A nurse is caring for a 46-year-old patient who has had a major ischemic stroke in the last 25 minutes.
The patient’s vital signs are: Temp 98.7, HR: 98, RR: 28, BP: 165/98. Which medication does the nurse anticipate the doctor will order?
Tissue plasminogen activator (tPA)
Ibuprofen
Aspirin
Warfarin
The Correct Answer is A
Choice A rationale
In the case of a major ischemic stroke, the medication that a nurse would anticipate the doctor to order is tissue plasminogen activator (tPA)8. This medication works by dissolving the clot that is blocking blood flow to the brain. It is most effective when given as soon as possible after the onset of stroke symptoms.
Choice B rationale
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that is used to relieve pain and reduce inflammation. It is not typically used in the treatment of ischemic stroke.
Choice C rationale
Aspirin is an antiplatelet drug that is sometimes used in the prevention of stroke. However, it is not typically used as an immediate treatment for a major ischemic stroke.
Choice D rationale
Warfarin is an anticoagulant medication that is used to prevent blood clots from forming or growing larger. It is not typically used as an immediate treatment for a major ischemic stroke.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Assessing lung sounds is an important part of monitoring a patient’s respiratory status, but it may not be the most immediate action if the patient is finding it increasingly difficult to breathe.
Choice B rationale
While explaining the progression of the syndrome is important for patient education, it may not be the most immediate action if the patient is experiencing difficulty breathing.
Choice C rationale
Guillain-Barre syndrome can affect the muscles used for breathing, resulting in a weakened or paralyzed diaphragm, which can lead to an ineffective breathing pattern. Therefore, if a patient states that it is getting harder to take a deep breath, the nurse should call the physician and prepare for possible intubation.
Choice D rationale
Encouraging the client to cough may not be the most appropriate action if the patient is finding it increasingly difficult to breathe.
Correct Answer is B
Explanation
Choice A rationale
While hypertension is a risk factor for stroke, it is a modifiable risk factor. This means it can be controlled and managed through lifestyle changes and medication.
Choice B rationale
Family history is a non-modifiable risk factor for stroke. If a close family member, like a parent or sibling, has had a stroke, a person’s risk of stroke is slightly higher.
Choice C rationale
Smoking is a modifiable risk factor for stroke. Quitting smoking can significantly reduce the risk of stroke.
Choice D rationale
Obesity is a modifiable risk factor for stroke. Maintaining a healthy weight through diet and regular exercise can help reduce the risk of stroke.
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