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Stroke (CVA) NCLEX Questions

Stroke (CVA) NCLEX practice questions for nursing students. A stroke is where
there is decreased blood flow to brain cell tissue. This can be due to either a

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blockage or ruptured blood vessel.

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In the previous NCLEX review, I explained about other neurological disorders,

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NURSING NOTES
As the nurse, it is important to know the pathophysiology of stroke, the types of
drugs used to treat this condition, risk factors, signs and symptoms, and the
nursing interventions.

Don’t forget to watch the lecture on stroke before taking the quiz.

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Your Grade: F
Percentage of What you Got Right: 43

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Your Answers & what you got Right & Wrong:

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1. A patient is admitted with uncontrolled atrial fibrillation. The patient’s Cushing's Syndrome vs Disease
medication history includes vitamin D supplements and calcium. What type of Nursing Pathophysiology, Symptoms,
stroke is this patient at MOST risk for? Treatment NCLEX

A. Ischemic thrombosis
Nurse CPR E-C Seal Technique - Ambu
B. Ischemic embolism Bag Mask Resuscitation

Inject Air Into a Vial for Medication

C. Hemorrhagic
Administration Nursing Tip #shorts
D. Ischemic stenosis
Nurse Humor...Nurses Be Like Pulse

The answer is B. If a patient is in uncontrolled a-fib they are at risk for clot Check #shorts

formation within the heart chambers. This clot can leave the heart and travel to
the brain. Hence, an ischemic embolism type stroke can occur. An ischemic
thrombosis type stroke is where a clot forms within the artery wall of the neck
or brain.

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.

The answer is C. A hemorrhagic stroke occurs when bleeding in the brain RECENT POSTS
happens due to a break in a blood vessel. Risk factors for a hemorrhagic stroke
is uncontrolled hypertension, history of brain aneurysm, old age (due to aging Cushing’s Disease/Syndrome NCLEX
Questions
blood vessels.) All the other options are at risk for an ischemic type of stroke.

Nursing Suffixes Terminology Quiz

3. You're educating a patient about transient ischemic attacks (TIAs). Select all Nursing Medical Suffixes Made Easy
the options that are incorrect about this condition:
I HATE Nursing! I Quit! Do NOT
A. TIAs are caused by a temporary decrease in blood flow to the brain.
Become a Nurse EVER!
B. TIAs produce signs and symptoms that can last for several weeks to
Medical Prefixes Terminology Quiz
months.

C. A TIAs is a warning sign that an impending stroke may occur.

D. TIAs don't require medical treatment.

The answers are B and D. Options A and C are CORRECT statements about
TIAs. However, option B is wrong because TIAs produce signs and symptoms
that can last a few minutes to hours and resolve (NOT several weeks to
months). Option D is wrong be TIAs do 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

The answer is D. The temporal lobe is responsible for hearing, learning, and
feelings/emotions.

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

The answer is B. The cerebellum is important for coordination and balance.

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

D. Occipital lobe

The answer is D. The occipital lobe is responsible for vision and color
perception.

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

The answers are B, D, F, and G. Patients who have right side brain damage will
have LEFT side hemiplegia (opposite side), confused on date, time, and place,
unilateral neglect (left side neglect), DENIAL about limitations, be impulsive,
and have a short attention span. Agraphia, right side hemiplegia, aware of
limitations, and aphasia occur in a LEFT SIDE brain injury.

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

The answers are A, C, D, F, and H. Patients who have left side brain damage will
have aphasia, be AWARE of their limitations, impaired math skills, issues with
seeing on the right side, no deficit in memory, depression/anger, cautious, and
agraphia. All the other options are found in right side brain injury.

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

The answers are A, D, and E. These risk factors are modifiable in that the
patient can attempt to change them to prevent another stroke in the future.
The other risk factors are NOT modifiable.

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

The answer is D.

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.

The answers are C and D. Patients with expressive aphasia can understand
spoken words but can't respond back effectively or at all. Therefore be patient,
let them speak, be direct and ask simple questions that require a simple
response, and communicate with a dry erase board etc.

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

The answer is A.

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.

The answer is C.

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

C. Hemianopia

D. Apraxia

The answer is A.

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

The answer is A.

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

The answer is C. Hemianopia is limited vision in half of the visual field. The
patient needs to scan the room from side to side to prevent injury.

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

The answer is B. Scores on the NIH stroke scale range from 0 to 42, with 0 (no
stroke symptoms) and 21-42 (severe 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

The answer is C. tPA dissolves the clot causing the blockage in stroke by
activating the protein that causes fibrinolysis. It should be given within 3 hours
after the onset of stroke symptoms. It can be given 3 to 4.5 hours after onset IF
the patient meets strict criteria. It is used for acute ischemia stroke, NOT
hemorrhagic!!

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.

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

D. A patient who received Heparin 24 hours ago.

The answers are B and D. Patients who are experiencing signs and symptoms of
a hemorrhagic stroke, who have a BP for >185/110, and has received heparin
or any other anticoagulants etc. are NOT a candidate for tPA. tPA is only for an
ischemic stroke.

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.

The answer is B. This patient has weakness on the right side (hemiparesis) and
dysphagia (difficultly swallowing). Therefore, the nurse should perform regular
mouth checks by assessing for pouching of food in the right cheek. Pouching of
food in the cheek can lead to aspiration or choking. The HOB should be >30
degrees, liquids thickened per provider's order, and the patient should tuck in
the chin to the chest to help with swallowing.

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.

The answer is A. It is important to watch for neglect syndrome. This tends to

happen in right side brain damage. The patient ignores the left side of the body
in this condition. The nurse needs to remind the patient to use and touch both
sides of the body daily and that the patient must make a conscious effort to do
so.

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Stroke (CVA) NCLEX Questions

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

The answer is B. If a patient is in uncontrolled a-fib they are at risk for clot
formation within the heart chambers. This clot can leave the heart and travel to
the brain. Hence, an ischemic embolism type stroke can occur. An ischemic
thrombosis type stroke is where a clot forms within the artery wall of the neck
or brain.

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.

The answer is C. A hemorrhagic stroke occurs when bleeding in the brain

happens due to a break in a blood vessel. Risk factors for a hemorrhagic stroke
is uncontrolled hypertension, history of brain aneurysm, old age (due to aging
blood vessels.) All the other options are at risk for an ischemic type of stroke.

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.

The answers are B and D. Options A and C are CORRECT statements about
TIAs. However, option B is wrong because TIAs produce signs and symptoms
that can last a few minutes to hours and resolve (NOT several weeks to
months). Option D is wrong be TIAs do 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

The answer is D. The temporal lobe is responsible for hearing, learning, and
feelings/emotions.

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

The answer is B. The cerebellum is important for coordination and balance.

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

D. Occipital lobe

The answer is D. The occipital lobe is responsible for vision and color
perception.

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

The answers are B, D, F, and G. Patients who have right side brain damage will
have LEFT side hemiplegia (opposite side), confused on date, time, and place,
unilateral neglect (left side neglect), DENIAL about limitations, be impulsive,
and have a short attention span. Agraphia, right side hemiplegia, aware of
limitations, and aphasia occur in a LEFT SIDE brain injury.

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

The answers are A, C, D, F, and H. Patients who have left side brain damage will
have aphasia, be AWARE of their limitations, impaired math skills, issues with
seeing on the right side, no deficit in memory, depression/anger, cautious, and
agraphia. All the other options are found in right side brain injury.

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

The answers are A, D, and E. These risk factors are modifiable in that the
patient can attempt to change them to prevent another stroke in the future.
The other risk factors are NOT modifiable.

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

The answer is D.

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.

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