Which statement is accurate about the recommendations for BP management after an ischemic stroke?

The BP must be lower than 130/70 mm Hg to receive fibrinolytic agents.

Elevated BPs are expected after a stroke, and drug therapy should be initiated.

A lower BP is a protective response to maintain cerebral perfusion.

Drugs to lower BP are recommended if the BP is 220/120 mm Hg or higher

Answer and Explanation

The Correct Answer is D

A.   The BP must be lower than 180/105 mm Hg to receive fibrinolytic agents, not 130/70 mm Hg.
B.   Elevated BPs are common immediately after a stroke, but drug therapy to lower BP is not initiated unless it reaches high levels (typically > 220/120 mm Hg).
C.   A lower BP does not act as a protective response; maintaining a higher BP can be necessary initially after a stroke to ensure adequate cerebral perfusion.

D.   If BP is 220/120 mm Hg or higher after ischemic stroke, aggressive antihypertensive therapy is initiated to reduce the risk of hemorrhagic transformation and other complications.

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Correct Answer is D

Explanation

A. A ventriculostomy involves inserting a catheter into the ventricles of the brain to monitor ICP, not a procedure for instilling drugs.
B. A ventriculostomy involves the insertion of a catheter to monitor ICP, not an internal transducer.
C. Cerebrospinal fluid (CSF) samples can be taken via ventriculostomy; the procedure does not prevent this.
D. A ventriculostomy measures the pressure within the brain’s ventricles to monitor intracranial
pressure, which is the correct understanding.

A. Place food in the affected side of the mouth. B. Place the client with the head reclined back to facilitate swallowing. C. Encourage brief exercise before meals to promote appetite. D. Encourage the client to take small bites.

Correct Answer is D

Explanation

A. The nurse should instruct family members to place food on the unaffected side of the mouth to avoid choking or aspiration.
B. Reclining the head back can make swallowing more difficult. The client should be positioned upright to facilitate safe swallowing.
C. Exercise before meals may not be beneficial for a stroke patient with dysphagia.
D. Taking small bites helps reduce the risk of aspiration and choking and facilitates safer swallowing.

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Which statement is accurate about the recommendations for BP management after an ischemic stroke?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

After receiving pre procedural instructions, which patient statement demonstrates an understanding of a scheduled ventriculostomy?

Correct Answer is D

Explanation

A nurse is instructing a client's family members about feeding safety for a client who has dysphagia following a stroke. Which of the following instructions should the nurse include?

Correct Answer is D

Explanation

A nurse is caring for a client who had a stroke involving the left cerebral hemisphere. The nurse should monitor for which of the following findings?

A nurse observes a patient whose right eye is fixed and dilated, for which cranial nerve (CN) would the nurse suspect nerve compression?

A nurse is teaching the partner of a client who had a stroke about dysphagia. Which of the following statements by the client's partner should indicate to the nurse that the teaching was effective?

A nurse is monitoring a client who had a cerebral aneurysm rupture. Which of the following findings should the nurse identify as a manifestation of increased intracranial pressure?

A nurse is taking care of a client who has sustained a neurologic injury with increased intracranial pressure and decreased cerebral perfusion. Which of the following will keep cerebral perfusion pressure constant?

For the patient who wears contact lenses, which intervention would the nurse teach the patient when diagnoses with bacterial conjunctivitis?

Which condition would the nurse associate with an infection of a sebaceous gland when the patient presents with a small, white, superficial nodule on the margin of the eyelid?

A nurse is caring for a client who has increased intracranial pressure and has a worsening neurologic condition. Which of the following cues should the nurse recognize as a worsening condition? (Select All that Apply.)