Do I smell burning toast?
CVA
CVA
A patient with a right-sided CVA is most likely to exhibit which of the following symptoms?
A. Expressive aphasia
B. Right hemiplegia
C. Impulsivity and poor judgment
D. Slow, cautious behavior
B. Right hemiplegia
What is the priority action during a tonic-clonic seizure?
A. Insert an oral airway
B. Restrain the patient
C. Turn the patient to the side
D. Give lorazepam
C. Turn the patient to the side
Which sign suggests increased intracranial pressure (ICP)?
A. Tachycardia
B. Bilateral reactive pupils
C. Widening pulse pressure
D. Hypothermia
C. Widening pulse pressure
Which finding during a neuro check is most concerning?
A. Patient forgets the day
B. GCS drops from 13 to 9
C. PERRLA
D. Mild slurred speech
B. GCS drops from 13 to 9
A patient on levetiracetam should be monitored for:
A. Hyperglycemia
B. Suicidal thoughts
C. Nephrotoxicity
D. Tachycardia
B. Suicidal thoughts
Which is the priority nursing action during the acute phase of an ischemic stroke?
A. Prepare for surgery
B. Assess gag reflex
C. Administer tissue plasminogen activator (tPA)
D. Monitor potassium levels
C. Administer tissue plasminogen activator (tPA)
A nurse is teaching seizure precautions. Which item is appropriate at the bedside?
A. Restraint straps
B. Suction equipment
C. Tongue blade
D. Oral thermometer
B. Suction equipment
A patient with increased ICP should be positioned:
A. Supine, flat
B. Prone
C. High Fowler’s
D. Head midline, HOB 30°
D. Head midline, HOB 30°
The nurse finds a patient with left pupil fixed and dilated. What does this suggest?
A. Cataract
B. Glaucoma
C. Increased ICP
D. Normal aging
C. Increased ICP
The nurse is administering tPA. What must be verified first?
A. Blood type
B. Onset of stroke symptoms
C. GCS score
D. Blood pressure above 180 systolic
B. Onset of stroke symptoms
The nurse is teaching about modifiable stroke risk factors. Which statement indicates understanding?
A. “My age puts me at high risk.”
B. “There’s nothing I can do about my family history.”
C. “Controlling my blood pressure will help lower my stroke risk.”
D. “Only smokers get strokes.”
C. “Controlling my blood pressure will help lower my stroke risk.”
The patient has a history of absence seizures. Which observation is consistent with this type?
A. Sudden collapse with limb jerking
B. Brief blank stare and lip smacking
C. Repetitive hand clapping
D. High-pitched cry before seizure onset
B. Brief blank stare and lip smacking
What is Cushing’s Triad?
A. Bradycardia, hypertension, irregular respirations
B. Tachycardia, hypotension, apnea
C. Bradypnea, hypotension, hypothermia
D. Hypertension, hyperthermia, tachycardia
A. Bradycardia, hypertension, irregular respirations
Decerebrate posturing indicates:
A. Deep brainstem damage
B. Metabolic encephalopathy
C. Cervical spinal injury
D. Cerebellar lesion
A. Deep brainstem damage
What teaching is most important for a patient on carbamazepine?
A. Take with milk
B. Report rash immediately
C. Avoid sodium-rich foods
D. Check heart rate daily
B. Report rash immediately
A patient with a stroke develops dysphagia. What is the priority nursing intervention?
A. Offer thickened liquids
B. Insert an NG tube
C. Encourage coughing
D. Place patient in a supine position
A. Offer thickened liquids
The nurse prepares to administer phenytoin. What is the correct action?
A. Mix with dextrose IV fluid
B. Administer quickly IV push
C. Monitor for gingival hyperplasia
D. Hold if patient is hypertensive
C. Monitor for gingival hyperplasia
Which medication helps lower ICP?
A. Mannitol
B. Furosemide
C. Nitroglycerin
D. Atropine
A. Mannitol
What is the purpose of the Romberg test?
A. Assess visual fields
B. Evaluate coordination
C. Check balance with eyes closed
D. Test deep tendon reflexes
C. Check balance with eyes closed
Donepezil (Aricept) is prescribed for:
A. Seizure prevention
B. Parkinson’s tremors
C. Alzheimer’s cognitive symptoms
D. Migraine prophylaxis
C. Alzheimer’s cognitive symptoms
Which diagnostic test is best for differentiating ischemic vs hemorrhagic stroke in the ED?
A. MRI
B. Lumbar puncture
C. Carotid Doppler
D. Xray of skull
A. MRI
Status epilepticus is defined as:
A. Two or more seizures in 24 hours
B. A seizure lasting >30 minutes or no return to consciousness
C. A seizure with febrile origin
D. Seizure unresponsive to benzodiazepines
B. A seizure lasting >30 minutes or no return to consciousness
Which intervention is contraindicated in a patient with increased ICP?
A. Administering stool softeners
B. Hyperventilation
C. Frequent suctioning
D. Elevating the head of bed
C. Frequent suctioning
The Babinski reflex is considered abnormal in adults when:
A. Toes curl downward
B. No response occurs
C. Big toe dorsiflexes and other toes fan out
D. Toes flex and foot rotates outward
C. Big toe dorsiflexes and other toes fan out
A patient taking valproic acid reports dark urine and jaundice. The nurse should:
A. Encourage fluids
B. Document as expected
C. Notify provider—possible hepatotoxicity
D. Reassure the patient it's harmless
C. Notify provider—possible hepatotoxicity