THIS EXAM STUDY GUIDE INC LUDES questions and Answers with
Explanations
vSim for Nursing: Fundame ntals: Vernon Russell
Vsim for Nursing: Post Quiz - Edith Jacobson
Post Quiz - Jared Griffin
Mr. Griffin Pre -Simulation vSim Quiz
vSim for Nursing: Fundamentals: Vernon Russell
When taking a patient's health history, which of the following does the nurse identify as risk factors f or
having a stroke? (Select all that apply.)
a) Diabetes Mellitus
b) Smoking
c) Recent weight loss
d) Asthma
e) Hypertension
a) Diabetes Mellitus
b) Smoking
e) Hypertension
Explanation: Risk factors for stroke include hypertension, smoking, and diabetes. Obesity, not weight
loss, is a risk factor for stroke. Asthma is not a risk factor for stroke.
The nurse has an order to complete neurochecks every four hours. Which assessments would the nurse
include in the neurological examination? (Select all that appl y.)
a) Range of motion
b) Level of consciousness
c) Sensory perception
d) Cranial nerves
e) Memory
b) Level of consciousness
c) Sensory perception
d) Cranial nerves
e) Memory
Explanation: Components of a neurological examination include memory, level of c onsciousness,
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sensory perception, cranial nerves, patterns of speech, and bilateral hand grips. Range of motion would
be appropriate for a musculoskeletal assessment.
The nurse is caring for four medical -surgical patients. Which patient should be assessed using the
Glasgow Coma Scale?
a) A 47 -year -old patient who suffered a brain injury and lost consciousness in a motor vehicle accident.
b) A 51 -year -old patient with cancer who is experiencing episodes of anxiety and depression.
c) An 85 -year -old patient wi th dementia and increasing confusion.
d) A 32 -year -old patient who is paraplegic and has pneumonia.
a) A 47 -year -old patient who suffered a brain injury and lost consciousness in a motor vehicle accident.
Explanation: The Glasgow Coma Scale measures eye opening, verbal response, and motor response and
is typically used with patients who have suffered a brain injury as a result of trauma.
The nurse is evaluating a patient's neurological status. What should t he nurse include when assessing a
patient's level of awareness?
When assessing level of awareness, the nurse should assess Time (e.g., what is today's date? what day
of the week is it?; Place (e.g., Where are you now? What is the name of this city?); and P erson (e.g.,
What is your name? How old are you?). If the patient is oriented to time, place, amd person, the nurse
would document that the patient is alert and oriented x 3.
The nurse is caring for a patient who is suspected of having a stroke. What shoul d be the nurse's first
action to ensure patient safety when it appears the patient is having difficulty swallowing prescribed
oral medication?
a) Educate the patient to substantial risk of aspiration associated with a stroke.
b) Schedule an immediate speec h therapist swallow study
c) Hold this dose of medication and make the patient NPO
d) Notify the provider of the suspected problem
c) Hold this dose of medication and make the patient NPO.
Explanation: Difficulty swallowing may lead to aspiration. The nur se's first action should be to hold the
medication dose and make the patient NPO. The nurse should then notify the provider, who will
probably order a swallow study.
A patient is experiencing dysphagia following a stroke. How should the nurse position the patient when
administering medications?
a) Semi -Fowler's
b) Supine
c) High Fowler's
d) Left lateral
c) High Fowler's
Explanation: The nurse should position the patient as 90 degrees (High Fowler's) or should sit the
patient upright in a chair. The nurse s hould not position the patient supine (on back), semi -Fowler's (45 Powered by TCPDF (www.tcpdf.org)
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Explanations
vSim for Nursing: Fundame ntals: Vernon Russell
Vsim for Nursing: Post Quiz - Edith Jacobson
Post Quiz - Jared Griffin
Mr. Griffin Pre -Simulation vSim Quiz
vSim for Nursing: Fundamentals: Vernon Russell
When taking a patient's health history, which of the following does the nurse identify as risk factors f or
having a stroke? (Select all that apply.)
a) Diabetes Mellitus
b) Smoking
c) Recent weight loss
d) Asthma
e) Hypertension
a) Diabetes Mellitus
b) Smoking
e) Hypertension
Explanation: Risk factors for stroke include hypertension, smoking, and diabetes. Obesity, not weight
loss, is a risk factor for stroke. Asthma is not a risk factor for stroke.
The nurse has an order to complete neurochecks every four hours. Which assessments would the nurse
include in the neurological examination? (Select all that appl y.)
a) Range of motion
b) Level of consciousness
c) Sensory perception
d) Cranial nerves
e) Memory
b) Level of consciousness
c) Sensory perception
d) Cranial nerves
e) Memory
Explanation: Components of a neurological examination include memory, level of c onsciousness,
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sensory perception, cranial nerves, patterns of speech, and bilateral hand grips. Range of motion would
be appropriate for a musculoskeletal assessment.
The nurse is caring for four medical -surgical patients. Which patient should be assessed using the
Glasgow Coma Scale?
a) A 47 -year -old patient who suffered a brain injury and lost consciousness in a motor vehicle accident.
b) A 51 -year -old patient with cancer who is experiencing episodes of anxiety and depression.
c) An 85 -year -old patient wi th dementia and increasing confusion.
d) A 32 -year -old patient who is paraplegic and has pneumonia.
a) A 47 -year -old patient who suffered a brain injury and lost consciousness in a motor vehicle accident.
Explanation: The Glasgow Coma Scale measures eye opening, verbal response, and motor response and
is typically used with patients who have suffered a brain injury as a result of trauma.
The nurse is evaluating a patient's neurological status. What should t he nurse include when assessing a
patient's level of awareness?
When assessing level of awareness, the nurse should assess Time (e.g., what is today's date? what day
of the week is it?; Place (e.g., Where are you now? What is the name of this city?); and P erson (e.g.,
What is your name? How old are you?). If the patient is oriented to time, place, amd person, the nurse
would document that the patient is alert and oriented x 3.
The nurse is caring for a patient who is suspected of having a stroke. What shoul d be the nurse's first
action to ensure patient safety when it appears the patient is having difficulty swallowing prescribed
oral medication?
a) Educate the patient to substantial risk of aspiration associated with a stroke.
b) Schedule an immediate speec h therapist swallow study
c) Hold this dose of medication and make the patient NPO
d) Notify the provider of the suspected problem
c) Hold this dose of medication and make the patient NPO.
Explanation: Difficulty swallowing may lead to aspiration. The nur se's first action should be to hold the
medication dose and make the patient NPO. The nurse should then notify the provider, who will
probably order a swallow study.
A patient is experiencing dysphagia following a stroke. How should the nurse position the patient when
administering medications?
a) Semi -Fowler's
b) Supine
c) High Fowler's
d) Left lateral
c) High Fowler's
Explanation: The nurse should position the patient as 90 degrees (High Fowler's) or should sit the
patient upright in a chair. The nurse s hould not position the patient supine (on back), semi -Fowler's (45 Powered by TCPDF (www.tcpdf.org)
2 / 2
