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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Correct Answer is ["A","C","D"]

Explanation

A. Paresthesia: Numbness or tingling sensations (paresthesia) can occur due to decreased blood supply and nerve function.
B. Pruritus: Itching (pruritus) is not typically associated with arterial occlusion. It is more often related to skin conditions or allergies.
C. Pain: Pain is a hallmark symptom of arterial occlusion, often described as severe and sudden, due to tissue ischemia.
D. Pallor: Affected limbs or areas may appear pale (pallor) because of reduced blood flow.
E. Palpitations: Palpitations are not a direct symptom of arterial occlusion. They are more related to cardiac conditions.

A. Cigarette smoking B. Physical inactivity C. Family history of stroke D. Obesity E. Age

Correct Answer is ["A","B","D"]

Explanation

A. Cigarette smoking: This is correct. Smoking is a significant modifiable risk factor for stroke because it contributes to atherosclerosis and other cardiovascular issues.
B. Physical inactivity: This is correct. Regular physical activity reduces the risk of stroke by improving cardiovascular health and reducing other risk factors such as hypertension and obesity.
C. Family history of stroke: This is not modifiable. While family history increases risk, it cannot be changed. However, knowing this risk can prompt proactive management of modifiable factors.
D. Obesity: This is correct. Obesity is a modifiable risk factor for stroke because it is associated with other risks such as hypertension, diabetes, and hyperlipidemia. Weight loss and healthy lifestyle changes can reduce stroke risk.
E. Age: This is not modifiable. While older age increases stroke risk, it is a factor that cannot be changed.

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Naxlex Comprehensive Predictor Exams

Which of the following are clinical manifestations of arterial occlusion? Select all that apply.

Correct Answer is ["A","C","D"]

Explanation

Which risk factors would be considered modifiable in the prevention of stroke? Select all that apply.

Correct Answer is ["A","B","D"]

Explanation

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

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?

The nurse explains to the patient that blood pressure measures

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The nurse is assisting with the care of a patient with rheumatoid arthritis (RA). What should the nurse consider when providing care?

The nurse is providing education about the warning signs of stroke to a nursing student. Which information would be appropriate for the nurse to include in the teaching?

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?