1.
Weak or thin spot on a blood vessel in the brain that ballons with blood
Correct Answer
B. Cerebral aneurysm
Explanation
A cerebral aneurysm is a weak or thin spot on a blood vessel in the brain that balloons with blood. This condition can be dangerous as the aneurysm can rupture, leading to bleeding in the brain. Symptoms may include severe headache, blurred vision, and loss of consciousness. Prompt medical attention is necessary to prevent complications and potentially life-threatening situations.
2.
Most common place for cerebral aneurysms
Correct Answer
A. Junction of Circle of Willis arteries
Explanation
Although they can occur anywhere in the brain
3.
HTN is a congenital cause of cerebral aneurysms
Correct Answer
B. False
Explanation
Congenital - CTD, polycystic kidney disease, circ disorders
Mycotic - infection
Other - HTN, Tumor, atherosclerosis, drug abuse
4.
Risk factors for Cerebral aneurysms: (select all that apply)
Correct Answer(s)
A. Women
C. Adult
E. HTN
F. Alcohol/Drug abuse
H. Genetic disorders
I. Smoking
Explanation
This question asks for the risk factors for cerebral aneurysms. The correct answer includes "Women" because they have a higher risk compared to men. "Adult" is included because aneurysms are more common in adults rather than children. "HTN" refers to hypertension, which is a risk factor for aneurysms. "Alcohol/Drug abuse" is a risk factor as substance abuse can weaken blood vessels. "Genetic disorders" are included as certain genetic conditions can increase the risk of aneurysms. "Smoking" is also a risk factor as it can damage blood vessels.
5.
Surgery would normally be performed for an aneurysm of 2 cm with no impairment.
Correct Answer
B. False
Explanation
Usually >5cm or if impairment has occured
6.
Usually there are no signs or symptoms of cerebral aneurysms unless they are very large or burst.
Correct Answer
A. True
Explanation
Cerebral aneurysms typically do not exhibit any signs or symptoms unless they are either very large or have ruptured. This means that individuals with small or unruptured aneurysms may not experience any noticeable symptoms, making it difficult to detect the condition without medical imaging. Therefore, the statement "Usually there are no signs or symptoms of cerebral aneurysms unless they are very large or burst" is true.
7.
Signs and Symptoms of Cerebral Aneurysm:
Correct Answer(s)
A. Sudden intense headache
B. Pain behind the eyes
D. Diplopia
F. Tinnitus
G. Seizures
I. Nuchal rigidity
J. Sensitivity to light
Explanation
The signs and symptoms listed in the answer are all associated with cerebral aneurysm. A sudden intense headache is a common symptom, often described as the worst headache of a person's life. Pain behind the eyes can also occur. Diplopia, or double vision, can be a result of the aneurysm pressing on nerves. Tinnitus, or ringing in the ears, is another possible symptom. Seizures can occur if the aneurysm causes bleeding or puts pressure on the brain. Nuchal rigidity, or stiffness in the neck, can be a sign of a ruptured aneurysm. Sensitivity to light is also a symptom that can occur.
8.
Cushing's Triad includes which symptoms:
Correct Answer(s)
A. Widening pulse pressure (>40)
C. Bradycardia
F. SBP increase
Explanation
Cushing's Triad is a set of symptoms that indicate increased intracranial pressure. One of the symptoms is widening pulse pressure, which refers to the difference between systolic and diastolic blood pressure, and it is expected to be greater than 40. Bradycardia, a slow heart rate, is also a symptom of Cushing's Triad. Additionally, an increase in systolic blood pressure is seen in Cushing's Triad. Therefore, the correct answer includes widening pulse pressure (>40), bradycardia, and SBP increase.
9.
For small aneurysms the treatment is monitoring.
Correct Answer
A. True
Explanation
For small aneurysms, the recommended treatment is monitoring. This means that instead of immediately undergoing surgery or other invasive procedures, the aneurysm is closely observed over time to check for any changes or potential risks. This approach is typically taken when the aneurysm is small and not causing any symptoms or complications. By monitoring the aneurysm, healthcare professionals can determine if any intervention is necessary in the future.
10.
Maintain airway and oxygenate are always priorities.
Correct Answer
A. True
Explanation
Maintaining the airway and ensuring proper oxygenation are fundamental priorities in any medical situation. These actions are crucial for sustaining life and preventing further complications. By keeping the airway open and ensuring adequate oxygen supply, the body's vital organs receive the necessary oxygen to function properly. Therefore, it is essential to prioritize airway maintenance and oxygenation in any medical intervention or emergency situation.
11.
You should always take the temperature of a pt with cerebral aneurysm rectally.
Correct Answer
B. False
Explanation
you should NEVER take it rectally. It will increase the ICP
12.
Head of bed should be kept at a 90 degree angle for pts with cerebral aneuryms.
Correct Answer
B. False
Explanation
It should be at 0-30 degrees to reduce ICP
13.
