Stroke (CVA) QUIZ

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

C.      Parietal lobe

E.       Occipital lobe

7. A patient has right side brain damage from a stroke. Select all the signs and symptoms that occur 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

H.      Agraphia

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

D.      Hemianopia

E.       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

C.      Alexia

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.

F.       A patient who is showing signs and symptoms of ischemic stroke.

G.      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 for the nurse to ensure which of the following during this activity?

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.

NCLEX                                            ANSWER

10 ways health care leaders sabotage their own success—and how to stop

 Let me share a post by Roger A. Gerard, PhD,   Policy March 15, 2025  

As a former health care executive, I have witnessed many leaders at all levels sabotage their own success. Most of it was unintentional but rather the result of a failure to learn from those who have gone before. Many in the health care industry are promoted into leadership roles without the benefit of leadership or management training and are then left to their own devices to learn “on the job,” as if that were an easy process. It is not. A medical degree does not impart leadership wisdom.

The following ten ways that leaders sabotage their own success are not an exhaustive list but, in my experience, some of the most common. Each of these, standing alone, can rapidly undermine any leader's credibility, and several at any given time will undoubtedly lead to failure. Take heed!

 1. They fail to be clear about what matters most.

Leaders must be clear about the organization’s mission, vision, values, and strategy. If they are not, decisions will be unclear, mistakes will occur, and the professionals doing the daily work will be confused about priorities.

2. They think their job is to motivate others.

People who come to work in health care are typically already motivated. They enter health care wanting to take care of people and their health care needs. They come with a great deal of training and often experience. What passes as motivation is often manipulation—a tactic on the part of the leader to convince a professional to do something they are not doing. Instead of “motivating” via incentives and other tactics, it is time to have a conversation about what matters most—a conversation that begins with the leader doing a great deal of listening first.

3. They treat people as liabilities, not as assets.

Health care is increasingly a business, but using business language to describe the workplace can create a climate adverse to professional work. Health care is a collaborative process, with many professionals working together to meet patient needs. These are not liabilities; these are professionals there to do the work of the business. They need to be treated with respect.

4. They fail to go to where the work is being done.

Leaders who think they can lead from their offices do not understand leadership. If you are going to truly understand the work being done by your professionals, you must go and see. Look for the obstacles and barriers to success. Look for those things that frustrate your professionals, causing “workarounds” and other band-aid fixes. And then do something as a leader to remove those barriers.

5. They see mistakes as failure rather than as learning.

The best leaders understand that failure is not the end; it is the beginning of learning what now must be done to be successful.

6. They permit blame and shame—and often participate in it.

Blame and shame are poisons in any productive work culture, especially in health care, where lives depend on collaborative professional practice every day. Outstanding leaders abolish all blame and shame and work to find out the root causes of mistakes, accidents, and poor results. Allowing blame and shame creates dissension, polarization, and relationships that simply do not work.

7. They make promises and then rationalize when those promises are broken.

When listening to what professionals need and want in their work, it is tempting for leaders to make promises “on the spot” about what will be done, only to fail to follow through due to budget, timing, or other “rational” reasons. This is a slow death by a thousand cuts for leadership credibility. Leaders who cannot keep the promises they make are not trusted by those in their charge.

8. They fail to listen to the wisdom and advice of those doing the daily work.

In health care, the people who know best what the patient wants and needs are those doing the daily work of patient care. This is not arguable. Those in leadership are not as exposed to those needs and wants. Leaders who fail to listen to their staff without respect for their opinions will lose credibility fast. Listen to your professionals!

9. They take credit for the work done by others.

No one likes braggarts. We like them even less when they take credit for something that someone else has done. The reality in health care leadership is that the true heroes are those doing the patient care work, not the folks in the administrative suites. Take the time to recognize high-performing professionals and make them successful beyond their wildest dreams.

10. They lose focus in the chase for “bright shiny objects.”

Some in leadership simply cannot stay focused. They seem to chase every current project or initiative that has become popular instead of doing the hard, daily work of improving the processes at hand. Leaders who do this are not focused on what matters most, and those around them can see it.

The solution? 5 promises to keep and two actions

Promises:

• I will listen to you and respect what you tell me. If I disagree, I will tell you why.
• I will help you learn and grow as you practice your professional work.
• I will help you be wildly successful.
• I will make sure you are compensated competitively.
• I will have your back when things go south.

Actions:

• Go and see!
• Go and do!