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Revision Examination Tests
“Come all for this greatness”
...100% Correct Ans...
PYC4805 EXAM PACK 2024-2025 - DISTINCTION GUARANTEED 100%
An ER nurse is completing an assessment on a patient that is alert but
struggles to answer questions. When she attempts to talk, she slurs her
speech and appears very frightened. What additional clinical
manifestation does the nurse expect to find if nacy's sysmptoms have
been caused by a brain attack (stroke)?
A. A carotid bruit
B. A hypotensive blood pressure
C. hyperreflexic deep tendon relexes.
D. Decreased bowel sounds
ans:> A) A carotid bruit.
Rationale: the carotid artery (artery to the brain) is narrowed in clients
with a brain attack. A bruit is an abnormal sound heard on auscultation
resulting from interference with normal blood flow. Usually the blood
pressure is hypertensive. Initially flaccid paralysis occurs, resulting in
hyporefkexic deep tendon reflexes. Bowel sounds are not indicative of a
brain attack.
Which clinical manifestation further supports an assessment of a left-
sided brain attack?
A) Visual field deficit on the left side.
B) Spatial-perceptual deficits.
C) Paresthesia of the left side.
D) Global aphasia.
D) Global aphasia.
ans:> D) Global aphasia.
Rationale: Global aphasia refers to difficulty speaking, listening, and
understanding, as well as difficulty reading and writing. Symptoms vary
,from person to person. Aphasia may occur secondary to any brain injury
involving the left hemisphere. Visual field deficits, spatial-perceptual
deficits, and paresthsia of the left side usually occur with right-sided
brain attack.
When preparing a patient for a noncontrast computed tomography (CT)
scan STAT, what nursing intervention should the nurse implement?
A) Determine if the client has any allergies to iodine
B) Explain that the client will not be able to move her head throughout
the CT scan.
C) Premedicate the client to decrease pain prior to having the procedure.
D) Provide an explanation of relaxation exercises prior to the procedure.
ans:> B) Explain that the client will not be able to move her head
throughout the CT scan.
Rationale: Because head motion will distort the images, Nancy will have
to remain still throughout the procedure. Allergies to iodine is important if
contrast dye is being used for the CT scan. Premedicating the client to
decrease pain prior to the procedure is unnecessary because CT
scanning is a noninvasive and painless procedure. Providing an
explanation of relaxation exercises prior to the procedure is a worthwhile
intervention to decrease anxiety but is not of highest priority.
A neurologist prescribes a magnetic resonance imaging (MRI) of the
head STAT for a patient. Which data warrants immediate intervention by
the nurse concerning this diagnostic test?
A) Elevated blood pressure.
B) Allergy to shell fish.
C) Right hip replacement.
D) History of atrial fibrillation.
ans:> C) Right hip replacement.
The magnetic field generated by the MRI is so strong that metal-
containing items are strongly attracted to the magnet. Because the hip
joint is made of metal, a lead shield must be used during the procedure.
Elevated blood pressure, an allergy to shell fish, and a history of atrial
fibrillation would not affect the MRI.
A client's daughter is sitting by her mother's bedside who was recently
transferred to the Intermediate Care Unit. She states "I don't understand
what a brain attack is. The healthcare provider told me my mother is in
,serious condition and they are going to run several tests. I just don't
know what is going on. What happened to my mother?" What is the best
response by the nurse?
A) "I am sorry, but according to the Health Insurance Portability and
Accounting Act (HIPAA), I cannot give you any information."
B) "Your mother has had a stroke, and the blood supply to the brain has
been blocked."
C) "How do you feel about what the healthcare provider said?"
D) "I will call the healthcare provider so he/she can talk to you about
your mother's serious condition."
ans:> B) "Your mother has had a stroke, and the blood supply to the
brain has been blocked."
Rationale: The nurse can discuss what a diagnosis means. Nancy is
unable to make decisions, so the next of kin, her daughter, Gail, needs
sufficient information to make informed decisions. The nurse has the
knowledge, and the responsibility, to explain Nancy's condition to Gail.
The nurse should give facts first, and then address her feelings after the
information is provided.
What is the normal range for cardiac output?
ans:> The normal range for cardiac output to ensure cerebral blood flow
and oxygen delivery is 4 to 8 L/min.
