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 B
Explanation
Choice B rationale
Patients who experience severe cluster headaches should be instructed to take medications as soon as they sense the onset of symptoms. Cluster headaches are characterized by severe, debilitating pain that reaches peak intensity within a short period of time, often within 15 minutes. Therefore, early intervention is crucial to manage the pain effectively.
Choice A rationale
Waiting twenty to thirty minutes after the onset of symptoms to take medications may not be effective for cluster headaches. The pain of a cluster headache often reaches peak intensity within 15 minutes, so delaying medication could result in unnecessary suffering.
Choice C rationale
Waiting until the patient’s pain becomes unbearable is not recommended for managing cluster headaches. The goal of treatment is to prevent or reduce pain, not to wait until it becomes unbearable.
Choice D rationale
Taking medications when the patient senses their symptoms are peaking is not the most effective strategy for managing cluster headaches. Given the rapid onset and severe pain associated with cluster headaches, medications should be taken as soon as the patient senses the onset of symptoms.
Correct Answer is A
Explanation
Choice A rationale
After a lumbar puncture, it is important for the patient to lie flat for approximately 6 hours. This position helps to prevent headaches that can occur after the procedure, which are caused by leakage of cerebrospinal fluid at the needle puncture site. Lying flat allows the puncture site to seal and prevents the leakage of cerebrospinal fluid.
Choice B rationale
Having the patient lie in a semi-Fowler’s position with the head of the bed at 35 degrees is not typically recommended immediately after a lumbar puncture. This position could potentially increase the risk of a post-lumbar puncture headache.
Choice C rationale
Early ambulation is not recommended after a lumbar puncture. Moving around too soon after the procedure can increase the risk of a headache and may also increase the risk of complications at the puncture site.
Choice D rationale
Having the patient lie flat for 1 hour, then sit up for 1 hour before ambulating is not a typical recommendation after a lumbar puncture. The standard recommendation is to have the patient lie flat for approximately 6 hours to reduce the risk of complications.
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