Deck 38: Caring for Clients With Cerebrovascular Disorders

Question 1

A client who is at high-risk for a cerebrovascular accident has medication ordered to lower their cholesterol and to prophylactically anticoagulate them. What specific agent might be diagnosed for this client?

A) Daily aspirin
B) Heparin
C) Victorin
D) Celebrex

Answer 1

Daily aspirin

Question 2

A client tells the nurse that they have transient ischemic attacks. The client reports having undergone a carotid artery surgery. In such a case, what important assessments should be performed by the nurse?

A) Sexual history
B) Motor and sensory responses
C) Blood pressure and weight
D) Frequent neurologic checks

Answer 2

Frequent neurologic checks

Question 3

You are caring for a client admitted with a stroke. Imaging studies indicate an embolus partially obstructing the right carotid artery. What type of stroke do you know this client has?

A) Ischemic
B) Hemorrhagic
C) Right-sided
D) Left-sided

Answer 3

Ischemic

Question 4

A client presents to the walk-in clinic complaining of a migraine. The client is prescribed a neuronal stabilizer. What should the nurse suggest to the client?

A) Avoid crowds.
B) Take drugs only after meals at night.
C) Avoid caffeine and alcohol.
D) Use caution while driving or performing hazardous activities.

Question 5

A client is diagnosed with tension headaches. The nurse recommends massage as a treatment for tension headaches. How does massage help clients with tension headaches?

A) Reduces hypotension
B) Increases appetite
C) Relaxes muscles
D) Relieves migraines

Question 6

During a class on stroke, a junior nursing student asks what the clinical manifestations of stroke are. What would be the instructor's best answer?

A) "Clinical manifestations of a stroke are highly variable, depending on the cardiovascular health of the client."
B) "Clinical manifestations of a stroke depend on the area of the cortex, the affected hemisphere, the degree of blockage, and the availability of collateral circulation."
C) "Clinical manifestations of a stroke generally include aphasia, one-sided flaccidity, and trouble swallowing."
D) "Clinical manifestations of a stroke depend on how quickly the clot can be dissolved."

Question 7

A diabetic client is hospitalized with a TIA. When planning this client's discharge teaching the nurse knows to include which of the following?

A) Signs and symptoms of hyperglycemia
B) Techniques to control blood sugar within normal ranges
C) Signs and symptoms of hypoglycemia
D) How to inject insulin

Question 8

You are caring for a client with chronic migraines who is prescribed medication. What drug-related instructions should the nurse give the client?

A) Take medication just before going to bed at night.
B) Take medication only when migraine is intense.
C) Take medication as soon as symptoms of the migraine begin.
D) Take medication only during the morning when it's calm and quiet.

Question 9

While making your initial rounds after coming on shift, you find a client thrashing about in bed complaining of a severe headache. The client tells you the pain is behind their right eye which is red and tearing. What type of headache would you suspect this client of having?

A) Migraine
B) Tension
C) Cluster
D) Sinus

Question 10

The nurse is caring for a client with a cerebral aneurysm. Why does the nurse limit the interaction of visitors or family members with the client with an aneurysm?

A) The interaction may cause the client to become violent.
B) The interaction may cause migraine in the client.
C) The stimulation can increase intracranial pressure (ICP) or trigger a seizure.
D) The client may become emotional and lose interest in the treatment.

Question 11

A client, prone to cerebrovascular accidents (CVAs), complains of not being able to breathe freely after swallowing food. What measures can the nurse take to help the client breathe freely?

A) Perform the Heimlich maneuver on the client.
B) Provide adequate water or fluids to the client.
C) Suction the mouth or the pharynx of the client.
D) Perform the Valsalva maneuver on the client.

Question 12

A client diagnosed with migraine headaches asks the nurse what they can do to help control the headaches and minimize the number of attacks they are having. What instructions should the nurse give this client?

A) Identify and avoid factors that precipitate or intensify an attack.
B) Keep a record of activities following an attack.
C) When an attack occurs stay in a brightly lit area.
D) Write down any adverse drug effects.

Question 13

The nursing instructor is discussing cerebral aneurysms with the junior nursing class. The instructor is talking about medications given to clients with aneurysms. What substances would the instructor tell the students should not be administered to clients with an aneurysm who experience pain?

