Nursing > Stroke > Flashcards

Stroke Flashcards

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1
Q

How can the nurse explain a TIA to her pt?

A. It is a long-term, chronic problem
B. It usually occurs during sleep
C. It is localized cerebral ischemia and symptoms should fade
D. Sudden decrease in blood flow to a localized area of the brain, causing neurological deficits

A

C

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2
Q

How can the nurse explain a Stroke to her pt?

A. It is a long-term, chronic problem
B. It usually occurs during sleep
C. It is localized cerebral ischemia and symptoms should fade
D. Sudden decrease in blood flow to a localized area of the brain, causing neurological deficits

A

D

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3
Q

What manifestations of a TIA may the pt temporarily experience? (select all)

A. Dysphonia
B. One eyed blindness
C. Aphasia
D. Ataxia
E. Dysarthria

A

B
C
E

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4
Q

How quickly does the damage in the brain begin after a disruption?

A. 10 - 15 min
B. 5 - 10 min
C. 4 - 5 min
D. 30 seconds - 2 min

A

C

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5
Q

Upon assessment:
-Unilateral L sided weakness
-L Facial droop
-L Pupil blown

A. Right hemisphere
B. Left hemisphere

A

A

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6
Q

What surrounds the infarction (area of ischemia)?

A. Oligodendrites
B. Blood brain barrier
C. Necrosis
D. Penumbra

A

D

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7
Q

Upon assessment:
-HX of recent MI, atherosclerosis, A-fib
-Occurred during a jog with his dog
-Pt states: “I was running and suddenly my left leg gave out & I fell!”
What type of stroke does he have?

A. Thrombotic ischemic stroke
B. Embolic ischemic stroke

A

B

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8
Q

Upon assessment:
-Pt states: “My right leg and arm started feeling weak 2 days ago, and this morning I couldn’t move them”

A. Thrombotic ischemic stroke
B. Embolic ischemic stroke

A

A

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9
Q

Which type of stroke usually occurs in narrow vessels and bifurcations?

A. Thrombotic ischemic stroke
B. Embolic ischemic stroke

A

B

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10
Q

Which type of stroke usually occurs in large vessels?

A. Thrombotic ischemic stroke
B. Embolic ischemic stroke

A

A

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11
Q

Match the type of hemorrhagic stroke to it’s location:

A. Intracerebral
B. Subarachnoid

C. Within the tissue itself
D. Spaces around the brain

A

A - C
B - D

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12
Q

What is the Left Hemisphere responsible for? (select all)

A. Language
B. Proprioception
C. Visual/Spatial awareness
D. Mathematical skills
E. Analytical thinking

A

A
D
E

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13
Q

What is the Right Hemisphere responsible for? (select all)

A. Language
B. Proprioception
C. Visual/Spatial awareness
D. Mathematical skills
E. Analytical thinking

A

B
C

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14
Q

Upon assessment:
-Easily frustrated with agnosia test
+ Global aphasia
-Lost vision in R eye
Where did the stroke occur?

A. Left hemisphere
B. Right hemisphere

A

A

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15
Q

Upon assessment:
-Minimal expression
-Refuses to stay in bed despite being reminded he can not walk
-Very thick, long nails on L side of body
Where did the stroke occur?

A. Left hemisphere
B. Right hemisphere

A

B

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16
Q

Place these in order of how fast they should be started/completed:

A. NCCT or MRI
B. Initiation of IV alteplase
C. Evaluation by physician
D. Interpretation of neuro imaging
E. Stroke or neurologic expert contacted

  1. 10 minuets from arrival
  2. < 15 minuets
  3. < 20 minuets
  4. < 45 minuets or sooner
  5. < 60 minuets
A

A - 3
B - 5
C - 1
D - 4
E - 2

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17
Q

How should the nurse administer:
-TNK

A. IV push over 5 minuets followed by lab draw
B. IV push bolus, then 1 hour infusion
C. IV drip with 0.45% NS
D. 1 single IV push bolus

A

D

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18
Q

How should the nurse administer:
-TPA

A. IV push over 5 minuets followed by lab draw
B. IV push bolus, then 1 hour infusion
C. IV drip with 0.45% NS
D. 1 single IV push bolus

A

B

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19
Q

What should stop the nurse from administering TPA or TNK? (select all)

A. Hemodynamic instability
B. Severe hypertension
C. Clopidogrel given 1 hr ago
D. Onset of symptoms was 4hrs ago

A

B
C

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20
Q

What are the 4 main medications given to pts post stroke?

