A patient is being admitted with a possible stroke. Which information from the assessment indicates that the nurse should consult with the health care provider before giving a prescribed dose of aspirin?

The patient has dysphasia.

The patient has atrial fibrillation.

The patient has a history of brief episodes of right-sided hemiplegia.

The patient reports that symptoms began with a severe headache.

Answer and Explanation

The Correct Answer is D

A. The patient has dysphasia: Dysphasia (difficulty with speech) is a common symptom of stroke but does not contraindicate the use of aspirin for acute ischemic stroke management. Aspirin is routinely administered in the acute phase of ischemic stroke to prevent further clot formation.

B. The patient has atrial fibrillation: Atrial fibrillation increases the risk of embolic strokes, and aspirin may be used for stroke prevention in certain cases. However, the presence of atrial fibrillation alone does not indicate a contraindication to aspirin administration in the acute setting of a suspected stroke.

C. The patient has a history of brief episodes of right-sided hemiplegia: A history of transient ischemic attacks (TIAs) or brief episodes of hemiplegia suggests a risk factor for stroke but does not necessarily contraindicate the use of aspirin in the acute phase of stroke
management. Aspirin is commonly used for secondary prevention after TIAs or minor strokes.

D. The patient reports that symptoms began with a severe headache: Severe headache as the initial symptom of stroke raises concerns about a possible hemorrhagic stroke rather than an ischemic stroke. Administration of aspirin in the setting of a hemorrhagic stroke can worsen bleeding and increase morbidity and mortality. Therefore, the nurse should consult with the healthcare provider before giving aspirin to determine the appropriate course of action based on the patient's presentation and diagnostic evaluation.

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Correct Answer is A

Explanation

A. Paraplegia: Paraplegia is the paralysis of the lower extremities and possibly the trunk, which can occur with a spinal cord injury at the level of the T2-T3 vertebrae.

B. Paresthesia: Paresthesia refers to abnormal sensations such as tingling or numbness and is not typically associated with a spinal cord injury at the T2-T3 level. It may occur with nerve damage but is not the primary disability anticipated in this scenario.

C. Quadriplegia: Quadriplegia, also known as tetraplegia, involves paralysis of all four limbs and the trunk. It is more commonly associated with injuries at higher levels of the spinal cord, such as cervical injuries.

D. Hemiplegia: Hemiplegia involves paralysis of one side of the body and is typically caused by a stroke or brain injury, not a spinal cord injury at the T2-T3 level.

A. Observe the client's ability to smile and frown. B. Instruct the client to look up and down without moving his head. C. Ask the client to shrug his shoulders against passive resistance. D. Have the client stand with eyes his closed and touch his nose.

Correct Answer is B

Explanation

A. Observe the client's ability to smile and frown: This assessment is related to cranial nerve VII (facial nerve), which controls facial expressions.
B. Instruct the client to look up and down without moving his head: Cranial nerve III (oculomotor nerve) controls eye movements, including upward and downward gaze. Asking the client to look up and down without moving the head assesses the function of this nerve.

C. Ask the client to shrug his shoulders against passive resistance: This assessment is related to cranial nerve XI (accessory nerve), which innervates the trapezius and sternocleidomastoid muscles involved in shoulder shrugging.

D. Have the client stand with eyes his closed and touch his nose: This assessment is part of the cerebellar function test and assesses coordination and proprioception but does not specifically assess cranial nerve III.

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A patient is being admitted with a possible stroke. Which information from the assessment indicates that the nurse should consult with the health care provider before giving a prescribed dose of aspirin?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is B

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