Tia Lauren, a 95 year-old female, presents to the Emergency Department (ED) with, what daughter thought, were stroke-like symptoms that began approximately 6 hours ago. She is brought in by her daughter who she lives with. Her daughter states the symptoms are starting to go away. The daughter also states that maybe she made a mistake thinking her mom may have had a stroke since the symptoms are resolving.
What type of stroke is the patient most likely experiencing and which of the following are common symptoms? (Select all that apply)
Transient Ischemic Attack (TIA)
Hemorrhagic Stroke
Severe vision loss in both eyes
Sudden loss of consciousness
Sudden severe headache with vomiting
Ischemic Stroke
Sudden weakness or numbness, often on one side of the body
Correct Answer : A,G
A. Transient Ischemic Attack (TIA): A TIA presents with stroke-like symptoms that resolve within minutes to hours without permanent damage. Ms. Lauren’s symptom resolution within 6 hours and return to baseline strongly suggests a TIA. Prompt recognition is essential, as TIAs are often precursors to future strokes and require further evaluation.
B. Hemorrhagic Stroke: Hemorrhagic strokes typically present with sudden, severe symptoms such as intense headache, vomiting, or rapid loss of consciousness. These symptoms usually do not resolve quickly. Ms. Lauren’s gradual symptom resolution and stable vital signs are not consistent with this type of stroke.
C. Severe vision loss in both eyes: While visual disturbances can occur during strokes, bilateral severe vision loss is less common and would typically be seen in strokes involving the occipital lobes or vertebrobasilar system. Ms. Lauren’s case does not provide evidence of this symptom, hence an unlikely feature here.
D. Sudden loss of consciousness: Loss of consciousness is more common in massive strokes, particularly hemorrhagic ones or those involving the brainstem. Ms. Lauren remained awake and was able to report symptoms and anxiety, which rules out this presentation.
E. Sudden severe headache with vomiting: This symptom combination is more typical of a hemorrhagic stroke or subarachnoid hemorrhage. Ms. Lauren did not report a headache or vomiting, which makes this an unlikely symptom in her current presentation.
F. Ischemic Stroke: Ischemic strokes result in prolonged neurological deficits lasting more than 24 hours. Since Ms. Lauren’s symptoms are resolving within a short window and she is returning to baseline, this is less likely than a TIA in her situation.
G. Sudden weakness or numbness, often on one side of the body: This is a hallmark sign of a TIA or stroke. Ms. Lauren’s initial symptoms were stroke-like and likely included unilateral weakness or numbness, which are classic indicators of a TIA.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Brain, blood, cerebrospinal fluid (CSF): These are the three main components within the cranial vault as described by the Monro-Kellie doctrine. The total volume of these components remains constant, and any increase in one must be offset by a decrease in another to prevent elevated ICP.
B. Cerebrospinal fluid (CSF), blood, oxygen: While CSF and blood are intracranial components, oxygen is not a physical substance occupying volume in the cranial cavity. It is transported within the blood and does not contribute to changes in ICP in terms of physical space.
C. Brain, cerebrospinal fluid (CSF), air: Air is not a normal component of the cranial cavity. The presence of air would indicate pathology, such as a skull fracture with pneumocephalus, which is abnormal and can contribute to increased ICP but is not a standard component.
D. Brain, blood, lymphatic fluid: While the brain and blood are correct components, the central nervous system, including the brain, does not have a conventional lymphatic system like other parts of the body. Waste products are primarily cleared by the glymphatic system, which utilizes CSF, rather than traditional lymphatic fluid.
Correct Answer is B
Explanation
A. Primary disorders affect hormone receptors, while secondary disorders affect hormone production: While receptor sensitivity may play a role in some conditions, the main distinction between primary and secondary endocrine disorders is based on the location of dysfunction, not receptor or hormone function alone.
B. Primary disorders originate in the target organ, while secondary disorders originate in the pituitary gland or hypothalamus: In primary disorders, the problem lies in the endocrine gland itself (e.g., the thyroid gland in primary hypothyroidism), while secondary disorders result from dysfunction in regulatory centers like the pituitary or hypothalamus.
C. Primary disorders involve the hypothalamus, while secondary disorders involve the target organ: This reverses the correct relationship. Secondary disorders typically involve the hypothalamus or pituitary, not primary disorders.
D. Primary disorders are caused by external factors, while secondary disorders are caused by genetic mutations: While both external and genetic factors can contribute to endocrine disorders, this distinction does not define the difference between primary and secondary types. The classification is based on the anatomical source of dysfunction.
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