorrhagic
B) Clotting; ischemic
C) Paralysis; transient
D) Seizure; embolic
