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","B","C","E"]
Explanation
A. Blood glucose levels in DKA are typically higher than in HHS: In fact, HHS usually presents with higher blood glucose levels than DKA—often exceeding 600 mg/dL, while DKA typically ranges from 250 to 600 mg/dL.
B. DKA involves significant ketosis and metabolic acidosis, while HHS typically does not: DKA is characterized by the breakdown of fats into ketones, leading to metabolic acidosis. HHS typically lacks significant ketosis because insulin levels, while low, are still sufficient to suppress ketogenesis.
C. DKA is more common in type 1 diabetes, while HHS is more common in type 2 diabetes: DKA usually occurs in individuals with type 1 diabetes due to absolute insulin deficiency. HHS is more often seen in type 2 diabetics who still produce some insulin but not enough to prevent severe hyperglycemia and dehydration.
D. None of the above: This choice is incorrect, as B, C, and E are valid differences between DKA and HHS.
E. HHS patients often have more severe dehydration than DKA patients: HHS leads to profound osmotic diuresis over a longer period, causing extreme dehydration. DKA progresses faster but with less total fluid loss compared to HHS.
Correct Answer is C
Explanation
A. Bruton's disorder: Also known as X-linked agammaglobulinemia, this is a primary immunodeficiency that results in absent or reduced B cells and recurrent bacterial infections. It does not involve distinct facial features or limb defects as described in the question.
B. SCID: Severe Combined Immunodeficiency involves profound defects in both B and T lymphocyte function, leading to severe infections early in life. It is not associated with the described craniofacial abnormalities or limb deformities.
C. Potter syndrome: This condition is caused by severe oligohydramnios, often due to bilateral renal agenesis, and leads to characteristic physical features including widely spaced eyes with epicanthic folds, low-set ears, a broad or beaked nose, a receding chin, and limb deformities.
D. Down Syndrome: While individuals with Down Syndrome often have characteristic facial features such as upslanting palpebral fissures, flat nasal bridges, and low-set ears, they typically do not have beak-like noses, receding chins, or limb defects in the way described.
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