A. Diuretics
B. Antiplatelets
C. Statins
D. Phenytoin
E. Anti-coagulant
F. Anti-hypertensives
G. Anti-arrhythmics

A

B
C
E
F

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21
Q

What manifestations may lead the nurse to believe the neonate had a stroke? (select all)

A. Sleepiness
B. Apnea
C. Seizures
D. Repetitive facial movements
E. Staring
F. Muscle jerking

A

B
D
E
F

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22
Q

What manifestations may lead the nurse to believe the infant had a stroke? (select all)

A. Extreme sleepiness
B. Favoring one side of the body
C. + Babinsky
D. Seizures

A

A
B
D

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23
Q

How can the nurse explain sinovenous thrombosis to the parent?

A. It is due to a malformation of the vein in utero
B. It is caused by pressure during delivery, it can happen to anyone
C. It occurs in the vein that drains blood from the brain
D. It happened because the sinus is diverted, causing increased ICP

A

C

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24
Q

What signs in children & adolescents alert the nurse they may be having a stroke? (select all)

A. Seizures
B. Aura
C. Irrational behavior
D. Severe headache
E. Vomiting
F. Language/balance problems

A

A
D
E
F

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25
What is depleted when cerebral blood flow is interrupted- leading to decreased blood flow? (select all) A. Potassium B. Glucose C. Proteins D. Glycogen E. ATP
B D E
26
Why are TIA's common during sleep? A. Reduced BP & slower blood flow B. Prolonged immobility causes clot formation C. It causes respiratory acidosis due to lowered respirations D. During repair, blood coagulates and forms a thrombus
A
27
Which vessels are the common sites for: Thrombotic strokes A. Vertebral arteries B. Bifurcation sites C. Carotid/Middle cerebral arteries D. Internal carotid artery E. Junction of the vertebral and basilar arteries
A D E
28
Which vessels are the common sites for: Emolitic strokes A. Vertebral arteries B. Bifurcation sites C. Carotid/Middle cerebral arteries D. Internal carotid artery E. Junction of the vertebral and basilar arteries
B C
29
How long does it take for the stroke to reach its full impact, known as: Stroke in evolution A. 12-24hrs B. 24-48hrs C. 3-4 days D. 1 week
B
30
By day 3, what occurs to the brain tissue after a stroke? (select all) A. Shrivels up B. Edema C. Necrosis D. Perforation
B C
31
What strokes appear in: -Deep, noncortical areas of the brain/brainstem A. Thrombotic B. Embolic C. Subarachnoid D. Lacunar
D
32
Match the stroke with the onset & age: A. Emolitic B. Thrombotic C. Awake & Active D. Sleeping & Resting
A - C B - D
33
How can the nurse describe a: Cardiogenic embolic stroke to her pt? A. The thrombus originates from a DVT in the lower extremity B. The embolus originates due to compartment syndrome C. The embolus is caused by atherosclerosis D. The embolus originates from the L side of the heart
D
34
What are some conditions that precedes embolic strokes? (select all) A. Meningitis B. Ventricular aneurysm C. Recent MI D. Anti-coagulant use E. Bacterial endocarditis
B C E
35
When blood is present in the ventricles or subarachnoid spaces, what does it trigger? A. Clot formation B. Vessel colic C. Vessel regurgitation D. Inflammation
D
36
Due to the inflammatory response of blood in the brain, what is interrupted? A. Sodium-potassium pump B. Blood-brain-barrier C. Absorption & circulation of CSF D. Filtration of blood within the brain
C
37
What manifestations of a stroke will females experience? (select all) A. Paralysis of face B. Sudden N/SOB C. Face/Limb pain D. Incontinence E. Hiccups
B C E
38
If the dominant (Left) hemisphere is affected, what may the pt have? A. Apraxia B. Aphasia C. Agnosia D. Unilateral neglect
B
39
If the non- dominant (Right) hemisphere is affected, what may the pt have? A. Apraxia B. Aphasia C. Agnosia D. Unilateral neglect
A C D
40
Where is the stroke: -Contralateral hemiplegia of the arm and face -Drowsiness, stupor, coma -Global aphasia A. Vertebral artery B. Middle cerebral artery C. Anterior cerebral artery D. Internal carotid artery
B
41
Where is the stroke: -Contralateral paralysis of the arm, leg, and face -Aphasia, Apraxia, Agnosia -Unilateral neglect A. Vertebral artery B. Middle cerebral artery C. Anterior cerebral artery D. Internal carotid artery
