A patient arrives in the emergency department at 0200 exhibiting signs and symptoms of a stroke. The patient went to bed at 2300 and was "feeling fine" but woke up at 0100 to go to the restroom and fell on the way there. The CT scan shows a hemorrhagic stroke. For what reason would tPA therapy be withheld?

tPA is not delivered for hemorrhagic stroke.

The total effects of ischemia are not currently known.

Too much time has passed since the symptoms began.

The patient's symptoms have progressed too quickly.

Answer and Explanation

The Correct Answer is A

A. tPA is not delivered for hemorrhagic stroke: This is correct. tPA is a thrombolytic medication used for ischemic strokes, not haemorrhagic strokes, as it would exacerbate bleeding.
B. The total effects of ischemia are not currently known: While assessing the extent of ischemia is important for ischemic stroke, it is irrelevant here because the stroke is hemorrhagic.
C. Too much time has passed since the symptoms began: The time window is important for tPA in ischemic strokes, but in this case, the type of stroke (haemorrhagic) is the determining factor.
D. The patient's symptoms have progressed too quickly: The progression of symptoms does not affect the decision to use tPA; the contraindication is solely due to the hemorrhagic nature of the stroke.

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Free Nursing Study Resources

Correct Answer is C

Explanation

A. Dislocation injury: This refers to a joint being forced out of its normal position and is not related to strains.
B. Compression injury: This typically involves pressure that causes damage to a body part, such as crushing injuries, and does not describe a strain.
C. Muscle or tendon injury: A strain involves stretching or tearing of muscle or tendon fibers, making this the correct description of a strain.
D. Ligament injury: Injuries to ligaments are referred to as sprains, not strains.

A. “Take off work for the rest of the day to rest at home." B. "Return to work and have your blood pressure rechecked in 2 days." C. "Take two doses of blood pressure medication right now." D. "Sit quietly while we call 911 to request an ambulance."

Correct Answer is D

Explanation

A. “Take off work for the rest of the day to rest at home.": This advice is not adequate for such a high blood pressure reading, which indicates a hypertensive crisis that requires immediate medical intervention.
B. "Return to work and have your blood pressure rechecked in 2 days.": This is inappropriate as it delays necessary urgent medical evaluation and treatment.
C. "Take two doses of blood pressure medication right now.": Without medical supervision, this could be dangerous and is not appropriate in an emergency situation where the blood pressure is critically high.
D. "Sit quietly while we call 911 to request an ambulance.": A blood pressure of 220/120 mm Hg suggests a hypertensive emergency, which can lead to life-threatening complications like stroke or heart attack. The patient needs immediate medical attention, and calling 911 is the appropriate response.

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Naxlex Comprehensive Predictor Exams

Which statement best describes a strain?

Correct Answer is C

Explanation

During a health screening, a patient's blood pressure is confirmed by two clinic nurses to be 220/120 mm Hg. Which of the following actions should the nurse recommend to the patient?

Correct Answer is D

Explanation

The nurse is planning care for patients with hypertension. What side effect should be included with teaching about the beta blocker propranolol (Inderal)?

On which lifestyle modifications would the nurse reinforce teaching with the patient to reduce the risk of hypertension? Select all that apply.

When taking blood pressure medications, it is important to reinforce education with the patient on which topics? Select all that apply.

The nurse is caring for a patient suffering from left-sided hemianopsia after having a stroke. Which nursing diagnosis is priority for this patient?

Which factor would be the first step in the management of hypertension?

The nurse is teaching a patient with an abdominal aortic aneurysm (AAA) about activity. Which statement made by the patient indicates an understanding of the teaching?

A patient has been diagnosed with Raynaud's disease and asks the nurse what occurs with this disease. Which of the following is the most appropriate response?

The nurse is assisting with patients in an orthopedic unit. Which is an important factor to remember when caring for patients after a total hip replacement?