Deck 33: Cerebrovascular Disorders

Question 1

The research nurse, while participating in clinical trials, finds a client has receptive aphasia. Which pathophysiological change does the nurse expect to be the cause of this condition in the client?
1)Damage to the brainstem
2)Dysfunction in Broca's area
3)Dysfunction in Wernicke's area
4)Damage to one side of the cerebellum

Answer 1

3

Question 2

After performing a neurological examination on a client suspected of having a stroke, the nurse concludes that the client has a moderately severe impairment based on the National Institutes of Health Stroke Scale (NIHSS). Which score enabled the nurse to reach this conclusion? 1.4
2)10
3)16
4)28

Answer 2

3

Question 3

The nurse is counseling family members of a client diagnosed with a stroke. The family asks why the client cannot interpret or analyze visual information. Which part of the brain does the nurse identify as being damaged?
1)Frontal
2)Parietal
3)Occipital
4)Temporal

Answer 3

3

Question 4

The nurse administers IV recombinant tissue-type plasminogen activator (rt-PA) to a client diagnosed with an ischemic stroke. On further evaluation, the client still exhibits persistent vessel occlusion. Which treatment strategy does the nurse expect the health-care provider to prescribe?
1)Plan for a thrombectomy
2)Consult about an endarterectomy
3)Administer dabigatran (Pradaxa)
4)Start therapy with dipyridamole (Aggrenox)

Question 5

The nurse is providing care for a client admitted with a diagnosis of cerebrovascular accident. The client exhibits left-side deficits, memory deficits, and emotional breakdowns coupled with aggressive behaviors. Which area does the nurse identify as being affected based on assessment findings?
1)Frontal lobe
2)Parietal lobe
3)Temporal lobe
4)Occipital lobe

Question 6

The caregiver of a client tells a nurse the client has paralysis of the upper and lower left limbs on the right side. On assessment, the nurse finds motor and sensory loss in the client's limbs. Which diagnostic procedure does the nurse expect the health-care provider to prescribe?
1)Blood studies
2)Electrocardiogram
3)Magnetic resonance angiography (MRA)
4)Computed tomography (CT) scan with contrast

Question 7

The nurse is assessing a client with a diagnosis of cerebrovascular accident. The client is not able to determine the relationship between designated body parts and other body parts, which the nurse records as proprioception. Which lobe of the cerebrum does the nurse determine is involved?
1)Frontal lobe
2)Parietal lobe
3)Occipital lobe
4)Temporal lobe

Question 8

A computed tomography (CT) scan report for a client with a neurological disorder reveals the presence of bleeding in a specific area of the brain. On assessment, the nurse finds elevated blood pressure and cerebral edema. The health-care provider instructs the nurse to administer IV mannitol. Which condition does the nurse identify in the client?
1)Lacunar infarct
2)Ischemic stroke
3)Hemorrhagic stroke
4)Transient ischemic attack

Question 9

The nurse is assessing the visual fields in a client who was diagnosed with a stroke. The nurse uses the National Institutes of Health Stroke Scale (NIHSS) to document a score of 3 in the client's assessment records. Which condition is associated with the score?
1)No visual loss
2)Partial hemianopia
3)Bilateral hemianopia
4)Complete hemianopia

Question 10

The nurse is teaching a group of staff nurses about cerebrovascular disorders and associated pathophysiology. Which statement by an attending nurse requires correction?
1)"A small blood vessel infarction that is associated with hypertension is known as a lacunar infarct."
2)"The right atrium undergoes atrial fibrillation with stasis of blood and clot formation in an ischemic stroke."
3)"The ischemia of the brain is caused by a thromboembolism from carotid stenosis in a transient ischemic attack."
4)"The cerebral artery ruptures and causes a large amount of blood to compress the brain tissue in hemorrhagic shock."