A client was admitted with the diagnosis of a brain attack. Their
symptoms began 24 hours before being admitted. Why would this client
not be a candidate for for thrombolytic therapy?
ans:> Thrombolytic therapy is contraindicated in clients with symptom
onset longer than 3 hours prior to admission. This client had symptoms
for 24 hours before being brought to the medical center
What are plate guards?
ans:> Plate guards prevent food from being pushed off the plate. Using
plate guards and other assistive devices will encourage independence in
a client with a self-care deficit.
Which condition is considered a non-modifiable risk factor for a brain
attack?
A) High cholesterol levels.
B) Obesity.
C) History of atrial fibrillation.
, D) Advanced age.
ans:> D) Advanced age.
Rationale: People over age 55 are a high-risk group for a brain attack
because the incidence of stroke more than doubles in each successive
decade of life. Non-modifiable means the client cannot do anything to
change the risk factor. All the other options are modifiable risk factors.
A client is experiencing homonymous hemianopsia as the result of a
brain attack. Which nursing intervention would the nurse implement to
address this condition?
A) Turn Nancy every two hours and perform active range of motion
exercises.
B) Place the objects Nancy needs for activities of daily living on the left
side of the table.
C) Speak slowly and clearly to assist Nancy in forming sounds to words.
D) Request that the dietary department thicken all liquids on Nancy's
meal and snack trays.
ans:> B) Place the objects Nancy needs for activities of daily living on
the left side of the table.
Rationale: Homonymous hemianopsia is loss of the visual field on the
same side as the paralyzed side. This results in the client neglecting that
side of the body, so it is beneficial to place objects on that side. Nancy
had a left-hemisphere brain attack so her right side is the weak side.
Speaking slowly and clearly would address the client's verbal deficits
due to aphasia. Requesting all liquids to be thickened would address
dysphagia. Turning the client every 2 hours and performing active range
of motion exercises would address the client's risk for immobility due to
paralysis.
A physical therapist (PT) places a gait belt on a client and is assisting
them with ambulation from the bed to the chair. As they get up out of the
bed, they report being dizzy and begin to fall. The PT carefully allows
them to fall back to the bed and notifies the primary nurse. Which written
documentation should the nurse put in the client's record?
A) Client experienced orthostatic hypotension when getting out of bed.
B) PT reported client complained of dizziness when getting out of bed,
and gait belt was used to allow client to fall back onto the bed.
C) PT notified the primary nurse that the client could not ambulate at this
time because of dizziness.
Revision Examination Tests
“Come all for this greatness”
...100% Correct Ans...
PYC4805 EXAM PACK 2024-2025 - DISTINCTION GUARANTEED 100%
An ER nurse is completing an assessment on a patient that is alert but
struggles to answer questions. When she attempts to talk, she slurs her
speech and appears very frightened. What additional clinical
manifestation does the nurse expect to find if nacy's sysmptoms have
been caused by a brain attack (stroke)?
A. A carotid bruit
B. A hypotensive blood pressure
C. hyperreflexic deep tendon relexes.
D. Decreased bowel sounds
ans:> A) A carotid bruit.
Rationale: the carotid artery (artery to the brain) is narrowed in clients
with a brain attack. A bruit is an abnormal sound heard on auscultation
resulting from interference with normal blood flow. Usually the blood
pressure is hypertensive. Initially flaccid paralysis occurs, resulting in
hyporefkexic deep tendon reflexes. Bowel sounds are not indicative of a
brain attack.
Which clinical manifestation further supports an assessment of a left-
sided brain attack?
A) Visual field deficit on the left side.
B) Spatial-perceptual deficits.
C) Paresthesia of the left side.
D) Global aphasia.
D) Global aphasia.
ans:> D) Global aphasia.
Rationale: Global aphasia refers to difficulty speaking, listening, and
understanding, as well as difficulty reading and writing. Symptoms vary
,from person to person. Aphasia may occur secondary to any brain injury
involving the left hemisphere. Visual field deficits, spatial-perceptual
deficits, and paresthsia of the left side usually occur with right-sided
brain attack.
When preparing a patient for a noncontrast computed tomography (CT)
scan STAT, what nursing intervention should the nurse implement?
A) Determine if the client has any allergies to iodine
B) Explain that the client will not be able to move her head throughout
the CT scan.
C) Premedicate the client to decrease pain prior to having the procedure.
D) Provide an explanation of relaxation exercises prior to the procedure.
ans:> B) Explain that the client will not be able to move her head
throughout the CT scan.
Rationale: Because head motion will distort the images, Nancy will have
to remain still throughout the procedure. Allergies to iodine is important if
contrast dye is being used for the CT scan. Premedicating the client to
decrease pain prior to the procedure is unnecessary because CT
scanning is a noninvasive and painless procedure. Providing an
explanation of relaxation exercises prior to the procedure is a worthwhile
intervention to decrease anxiety but is not of highest priority.
