Stroke: Pathophysiology, Diagnosis, and Management for Nurses

Question 1

Which lifestyle choice is known to help protect against stroke?

Accepted Answer

Regular exercise

Answer

High blood pressure

Answer

Smoking cigarettes

Answer

Diabetes

Question 2

In ischemic stroke, what is the chronological sequence of events leading to brain tissue infarction, considering the interplay of thrombosis, embolism, and impaired perfusion?

Accepted Answer

Thrombosis obstructs a cerebral artery, potentially leading to embolism and subsequent impaired perfusion.

Answer

Embolism obstructs a cerebral artery, followed by thrombosis development and eventual impaired perfusion.

Answer

Atherosclerosis directly causes tissue infarction without involving thrombosis or embolism.

Answer

Impaired perfusion alone can cause brain tissue infarction in the absence of thrombosis or embolism.

Question 3

Which type of stroke is caused by a sudden blockage in a blood vessel supplying blood to the brain?

Accepted Answer

Ischemic stroke

Answer

Hemorrhagic stroke

Answer

Subarachnoid hemorrhage

Answer

Transient ischemic attack (TIA)

Question 4

What is the most prevalent underlying cause of an ischemic stroke?

Accepted Answer

Atherosclerosis

Answer

Vasospasm

Answer

Abnormal bleeding

Answer

Subarachnoid hemorrhage

Question 5

Which imaging examination is the initial diagnostic tool of choice in the evaluation of stroke?

Accepted Answer

Computed tomography (CT) scan

Answer

Magnetic resonance imaging (MRI)

Answer

Electroencephalogram (EEG)

Answer

X-ray

Question 6

Which medication is the first-line treatment for breaking up blood clots in acute ischemic stroke?

Accepted Answer

Tissue plasminogen activator (tPA)

Answer

Aspirin

Answer

Heparin

Answer

Warfarin

Question 7

For a patient experiencing a hemorrhagic stroke, what nursing intervention is of paramount importance?

Accepted Answer

Maintaining blood pressure control

Answer

Providing oxygen therapy

Answer

Administering anticonvulsants

Answer

Performing neurological assessments

Question 8

What is the name of the assessment tool specifically designed to evaluate the severity of a stroke?

Accepted Answer

National Institutes of Health Stroke Scale (NIHSS)

Answer

Glasgow Coma Scale (GCS)

Answer

Barthel Index

Answer

Modified Rankin Scale

Question 9

In the context of stroke management, which healthcare professional is primarily responsible for assessing and addressing the underlying neurological impairments?

Accepted Answer

Neurologist

Answer

Emergency physician

Answer

Neurointerventionalist

Answer

Physical therapist

Question 10

Which type of stroke is most prevalent, accounting for approximately 87% of all cases?

Accepted Answer

Ischemic stroke

Answer

Hemorrhagic stroke

Answer

Transient ischemic attack (TIA)

Answer

Cerebellar stroke

Question 11

The primary pharmacological intervention for treating acute ischemic stroke is:

Accepted Answer

Intravenous tissue plasminogen activator (tPA)

Answer

Aspirin

Answer

Heparin

Answer

Statin

Question 12

Which of the following risk factors is strongly linked to an increased risk of developing a hemorrhagic stroke?

Accepted Answer

Hypertension

Answer

Diabetes mellitus

Answer

Smoking

Answer

Atrial fibrillation

Question 13

In stroke management, why is the concept of 'time is brain' clinically significant?

Accepted Answer

Prompt treatment minimizes brain damage and improves outcomes.

Answer

Treatment can be delayed if the patient's condition is stable.

Answer

Time-sensitive interventions are only relevant for ischemic strokes.

Answer

The 'time is brain' concept is not a factor in stroke treatment decisions.

Question 14

A 52-year-old male patient arrives with sudden onset of left-sided weakness, aphasia, and neglect. His symptoms began 2 hours ago. What is the most appropriate immediate next step in his management?

