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 D
Explanation
A. Acute renal disease–acute glomerulonephritis: This leads to inflammation and damage of the glomerular basement membrane, impairing filtration and causing intrarenal injury. It often presents with hematuria, proteinuria, and hypertension.
B. Exposure to nephrotoxic drugs, heavy metals, and organic solvents: These substances damage renal tubules through direct toxicity or by causing crystal formation, leading to acute tubular necrosis. Common agents include aminoglycosides and contrast dyes.
C. Prolonged renal ischemia: Sustained low perfusion causes tubular cell death and sloughing, leading to obstruction and decreased GFR. It is often a progression from untreated prerenal AKI.
D. Liver failure: Liver dysfunction reduces renal perfusion and may cause hepatorenal syndrome, but this is classified as prerenal, not intrarenal, in origin. The kidneys are structurally intact but functionally impaired.
Correct Answer is D
Explanation
A. High fiber diet, laxatives, increased water intake, increased reflex for defecation: These factors promote healthy bowel movements. Fiber adds bulk to stool, water softens it, laxatives stimulate movement, and an intact defecation reflex supports regular elimination, all of which prevent constipation.
B. Decreased fiber diet, decreased water intake, decreased reflex for defecation: These are contributing factors to constipation. However, it leaves out other significant causes like medications and medical conditions that impair bowel function.
C. Increased fiber diet, increased hydration, increased reflex for defecation, medications, absence of disease processes: Fiber, hydration, absence of disease and a strong reflex help prevent constipation. However, medications like opioids and anticholinergics often cause constipation regardless of diet and hydration.
D. Decreased fiber diet, decreased hydration, decreased reflex for defecation, medications, disease processes: A low-fiber diet and poor hydration lead to hard stools. A weak defecation reflex can result from neurological decline. Medications and chronic diseases such as diabetes or hypothyroidism can slow intestinal motility.
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