Question 11

The nurse is providing care for a client admitted with a stroke. Which information and manifestation support the presence of an ischemic stroke?
1)Symptoms followed a contact injury
2)Medical history indicates chronic hypertension
3)Manifestations occurred over a period of hours
4)Diagnostic tests reveal increased cranial pressure

Question 12

The nurse is assessing the level of consciousness (LOC) of a client with a head injury. The client is totally unresponsive. What is the score using the National Institutes of Health Stroke Scale (NIHSS)? 1.0
2)1
3)2
4)3

Question 13

The nurse is reviewing the medical record of a client admitted with the diagnosis of an ischemic stroke involving the middle cerebral artery. For which reason does the nurse consider the client's condition to be serious?
1)Onset of deficits is sudden.
2)Treatment involves anticoagulants.
3)High risk of the condition recurring.
4)A large area of brain tissue is involved.

Question 14

The nurse instructs a client to show their teeth, raise their eyebrows, and squeeze their eyes shut. Which section of the National Institutes of Health Stroke Scale is the nurse using to evaluate the client?
1)Facial palsy
2)Best language
3)Level of consciousness (LOC)
4)Sensory response

Question 15

A nurse is caring for four clients diagnosed with different cerebrovascular disorders. Which client is most likely to require an endarterectomy surgical procedure to prevent the recurrence of the condition?
1)The client with lacunar infarct
2)The client with ischemic stroke
3)The client with hemorrhagic stroke
4)The client with transient ischemic attack (TIA)

Question 16

The nurse is providing care for a client diagnosed with a hemorrhagic stroke. Which part of the brain is at greatest risk for interrupting cardiac and respiratory functions?
1)The pons
2)The midbrain
3)The cerebellum
4)The medulla oblongata

Question 17

The nurse is providing care for a client recently diagnosed with a cerebrovascular accident. For which reason does the nurse check the function of cranial nerve XII before advancing the client's prescribed diet from to full liquid to soft?
1)Verify the sense of smell
2)Determine the gag reflex
3)Ensure presence of facial sensation
4)Confirm ability for tongue movement

Question 18

The nurse is examining a client involved in a motor vehicle accident. The client is unable to recall past events and places visited before the accident. Which lobe of the cerebrum does the nurse suspect has been injured?
1)Frontal lobe
2)Parietal lobes
3)Occipital lobes
4)Temporal lobes

Question 19

The nurse finds that a client has motor and sensory loss on the right side of the body. The diagnostic tests reveal ischemia and the confirmation of an ischemic stroke. Which additional finding indicates the client has ischemia in the left hemisphere?
1)Speech problem
2)Hearing problem
3)Learning problem
4)Smelling problem

Question 20

A nurse is caring for four clients who have different cerebrovascular disorders. Which client would require a magnetic resonance angiography (MRA) to accurately confirm the client's condition?
1)The client with a brain tumor
2)The client with a cerebral abscess
3)The client with a carotid artery aneurysm
4)The client with a brain stroke

Question 21

Which cranial nerves are associated with extraocular movements? Select all that apply.
1)Trochlear
2)Abducens
3)Trigeminal
4)Hypoglossal
5)Oculomotor

Question 22

A health-care provider instructs the nurse to administer thrombolytic therapy to a client diagnosed with an ischemic stroke. Which detail does the nurse check in the client's health history before administering the medication? Select all that apply.
1)A history of diabetes
2)A history of bleeding ulcers
3)A history of a recent head injury
4)A history of aspirin use
5)A history of warfarin (Coumadin) use

Question 23

The nurse is performing a neurological examination in a client diagnosed with a stroke. The nurse finds that the client does not answer correctly about birth month and age, but opens and closes both eyes as instructed. The nurse also notes the affected arm drifts to the left and right when elevated, and the client does not speak when asked to name any items. Based on the National Institute of Health Stroke Scale (NIHSS), what is the total score the nurse obtains from these findings? Record your answer as a whole number. ____________________.

Question 24

The nurse is preparing review material for staff nurses about cranial nerves and their functions. Which cranial nerves does the nurse plan to refer to as mixed cranial nerves? Select all that apply.
1)IV
2)VI
3)VII
4)IX
5)X

Question 25

The nurse is assessing an older adult client who has a history of a previous transient ischemic attack (TIA). The nurse finds elevated blood pressure and suspects injury to the trigeminal nerve. Which findings enable the nurse to suspect cranial nerve injury? Select all that apply.
1)Impaired chewing
2)Excessive salivation
3)No facial expressions
4)Loss of facial sensation
5)Decreased extraocular movements