Accepted Answer

CT scan of the brain

Answer

MRI scan of the brain

Answer

Carotid Doppler ultrasound

Question 15

Which is the most common type of stroke, accounting for about 87% of all cases?

Accepted Answer

Ischemic stroke

Answer

Hemorrhagic stroke

Answer

Transient ischemic attack (TIA)

Answer

Subarachnoid hemorrhage

Question 16

What is the primary pathophysiological event that triggers an ischemic stroke?

Accepted Answer

Occlusion of a cerebral artery

Answer

Rupture of a cerebral artery

Answer

Vasospasm

Answer

Embolism

Question 17

Which medication is commonly used as thrombolytic therapy to dissolve blood clots in ischemic stroke?

Accepted Answer

Alteplase (tPA)

Answer

Aspirin

Answer

Heparin

Answer

Warfarin

Question 18

Which of the following is an absolute contraindication to thrombolytic therapy in stroke?

Accepted Answer

Active bleeding

Answer

Hypertension

Answer

Recent surgery

Answer

Diabetes

Question 19

Which technological innovation has revolutionized stroke treatment by facilitating the rapid and efficient removal of blood clots?

Accepted Answer

Mechanical Thrombectomy

Answer

Advanced Neuroimaging

Answer

Telemedicine

Answer

Robotic Rehabilitation

Question 20

Which of the following is the most prevalent type of stroke, accounting for approximately 85% of all cases?

Accepted Answer

Ischemic stroke

Answer

Transient ischemic attack (TIA)

Answer

Subarachnoid hemorrhage

Answer

Hemorrhagic stroke

Question 21

What is the primary pathophysiological mechanism underlying ischemic stroke?

Accepted Answer

Obstruction of a cerebral artery, depriving brain tissue of oxygen and nutrients

Answer

Embolization of a blood clot to the brain

Answer

Rupture of a blood vessel in the brain

Question 22

In the initial evaluation of suspected stroke, what neuroimaging technique is typically used first to rapidly rule out intracranial hemorrhage?

Accepted Answer

Non-contrast head computed tomography (CT) scan

Answer

Carotid duplex ultrasound, which visualizes the carotid arteries for stenosis or plaque

Answer

Magnetic resonance imaging (MRI) scan, which provides detailed anatomical images of the brain

Answer

Transcranial Doppler ultrasound, which assesses blood flow velocity in cerebral arteries

Question 23

For acute management of ischemic stroke within the recommended time frame, which medication is administered intravenously to dissolve the obstructing clot?

Accepted Answer

Tissue plasminogen activator (tPA)

Answer

Anticoagulant therapy, which prevents clot formation

Answer

Antiplatelet therapy, which inhibits platelet aggregation

Answer

Statin therapy, which reduces cholesterol levels

Question 24

What is the overarching goal of stroke rehabilitation?

Accepted Answer

To maximize recovery of function, enhance mobility, and improve overall quality of life for stroke survivors

Answer

To manage complications of stroke, such as contractures or pressure ulcers

Answer

To prevent recurrent strokes through lifestyle modifications and medication adherence

Answer

To provide emotional support and counseling to the patient and their family

Question 25

For patients with dysphagia following stroke, which dietary modification is recommended to minimize the risk of aspiration?

Accepted Answer

Thickened liquids and pureed foods, which have a modified consistency that is easier to swallow safely

Answer

Intravenous fluids, which are administered directly into a vein for hydration and nutrition

Answer

Nasogastric tube feeding, which involves passing a tube through the nose and into the stomach for direct feeding

Question 26

According to current guidelines, within what time frame from symptom onset is it recommended to administer tPA for acute ischemic stroke to achieve the greatest benefit?

Accepted Answer

Within 4.5 hours

Answer

Within 6 hours

Answer

Within 8 hours

Answer

Within 12 hours

Question 27

Which type of stroke is characterized by an abrupt blockage of blood flow to the brain due to a clot or embolus?

