A nurse in an emergency department is caring for a client who became unresponsive after stating she had a sudden, severe headache with vomiting and then seizure activity. The client's vital signs are as follows: blood pressure of 198/110 mm Hg pulse of 82 bpm, respirations of 24/min, and a temperature of 100.8 F (38.2° C). Which neurologic disorder would the nurse suspect?

Thrombotic stroke

Embolic stroke

Hemorrhagic stroke

Transient ischemic attack (TIA)

Answer and Explanation

The Correct Answer is C

A. Thrombotic stroke. A thrombotic stroke develops more gradually and is not typically associated with such sudden and severe symptoms.

B. Embolic stroke. An embolic stroke is often associated with a known embolic source, such as a clot from the heart, and can present more suddenly, but without all the symptoms seen here.

C. Hemorrhagic stroke: Hemorrhagic strokes often present with a sudden, severe headache, vomiting, seizure activity, and high blood pressure. A fever may also develop due to increased intracranial pressure.

D. Transient ischemic attack (TIA). TIAs are brief and resolve within minutes to hours and do not typically cause seizures.

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Correct Answer is D

Explanation

A. Propranolol: This is a beta-blocker, which may be used to control heart rate, but it does not address the risk of thromboembolism in atrial fibrillation.

B. Procainamide: This is an antiarrhythmic used for rhythm control, but it does not address stroke prevention in atrial fibrillation.

C. Aspirin: Although aspirin is sometimes used for stroke prevention, it is generally less effective than anticoagulation therapy in clients with higher CHA2DS2-VASC scores.

D. Warfarin: A CHA2DS2-VASC score of 2 indicates a moderate risk for stroke, and warfarin (or another anticoagulant) is indicated to reduce the risk of thromboembolic events.

A. Deficits in the right visual field B. Motor retardation C. Poor impulse control D. Unable to discriminate words and letters

Correct Answer is C

Explanation

A. Deficits in the right visual field: This would be associated with a left-sided stroke, as the right hemisphere controls the left visual field.

B. Motor retardation: This is not a specific sign of right hemisphere stroke. It might be seen with other types of strokes.

C. Poor impulse control: A right hemisphere stroke may cause behavioral changes, including impulsivity, poor judgment, and difficulty in regulating emotions.

D. Unable to discriminate words and letters: This would suggest aphasia, which is typically associated with left hemisphere damage, as the left hemisphere controls language.

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Naxlex Comprehensive Predictor Exams

The nurse is providing discharge instructions to a 76-year-old male client with chronic atrial fibrillation who has a CHA2DS2-VASC score of 2. Which medication would the nurse identify as most likely to be prescribed for the client?

Correct Answer is D

Explanation

A nurse is caring for a client who had a stroke involving the right cerebral hemisphere. The nurse should monitor the client for which finding?

Correct Answer is C

Explanation

A 55-year-old client who is diagnosed with an evolving myocardial infarction (MI) insists on going home. The nurse encourages the client to be admitted because he knows that within the first 24 hours of a MI, there is a high risk for which of the following?

A nurse is admitting a client who has acute heart failure following myocardial infarction (MI) Which order by the provider requires clarification by the nurse?

The nurse is teaching a class to a group of staff nurses about traumatic brain injury which condition would the nurse identify as having the highest risk of a fatal outcome within the first 24 hours post-injury?

The nurse is caring for a client with advanced coronary artery disease who has developed cardiac arrest. During the resuscitation, the health care provider prescribes atropine. Which is the intended outcome of this medication?

The nurse is assessing a client with a head injury Which finding would indicate that the client is developing diabetes insipidus?

The nurse is caring for a client who suffered a hemorrhagic stroke. In order to prevent increased intracranial pressure, the client should be placed in which position for the first 72 hours after the onset of a stroke?

The nurse is assessing a client with unstable angina. Which finding would the nurse expect the client to report that differentiates this from other types of anginas?