Right Side Damage Symptoms from Stroke (select all that apply)
Correct Answer(s)
B. Short attention span/rapid response
C. Left side neglect
E. Spatial-perceptual deficit
F. Denies or minimizes problem
I. Impulsive, Safety problems
J. Impaired judgment and time judgement
Explanation
The given answer options are all symptoms that can occur as a result of right side damage from a stroke. Short attention span/rapid response refers to difficulties in maintaining focus and reacting quickly. Left side neglect is a condition where individuals ignore or fail to acknowledge objects or events on their left side. Spatial-perceptual deficit refers to problems with perceiving and understanding spatial relationships. Denies or minimizes problem refers to a common coping mechanism where individuals downplay or deny the impact of their deficits. Impulsive, Safety problems and Impaired judgment and time judgement indicate difficulties in making safe decisions and accurately judging time.
14.
Left Side Damage Symptoms from Stroke (select all that apply)
Correct Answer(s)
A. Slow Performance
D. Right side neglect
G. Impaired speech/language
H. Aware of deficits (depression and anxiety because they are aware)
K. Impaired comprehension
Explanation
The left side damage symptoms from a stroke can include slow performance, right side neglect, impaired speech/language, being aware of deficits (which can lead to depression and anxiety), and impaired comprehension. These symptoms are commonly observed in individuals who have experienced damage to the left side of their brain due to a stroke.
15.
For pts with hemorrhagic stroke, give Coumadin.
Correct Answer
B. False
Explanation
NEVER give anticoagulant to pt with hemorrhage.
16.
Most signs and symptoms are very sudden in stroke pts.
Correct Answer
A. True
Explanation
Stroke is a medical emergency that occurs when blood flow to the brain is disrupted, either by a blood clot or a ruptured blood vessel. The sudden onset of signs and symptoms is a hallmark feature of stroke. These symptoms can include sudden numbness or weakness in the face, arm, or leg, especially on one side of the body, sudden confusion or trouble speaking or understanding speech, sudden trouble seeing in one or both eyes, sudden severe headache with no known cause, and difficulty walking or maintaining balance. Therefore, the statement that most signs and symptoms are very sudden in stroke patients is true.
17.
Anticoagulants should not be given for hemorrhagic stroke.
Correct Answer
A. True
Explanation
Anticoagulants are medications that help prevent blood clots. However, in the case of a hemorrhagic stroke, there is bleeding in the brain. Giving anticoagulants in such a situation can worsen the bleeding and potentially lead to more damage. Therefore, it is true that anticoagulants should not be given for hemorrhagic stroke.
18.
Eligibility for tPA treatment after stroke.
Correct Answer(s)
B. Stroke symptoms occurred less than 180 minutes ago
C. Ischemic Stroke
F. 18 years or older
Explanation
The correct answer is "Stroke symptoms occurred less than 180 minutes ago, Ischemic Stroke, 18 years or older." This is because tPA treatment is most effective when administered within 180 minutes (3 hours) of the onset of stroke symptoms. Additionally, tPA is specifically used for ischemic strokes, which occur when a blood clot blocks a blood vessel in the brain. Lastly, tPA treatment is only approved for individuals who are 18 years or older.
19.
You may give tPA if blood pressure is over 185/110 at time of treatment.
Correct Answer
B. False
Explanation
The statement is false because tPA (tissue plasminogen activator) is a medication used to dissolve blood clots in patients who have had a stroke. It is typically given within a few hours of the onset of symptoms. However, tPA should not be given if the patient's blood pressure is over 185/110 at the time of treatment, as it can increase the risk of bleeding in the brain. Therefore, the correct answer is false.
20.
You may give tPA is blood sugar is 150 at time of treatment
Correct Answer
A. True
Explanation
It cannot be given if BS is 400
21.
Position of pt for Post Acute Stroke
Correct Answer
B. Position pt 2 hrs on unaffected side and 20 mins on affected side
Explanation
The correct answer suggests that the patient should be positioned for 2 hours on the unaffected side and for 20 minutes on the affected side after a post-acute stroke. This positioning strategy helps to prevent complications such as pressure ulcers, respiratory issues, and contractures. By spending more time on the unaffected side, the patient can maintain proper blood flow and reduce the risk of developing pressure sores. Additionally, spending some time on the affected side helps to prevent muscle shortening and contractures.
22.
Suction fluids nasally and for 15 sections in a pt with acute stroke.
Correct Answer
B. False
Explanation
NEVER suction nasally or for longer than 10 secs (it will increase ICP)
23.
An LVN can feed the pt the first meal -post acute stroke.
Correct Answer
B. False
Explanation
ONLY an RN can perform the first feeding
24.
When the pt is eating post acute stroke, they should be sitting up with head and neck slightly forward and flexed
Correct Answer
A. True
Explanation
When a patient is eating after experiencing an acute stroke, it is important for them to sit up with their head and neck slightly forward and flexed. This position helps to prevent aspiration, which is the inhalation of food or liquid into the lungs. By sitting up and flexing the head and neck forward, the patient can facilitate the proper swallowing mechanism and reduce the risk of choking or aspiration pneumonia. Therefore, the statement "True" accurately reflects the correct position for a patient to be in while eating post acute stroke.
25.
Pts with chronic stroke symptoms should placed with their good vision side away from the door of the room.
Correct Answer
B. False
Explanation
The statement is false because patients with chronic stroke symptoms should be placed with their affected side away from the door of the room, not their good vision side. This positioning helps to prevent neglect and encourage the use of the affected side during daily activities.
26.
Maintain a BP of 150/100 in acute stroke pts.
Correct Answer
A. True
Explanation
To maintain cerebral perfusion