A) Corticosteroids
B) Opioid analgesics
C) Anticonvulsants
D) Tranquilizers or barbiturates

Question 14

A community health nurse is presenting a talk on cerebrovascular accidents (or strokes) to a local community group. What signs and symptoms of an impending stroke should the nurse include in her presentation? Select all that apply.

A) Hypersensitivity to light
B) Mental confusion
C) Difficulty understanding
D) Impaired coordination
E) Mild headache

Question 15

A critical care nurse is caring for a client with a cerebrovascular accident (CVA) The client is prescribed heparin for treatment. The nurse knows to monitor the client for what adverse effects?

A) Migraine attacks
B) Hemorrhage
C) Respiratory distress
D) High blood pressure

Question 16

A family member comes to the clinic to talk to the nurse about a client who has had a stroke on the right side of the brain. The family member is concerned because of the deficits the client is exhibiting. The nurse knows that when a client experiences a stroke on the right side of the brain common deficits include what? Select all that apply.

A) Left-sided hemiplegia
B) Tendency to distractibility
C) Impairment of long-term memory
D) Hyperaware of deficits
E) Neglect of objects and people on the left side

Question 17

A client is admitted to the Emergency Department with a ruptured cerebral aneurysm. What are the dangers to the client from this ruptured aneurysm? Select all that apply.

A) Disruption of nerve impulses to the brain
B) Building of collateral circulation
C) Interruption of oxygenated blood flow to cells and tissues
D) Neurologic changes from increased ICP
E) Blood collecting in the subarachnoid space

Question 18

A client has just been diagnosed with an aneurysm. In planning discharge teaching for this client, what instructions should be delivered by the nurse to the client?

A) Avoid heavy lifting.
B) Include peanut butter, bread, or tart foods in the diet.
C) Take opioid analgesics.
D) Take an herbal form of feverfew.

Question 19

A client is prescribed warfarin. Client teaching has included instructions to maintain a diet rich in foods that contain vitamin K. What sources of food should the nurse instruct the client to eat?

A) Fish, meats, and vegetable oils
B) Citrus fruits
C) Milk and dairy products
D) Cereals, soybeans, and spinach

Question 20

A client is hospitalized when they present to the Emergency Department with right-sided weakness. Within 6 hours of being admitted, the neurologic deficits had resolved and the client was back to their presymptomatic state. The nurse caring for the client knows that the probable cause of the neurologic deficit was what?

A) Left-sided stroke
B) Right-sided stroke
C) Cerebral aneurysm
D) Transient ischemic attack

Question 21

A 76-year-old male client is brought to the clinic by his daughter. The daughter states that her father has had 2 transient ischemic attacks (TIAs) in the past week. The physician orders carotid angiography, and the report reveals that the carotid artery has been narrowed by atherosclerotic plaques. What treatment option does the nurse expect the physician to offer this client to increase blood flow to the brain?

A) Stint placement
B) Removal of the carotid artery
C) Percutaneous transluminal coronary artery angioplasty
D) Carotid endarterectomy

Question 22

You are admitting a client with a cerebral aneurysm who is going to surgery in the morning. You know that you should ask this client what questions?

A) Extensive questions on history of present symptoms
B) Limited questions on family cerebrovascular history
C) Obtain history from family
D) Only essential questions limited to current symptoms

Question 23

The geriatric advanced practice nurse (APN) is doing client teaching with a client who has had a cerebrovascular accident (CVA) and the client's family. One concern the APN addresses is a potential for falls related to the CVA and resulting muscle weakness. What would be most important for the APN to include in teaching of the client and family related to this concern?

A) Leg exercises to strengthen muscle weakness.
B) Need for support group due to decreased self image related to restricted mobility.
C) Remove throw rugs and electrical cords from home environment.
D) Use of tripod cane.

Question 24

A client has had a stroke and now has right-sided hemiplegia. What other deficits might this client experience? Select all that apply.

A) Defects in right visual fields
B) Denial of deficits
C) Need for frequent reminding to complete tasks
D) Problems with abstract thinking, such as conceptualizing and generalizing
E) Impetuous behavior