Chapter 62 Management of Patients With Cerebrovascular Disorders

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Chapter 62  Management of Patients With Cerebrovascular Disorders

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

Multiple Choice

1. A patient has had an ischemic stroke and has been admitted to your unit. You know the importance of the principles of body alignment and correct positioning to stroke victims. What would you do to prevent joint deformities?
A) Place the patient in the prone position, laying flat, for 30 minutes/day

B) Assist the patient in acutely flexing the thigh to promote movement C) Place a pillow in the axilla when there is limited external rotation D) Place patient’s hand in pronation

Ans: C
Chapter: 62
Client Needs: A-1
Cognitive Level: Application Difficulty: Moderate
Integrated Process: Nursing Process Objective: 4
Page and Header: 1904, Ischemic Stroke

Feedback: A pillow in the axilla prevents adduction of the affected shoulder and keeps the arm away from the chest. The prone position with a pillow under the pelvis, not flat, promotes hyperextension of the hip joints, essential for normal gait. To promote venous return and prevent

edema, the upper thigh should not be flexed acutely. The hand is placed in slight supination, not pronation, which is its most functional position.

2. A patient diagnosed with TIAs is scheduled for a carotid endarterectomy. The nurse explains that this procedure will be done to what?
A) Decrease cerebral edema
B) Prevent seizure activity that is common following a TIA

C) Prevent a stroke by removing atherosclerotic plaques blocking cerebral flow D) Determine the cause of the TIA

Ans: C
Chapter: 62
Client Needs: D-1
Cognitive Level: Knowledge
Difficulty: Easy
Integrated Process: Teaching/Learning Objective: 3
Page and Header: 1902, Ischemic Stroke

Feedback: The main surgical procedure for select patients with TIAs is carotid endarterectomy, the removal of an atherosclerotic plaque or thrombus from the carotid artery to prevent stroke in patients with occlusive disease of the extracranial arteries. An endarterectomy does not decrease cerebral edema, prevent seizure activity, or determine the cause of a TIA.

3. The nurse is discharging home a patient who suffered a stroke. He has a flaccid right arm and leg and is experiencing problems with urinary incontinence. The nurse makes a referral to the Home Health Nurse because they are aware that the most common patient response to a change in body image is what?

A) Denial
B) Sexual dysfunction C) Depression
D) Disassociation

Ans: C
Chapter: 62
Client Needs: C
Cognitive Level: Knowledge Difficulty: Moderate
Integrated Process: Nursing Process Objective: 7

Page and Header: 1909, Ischemic Stroke

Feedback: Depression is a common and serious problem in the stroke patient. It can result from a profound disruption in his or her life and changes in total function, leaving the patient with a loss of independence. The nurse needs to encourage the patient to verbalize feelings to assess the effect of the stroke on self-esteem. A patient who had a stroke may be concerned about loss of sexual function. Denial and disassociation are not the most common patient response to a change in body image.

4. When caring for a patient who had a hemorrhagic stroke, close monitoring of vital signs and neurologic changes is imperative. What is the earliest sign of deterioration in a patient with a hemorrhagic stroke?
A) Headache

B) Alteration in level of consciousness C) Tonic-clonic seizures
D) Shortness of breath

Ans: B
Chapter: 62
Client Needs: D-1
Cognitive Level: Knowledge
Difficulty: Moderate
Integrated Process: Nursing Process Objective: 6
Page and Header: 1914, Hemorrhagic Stroke

Feedback: Alteration in level of consciousness is the earliest sign of deterioration in a patient with a hemorrhagic stroke such as mild drowsiness, slight slurring of speech, and sluggish papillary reaction. Therefore options A, C, and D are incorrect.

5. The nurse is performing stroke risk screenings at a hospital open house. Identification of high risk individuals is the goal of the screenings. The nurse has identified four patients who might be at risk for a stroke. Which patient is at highest risk for a stroke?
A) White female, age 60, with history of excessive alcohol intake

B) White male, age 60, with history of uncontrolled hypertension C) Black male, age 60, with history of diabetes
D) Black male, age 50, with history of smoking

Ans: B Chapter: 62

Client Needs: B
Cognitive Level: Knowledge
Difficulty: Moderate
Integrated Process: Teaching/Learning Objective: 2
Page and Header: 1899, Ischemic Stroke

Feedback: Uncontrolled hypertension is the primary cause of a hemorrhagic stroke. Control of hypertension, especially in individuals over 55 years of age, clearly reduces the risk for hemorrhagic stroke. Additional risk factors are increased age, male gender, and excessive alcohol intake. Another high-risk group is African Americans, where the incidence of first stroke is almost twice that in Caucasians. Modifiable risk factors for ischemic stroke include hypertension, atrial fibrillation, hyperlipidemia, obesity, smoking, and diabetes.

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