D
42
Where is the stroke: -Pain in the face, nose, or eye -Numbness or weakness of the face on the involved side -Problems with gait -Dysphagia A. Vertebral artery B. Middle cerebral artery C. Anterior cerebral artery D. Internal carotid artery
A
43
Where is the stroke: -Contralateral weakness or paralysis of the foot and leg -Loss of ability to make decisions or act voluntarily -Urinary incontinence A. Vertebral artery B. Middle cerebral artery C. Anterior cerebral artery D. Internal carotid artery
C
44
What is: -The inability to recognize one or more subjects that were previously familiar; agnosia may be visual, tactile, or auditory A. Aphasia B. Agnosia C. Dysarthria D. Dysphonia
B
45
What is: -Any disturbance in muscular control of speech A. Aphasia B. Agnosia C. Dysarthria D. Dysphonia
C
46
What is: -The inability to use or understand language. It may be expressive, receptive, or mixed (global) A. Aphasia B. Agnosia C. Dysarthria D. Dysphonia
A
47
What is: -Weakness of the left or right half of the body. A. Hemiplegia B. Hemiparesis C. Flaccidity D. Spasticity
B
48
What is: -Increased muscle tone (hypertonia), usually with some degree of weakness. In the arms, the flexor muscles are usually more strongly affected, while in the legs, the extensor muscles are more strongly affected. A. Hemiplegia B. Hemiparesis C. Flaccidity D. Spasticity
D
49
What is: -Absence of muscle tone (hypotonia). A. Hemiplegia B. Hemiparesis C. Flaccidity D. Spasticity
C
50
What is: -Paralysis of the left or right half of the body. A. Hemiplegia B. Hemiparesis C. Flaccidity D. Spasticity
A
51
What is true about flaccid and spasticity in pt's post stroke? A. Flaccid & spasticity set in 24hrs after occurrence B. Flaccid, then spasticity setting in about 6-8wks C. PT/OT reduce long term effects of this D. You will have constant spasticity with intermittent flaccidity
B
52
What else is often present initially following a stroke? (select all) A. Contractures B. Foot drop C. Dependent edema D. Impaired respiratory function E. Outward rotation of the leg
B C E
53
Where may the damage be if the pt post-stroke feels: -Hot , Cold , Burning , Tingling , Sharp , Stabbing In the affected extremities? A. Cerebellum B. Hippocampus C. Thalamus D. Hypothalamus
C
54
Why are lumbar puncture contraindicated for pt's with hemorrhagic strokes? (Increased ICP) A. It causes rapid swelling decrease, causing cerebral edema B. It increases the ICP further, due to stress C. Puts the pt into shock, causing further damage D. ^ risk of herniation of the brainstem
D
55
Which medications are the most useful in reducing stroke risk? (select all) A. Thiazide diuretics B. Ace inhibitors/CCBs C. Enoxaparin D. ARBs
A B D
56
What parameters should be set for pt's receiving IV TPA? (select all) A. NPO status B. No anti platlet/coagulant C. No Hepatic alterations D. Systolic >185 , Diastolic >110
B D
57
What may be administered for pts with cerebral edema? A. Osmotic diuretics (mannitol) B. Phenytoin C. Corticosteroids D. Loop diuretics E. Barbiturates
C
58
What may be administered for pts with Increased ICP? (select all) A. Osmotic diuretics (mannitol) B. Phenytoin C. Corticosteroids D. Loop diuretics E. Barbiturates
A D
59
What may be administered for pts with seizures due to increased ICP? (select all) A. Osmotic diuretics (mannitol) B. Phenytoin C. Corticosteroids D. Loop diuretics E. Barbiturates
B E
60
What is the nurses priority for her pt who is unconscious due to a stroke? (select all) A. Provide oral care Qshift B. Suction if necessary C. Elevate affected limbs D. Monitor respiratory function
B D
61
Which sign in your critically ill pt post stroke, indicates extension of cerebral damage? (select all) A. Babinsky B. Chvostek's C. Decorticate D. Decerebrate
A C D
62
What cardiac arrythmias can arise from a stroke? (Select all) A. A-fib B. AV block C. Bradycardia/Tachycardia D. Atrial flutter E. PVC's
B C E
63
What can occur due to damage to the pituitary gland? A. Insomnia B. Diabetes Insipidus C. Gynomastia D. Seizures
B
64
What can occur due to damage to the pituitary gland? A. Insomnia B. Diabetes Insipidus C. Gynomastia D. Seizures
B
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