1. A patient is admitted with uncontrolled atrial fibrillation. The patient’s medication history includes vitamin D supplements and calcium. What type of stroke is this patient at MOST risk for?
A. Ischemic thrombosis
B. Ischemic embolism
C. Hemorrhagic
D. Ischemic stenosis
2. Which patient below is at most risk for a hemorrhagic stroke?
A. A 65 year old male patient with carotid stenosis.
B. A 89 year old female with atherosclerosis.
C. A 88 year old male with uncontrolled hypertension and a history of brain aneurysm repair 2 years ago.
D. A 55 year old female with atrial flutter.
3. You’re educating a patient about transient ischemic attacks (TIAs). Select all the options that are incorrect about this condition:
A. TIAs are caused by a temporary decrease in blood flow to the brain.
B. TIAs produce signs and symptoms that can last for several weeks to months.
C. A TIAs is a warning sign that an impending stroke may occur.
D. TIAs don’t require medical treatment.
4. A patient who suffered a stroke one month ago is experiencing hearing problems along with issues learning and showing emotion. On the MRI what lobe in the brain do you expect to be affected?
A. Frontal lobe
B. Occipital lobe
C. Parietal lobe
D. Temporal
5. A patient’s MRI imaging shows damage to the cerebellum a week after the patient suffered a stroke. What assessment findings would correlate with this MRI finding?
A. Vision problems
B. Balance impairment
C. Language difficulty
D. Impaired short-term memory
6. A patient is demonstrating signs and symptoms of stroke. The patient reports loss of vision. What area of the brain do you suspect is affected based on this finding?
A. Brain stem
B. Hippocampus
D. Occipital lobe
7. A patient has right side brain damage from a stroke. Select all the signs and symptoms that occurs with this type of stroke:
A. Right side hemiplegia
B. Confusion on date, time, and place
C. Aphasia
D. Unilateral neglect
E. Aware of limitations
F. Impulsive
G. Short attention span
H. Agraphia
8. You’re educating a group of nursing students about left side brain damage. Select all the signs and symptoms noted with this type of stroke:
A. Aphasia
B. Denial about limitations
C. Impaired math skills
D. Issues with seeing on the right side
E. Disoriented
F. Depression and anger
G. Impulsive
9. During discharge teaching for a patient who experienced a mild stroke, you are providing details on how to eliminate risk factors for experiencing another stroke. Which risk factors below for stroke are modifiable?
A. Smoking
B. Family history
C. Advanced age
D. Obesity
E. Sedentary lifestyle
10. Your patient who had a stroke has issues with understanding speech. What type of aphasia is this patient experiencing and what area of the brain is affected?
A. Expressive; Wernicke’s area
B. Receptive, Broca’s area
C. Expressive; hippocampus
D. Receptive; Wernicke’s area
11. Your patient has expressive aphasia. Select all the ways to effectively communicate with this patient?
A. Fill in the words for the patient they can’t say.
B. Don’t repeat questions.
C. Ask questions that require a simple response.
D. Use a communication board.
E. Discourage the patient from using words.
12. While conversing with a patient who had a stroke six months ago, you note their speech is hard to understand and slurred. This is known as:
A. Dysarthria
B. Apraxia
C. Alexia
D. Dysphagia
13. You’re reading the physician’s history and physical assessment report. You note the physician wrote that the patient has apraxia. What assessment finding in your morning assessment correlates with this condition?
A. The patient is unable to read.
B. The patient has limited vision in half of the visual field.
C. The patient is unable to wink or move his arm to scratch his skin.
D. The patient doesn’t recognize a pencil or television.
14. You need to obtain informed consent from a patient for a procedure. The patient experienced a stroke three months ago. The patient is unable to sign the consent form because he can’t write. This is known as what:
A. Agraphia
B. Alexia
C. Hemianopia
D. Apraxia
15. You’re assessing your patient’s pupil size and vision after a stroke. The patient says they can only see half of the objects in the room. You document this finding as:
A. Hemianopia
B. Opticopsia
D. Dysoptic
16. A patient who has hemianopia is at risk for injury. What can you educate the patient to perform regularly to prevent injury?
A. Wearing anti-embolism stockings daily
B. Consume soft foods and tuck in chin while swallowing
C. Scanning the room from side to side frequently
D. Muscle training
17. You receive a patient who is suspected of experiencing a stroke from EMS. You conduct a stroke assessment with the NIH Stroke Scale. The patient scores a 40. According to the scale, the result is:
A. No stroke symptoms
B. Severe stroke symptoms
C. Mild stroke symptoms
D. Moderate stroke symptoms
18. In order for tissue plasminogen activator (tPA) to be most effective in the treatment of stroke, it must be administered?
A. 6 hours after the onset of stroke symptoms
B. 3 hours before the onset of stroke symptoms
C. 3 hours after the onset of stroke symptoms
D. 12 hours before the onset of stroke symptoms
19. Which patients are NOT a candidate for tissue plasminogen activator (tPA) for the treatment of stroke?
A. A patient with a CT scan that is negative.
B. A patient whose blood pressure is 200/110.
C. A patient who is showing signs and symptoms of ischemic stroke.
D. A patient who received Heparin 24 hours ago.
20. You’re assisting a patient who has right side hemiparesis and dysphagia with eating. It is very important to:
A. Keep the head of bed less than 30′.
B. Check for pouching of food in the right cheek.
C. Prevent aspiration by thinning the liquids.
D. Have the patient extend the neck upward away from the chest while eating.
21. A patient has experienced right side brain damage. You note the patient is experiencing neglect syndrome. What nursing intervention will you include in the patient’s plan of care?
A. Remind the patient to use and touch both sides of the body daily.
B. Offer the patient a soft mechanical diet with honey thick liquids.
C. Ask direct questions that require one word responses.
D. Offer the bedpan and bedside commode every 2 hours.
