Med Surg Exam 3- Neuro & Respiratory
Questions and Guide Answers
100% Verified Graded A+
1. An elderly client had a stroke and can only see the nasal visual field on one
side and the temporal portion on the opposite side. Which term correctly
describes this condition?
1. Astereognosis
2. Homonymous hemianopia
3. Oculogyric crisis
4. Receptive aphasia
Answer: *2.Homonymous hemianopia*
Homonymous hemianopia describes the loss of visual field on the nasal side and the opposite temporal side due to
damage of the optic nerves.
2. A client had an embolic stroke. Which condition places him at risk for throm-
boembolic stroke?
,1. Atrial fibrillation
2. Bradycardia
3. Deep vein thrombosis (DVT)
4, History of myocardial infarction (MI)
Answer: *1. Atrial fibrillation*
Atrial fibrillation occurs with the irregular . and rapid discharge from multiple ectopic atrial foci that causes quivering of
the atria without atrial systole. This asynchronous atrial contraction predisposes to mural thrombi, which may
embolize, leading to a stroke.
3. A 65-year-old client with a stroke in evolution has ordered t-PA, a thrombolyt-
ic agent. The order is for 0.9 mg/kg over 1hour. The client weighs 110lbs.What
is the total dose in milligrams (mg) the client will receive?
1.35mg
2.40mg
3.45mg
4.50mg
Answer: *3.
45mg*
0.9 mg X 50 kg = 45 mg.
,4. A client is admitted with thromboembolic stroke. Which medication should
be started by day 2?
1. Acetaminophen
2. Aspirin
3. Tenecteplase
4, Methylprednisolone
Answer: *2. Aspirin*
Aspirin, not acetaminophen, interferes with platelet aggregation and other antiplatelets, and is used in the treatment of
thromboembolic stroke.
5. To maintain airway patency during a stroke in evolution, which nursing
intervention is appropriate?
1. Thicken all dietary liquids.
2. Restrict dietary and parenteral fluids.
3. Place the client on oxygen.
4. Have tracheal suction available at all times.
Answer: *4. Have tracheal suction available at all times.* Because of a potential loss of the gag reflex
and potential altered level of consciousness, tracheal suction should be available atalltimes.
6. For a client with a stroke, which criterion must be fulfilled before the client
, isfed?
1. The gag reflex returns.
2. Speech returns to normal.
3. Cranial nerves III, IV, and VI are intact.
4. The client swallows small sips of water without coughing.
Answer: *1. The gag reflex returns.*
An intact gag reflex shows a properly functioning cranial nerve IX (glossopharyngeal).
7. Which diet would be least likely to lead to aspiration in a client who had a
stroke with residual dysphagia?
1. Clear liquid
2. Full liquid
3. Mechanical soft
4. Thickened liquid
Answer: *4.Thickened liquid*
Thickened liquids are easiest to form into a bolus and swallow.
8. A 77-year-old client had a thromboembolic right stroke; his left arm is
swollen. Which condition may cause swelling after a stroke?
1. Elbow contracture secondary to spasticity
Questions and Guide Answers
100% Verified Graded A+
1. An elderly client had a stroke and can only see the nasal visual field on one
side and the temporal portion on the opposite side. Which term correctly
describes this condition?
1. Astereognosis
2. Homonymous hemianopia
3. Oculogyric crisis
4. Receptive aphasia
Answer: *2.Homonymous hemianopia*
Homonymous hemianopia describes the loss of visual field on the nasal side and the opposite temporal side due to
damage of the optic nerves.
2. A client had an embolic stroke. Which condition places him at risk for throm-
boembolic stroke?
,1. Atrial fibrillation
2. Bradycardia
3. Deep vein thrombosis (DVT)
4, History of myocardial infarction (MI)
Answer: *1. Atrial fibrillation*
Atrial fibrillation occurs with the irregular . and rapid discharge from multiple ectopic atrial foci that causes quivering of
the atria without atrial systole. This asynchronous atrial contraction predisposes to mural thrombi, which may
embolize, leading to a stroke.
3. A 65-year-old client with a stroke in evolution has ordered t-PA, a thrombolyt-
ic agent. The order is for 0.9 mg/kg over 1hour. The client weighs 110lbs.What
is the total dose in milligrams (mg) the client will receive?
1.35mg
2.40mg
3.45mg
4.50mg
Answer: *3.
45mg*
0.9 mg X 50 kg = 45 mg.
,4. A client is admitted with thromboembolic stroke. Which medication should
be started by day 2?
1. Acetaminophen
2. Aspirin
3. Tenecteplase
4, Methylprednisolone
Answer: *2. Aspirin*
Aspirin, not acetaminophen, interferes with platelet aggregation and other antiplatelets, and is used in the treatment of
thromboembolic stroke.
5. To maintain airway patency during a stroke in evolution, which nursing
intervention is appropriate?
1. Thicken all dietary liquids.
2. Restrict dietary and parenteral fluids.
3. Place the client on oxygen.
4. Have tracheal suction available at all times.
Answer: *4. Have tracheal suction available at all times.* Because of a potential loss of the gag reflex
and potential altered level of consciousness, tracheal suction should be available atalltimes.
6. For a client with a stroke, which criterion must be fulfilled before the client
, isfed?
1. The gag reflex returns.
2. Speech returns to normal.
3. Cranial nerves III, IV, and VI are intact.
4. The client swallows small sips of water without coughing.
Answer: *1. The gag reflex returns.*
An intact gag reflex shows a properly functioning cranial nerve IX (glossopharyngeal).
7. Which diet would be least likely to lead to aspiration in a client who had a
stroke with residual dysphagia?
1. Clear liquid
2. Full liquid
3. Mechanical soft
4. Thickened liquid
Answer: *4.Thickened liquid*
Thickened liquids are easiest to form into a bolus and swallow.
8. A 77-year-old client had a thromboembolic right stroke; his left arm is
swollen. Which condition may cause swelling after a stroke?
1. Elbow contracture secondary to spasticity