A neurologist prescribes a magnetic resonance imaging (MRI) of the
head STAT for a patient. Which data warrants immediate intervention by
the nurse concerning this diagnostic test?
A) Elevated blood pressure.
B) Allergy to shell fish.
C) Right hip replacement.
D) History of atrial fibrillation.
ans:> C) Right hip replacement.
The magnetic field generated by the MRI is so strong that metal-
containing items are strongly attracted to the magnet. Because the hip
joint is made of metal, a lead shield must be used during the procedure.
Elevated blood pressure, an allergy to shell fish, and a history of atrial
fibrillation would not affect the MRI.
A client's daughter is sitting by her mother's bedside who was recently
transferred to the Intermediate Care Unit. She states "I don't understand
what a brain attack is. The healthcare provider told me my mother is in
,serious condition and they are going to run several tests. I just don't
know what is going on. What happened to my mother?" What is the best
response by the nurse?
A) "I am sorry, but according to the Health Insurance Portability and
Accounting Act (HIPAA), I cannot give you any information."
B) "Your mother has had a stroke, and the blood supply to the brain has
been blocked."
C) "How do you feel about what the healthcare provider said?"
D) "I will call the healthcare provider so he/she can talk to you about
your mother's serious condition."
ans:> B) "Your mother has had a stroke, and the blood supply to the
brain has been blocked."
Rationale: The nurse can discuss what a diagnosis means. Nancy is
unable to make decisions, so the next of kin, her daughter, Gail, needs
sufficient information to make informed decisions. The nurse has the
knowledge, and the responsibility, to explain Nancy's condition to Gail.
The nurse should give facts first, and then address her feelings after the
information is provided.
What is the normal range for cardiac output?
ans:> The normal range for cardiac output to ensure cerebral blood flow
and oxygen delivery is 4 to 8 L/min.
A client was admitted with the diagnosis of a brain attack. Their
symptoms began 24 hours before being admitted. Why would this client
not be a candidate for for thrombolytic therapy?
ans:> Thrombolytic therapy is contraindicated in clients with symptom
onset longer than 3 hours prior to admission. This client had symptoms
for 24 hours before being brought to the medical center
What are plate guards?
ans:> Plate guards prevent food from being pushed off the plate. Using
plate guards and other assistive devices will encourage independence in
a client with a self-care deficit.
Which condition is considered a non-modifiable risk factor for a brain
attack?
A) High cholesterol levels.
B) Obesity.
C) History of atrial fibrillation.
, D) Advanced age.
ans:> D) Advanced age.
Rationale: People over age 55 are a high-risk group for a brain attack
because the incidence of stroke more than doubles in each successive
decade of life. Non-modifiable means the client cannot do anything to
change the risk factor. All the other options are modifiable risk factors.
A client is experiencing homonymous hemianopsia as the result of a
brain attack. Which nursing intervention would the nurse implement to
address this condition?
A) Turn Nancy every two hours and perform active range of motion
exercises.
B) Place the objects Nancy needs for activities of daily living on the left
side of the table.
C) Speak slowly and clearly to assist Nancy in forming sounds to words.
D) Request that the dietary department thicken all liquids on Nancy's
meal and snack trays.
ans:> B) Place the objects Nancy needs for activities of daily living on
the left side of the table.
Rationale: Homonymous hemianopsia is loss of the visual field on the
same side as the paralyzed side. This results in the client neglecting that
side of the body, so it is beneficial to place objects on that side. Nancy
had a left-hemisphere brain attack so her right side is the weak side.
Speaking slowly and clearly would address the client's verbal deficits
due to aphasia. Requesting all liquids to be thickened would address
dysphagia. Turning the client every 2 hours and performing active range
of motion exercises would address the client's risk for immobility due to
paralysis.
A physical therapist (PT) places a gait belt on a client and is assisting
them with ambulation from the bed to the chair. As they get up out of the
bed, they report being dizzy and begin to fall. The PT carefully allows
them to fall back to the bed and notifies the primary nurse. Which written
documentation should the nurse put in the client's record?
A) Client experienced orthostatic hypotension when getting out of bed.
B) PT reported client complained of dizziness when getting out of bed,
and gait belt was used to allow client to fall back onto the bed.
C) PT notified the primary nurse that the client could not ambulate at this
time because of dizziness.