Accepted Answer

Ischemic stroke

Answer

Hemorrhagic stroke

Answer

Lacunar stroke

Answer

Transient ischemic attack (TIA)

Question 28

Among the following risk factors, which one is considered the most significant contributor to stroke incidence?

Accepted Answer

Hypertension

Answer

Diabetes

Answer

Atrial fibrillation

Answer

Smoking

Question 29

In the acute management of ischemic stroke, which pharmacological agent is the first-line treatment?

Accepted Answer

Tissue plasminogen activator (tPA)

Answer

Aspirin

Answer

Heparin

Answer

Warfarin

Question 30

When considering thrombolysis as a treatment option for acute ischemic stroke, which of the following is an absolute contraindication?

Accepted Answer

Recent major surgery within the past 24 hours

Answer

Advanced age

Answer

Hypertension

Answer

Diabetes

Question 31

Following a stroke, what is the primary objective of rehabilitation efforts?

Accepted Answer

To optimize functional recovery and regain independence in daily activities

Answer

To manage potential complications

Answer

To prevent future strokes

Answer

To provide emotional support

Question 32

Which of the following signs or symptoms may indicate a transient ischemic attack (TIA)?

Accepted Answer

Temporary weakness or numbness affecting one side of the body

Answer

Chest pain

Answer

Severe and persistent headache

Question 33

What is the fundamental distinction between ischemic and hemorrhagic strokes in terms of their underlying causes?

Accepted Answer

Ischemic strokes result from a blockage in a blood vessel, whereas hemorrhagic strokes occur due to a rupture of a blood vessel.

Answer

Ischemic strokes are more prevalent than hemorrhagic strokes.

Question 34

A patient presents with sudden onset of right-sided weakness and slurred speech. Which of the following is the most likely type of stroke?

Accepted Answer

Ischemic stroke

Answer

Transient ischemic attack (TIA)

Answer

Hemorrhagic stroke

Question 35

Which of the following is a risk factor for ischemic stroke that is modifiable?

Accepted Answer

Hypertension

Answer

Family history of stroke

Answer

Age

Question 36

A patient with a suspected stroke is undergoing a CT scan. What is the primary purpose of this diagnostic test?

Accepted Answer

To differentiate between ischemic and hemorrhagic stroke

Answer

To assess the extent of brain damage

Answer

To identify the specific location of the stroke

Question 37

Which of the following is a complication of stroke that can be prevented with appropriate nursing care?

Accepted Answer

Pneumonia

Answer

Cerebral edema

Answer

Permanent neurological deficits

Answer

Brain herniation

Question 38

A patient with a stroke is at risk for falls. Which of the following nursing interventions is most appropriate to prevent falls?

Accepted Answer

Assisting the patient with ambulation and providing a safe environment

Answer

Administering antihypertensive medication

Answer

Encouraging the patient to perform exercises to improve strength

Question 39

A patient with a stroke is experiencing dysphagia. What is the priority nursing intervention?

Accepted Answer

Assessing swallowing ability and recommending dietary modifications

Answer

Encouraging the patient to drink plenty of fluids

Answer

Administering anti-nausea medication

Question 40

Which of the following is a primary goal of rehabilitation after stroke?

Accepted Answer

To regain lost function and independence

Answer

To prevent further stroke

Answer

To manage chronic pain

Question 41

A patient is experiencing a TIA. What is the most important nursing intervention?

Accepted Answer

Promptly notify the physician

Answer

Perform a neurological assessment

Answer

Provide emotional support

Answer

Administer aspirin

Question 42

A patient with a stroke is receiving intravenous tPA. What is the most important nursing consideration?

Accepted Answer

Monitoring for signs of bleeding

Answer

Ensuring adequate hydration

Answer

Administering pain medication

Answer

Assessing the patient's level of consciousness