Stroke and Cerebrovascular Disorders Practice Questions
20 free Stroke and Cerebrovascular Disorders practice questions for the NCLEX Exam. Tap an option to answer — you get instant feedback, the correct answer, and a detailed explanation for every question.
When documenting the time of onset of stroke symptoms, what is the nurse's best action?
- A Record the time when the client arrived in the ED
- B Estimate the time when the symptoms were first noticed
- C Record the exact time the client was last seen at baseline (normal)
- D Document the time when the CT scan was performed
Correct answer: Record the exact time the client was last seen at baseline (normal)
Recording the “last known well” time (when the client was at baseline) is essential for determining eligibility for thrombolytic therapy in an Ischemic stroke.
What is a modifiable risk factor for stroke?
- A Age over 55 years
- B Family history of stroke
- C Atrial fibrillation
- D African-American ethnicity
Correct answer: Atrial fibrillation
Atrial fibrillation is a treatable cardiac rhythm disorder and thus a modifiable risk factor.
For a client diagnosed with a hemorrhagic stroke, what is the initial treatment goal?
- A Rapid clot-dissolution with tPA
- B Lowering blood pressure to reduce bleeding
- C Elevating arms above heart level to reduce edema
- D Inducing hyperglycaemia to increase perfusion
Correct answer: Lowering blood pressure to reduce bleeding
In hemorrhagic stroke, the priority is to control bleeding and reduce intracranial pressure, including management of hypertension.
What does the 'F' stand for in the acronym 'FAST' used to assess for stroke?
- A Face drooping
- B Finger tingling
- C Field of vision loss
- D Falling down
Correct answer: Face drooping
“F” in FAST stands for Face (facial droop) as a key sign of possible stroke.
Which of the following would a client with a left-hemisphere stroke most likely exhibit?
- A Left-sided neglect
- B Impulsivity and poor judgement
- C Expressive aphasia and right-sided weakness
- D Visual-spatial deficits and inability to dress self
Correct answer: Expressive aphasia and right-sided weakness
Damage to the left hemisphere often causes language problems (aphasia) and right-sided motor deficits.
What assessment finding would the nurse expect in a client with a Transient ischemic attack (TIA)?
- A Elevated intracranial pressure with infarction visible on CT
- B Transient deficits resolving within 24 hours, no infarction
- C Permanent motor deficits persisting beyond several days
- D Acute hemorrhage clearly visible on head MRI
Correct answer: Transient deficits resolving within 24 hours, no infarction
A TIA is a transient neurological deficit without permanent infarction and typically resolves within 24 hours.
Which intervention is most appropriate to prevent aspiration in a client post-stroke with dysphagia?
- A Encourage fluids through a straw at high Fowler’s position
- B Place the client supine during meals
- C Perform a swallowing evaluation before oral intake
- D Offer thickened liquids only if the client complains of choking
Correct answer: Perform a swallowing evaluation before oral intake
A formal swallowing assessment ensures safe oral intake and reduces aspiration risk in stroke clients with swallowing difficulties.
After administering tissue plasminogen activator (tPA), which sign would require immediate intervention?
- A A slight headache relieved by rest
- B Mild periorbital pain on eye movement
- C Bleeding from the IV insertion site
- D A mild fine tremor of the hand
Correct answer: Bleeding from the IV insertion site
Bleeding is a major risk after tPA; bleeding at IV sites is an early sign and requires urgent attention.
Why is early mobilization recommended within the first 24-48 hours in stroke rehabilitation?
- A To reduce intracranial pressure
- B To prevent deep-vein thrombosis and promote neuroplasticity
- C To correct vision deficits
- D To begin forced use of the affected limb for at least 8 hours/day
Correct answer: To prevent deep-vein thrombosis and promote neuroplasticity
Early mobilisation helps reduce complications such as DVT and supports neurological recovery via increased brain stimulation.
What is the best nursing strategy for a client with right-sided weakness and left-sided neglect post-stroke?
- A To reduce intracranial pressure
- B To prevent deep-vein thrombosis and promote neuroplasticity
- C To correct stroke-related vision deficits
- D To prevent pressure injuries and muscle deconditioning
Correct answer: To prevent deep-vein thrombosis and promote neuroplasticity
Placing objects and stimuli within the intact (right) visual field promotes engagement and helps reduce neglect.
In a 72-year-old client presenting with a sudden, severe headache, vomiting and decreased level of consciousness, what type of stroke is suspected?
- A Lacunar infarct
- B Ischemic thrombotic stroke
- C Embolic stroke from atrial fibrillation
- D Subarachnoid hemorrhage
Correct answer: Subarachnoid hemorrhage
A sudden severe headache, vomiting and rapid deterioration are characteristic of a subarachnoid hemorrhage (a hemorrhagic stroke).
Which statement by a client indicates understanding of secondary prevention after an ischemic stroke?
- A 'I’ll stop taking my aspirin once my blood pressure is normal.'
- B 'I’ll change from walking to a stationary bike once a week.'
- C 'I’ll switch to sugar-free snacks and stop smoking.'
- D 'I’ll limit my water intake to prevent edema.'
Correct answer: 'I’ll switch to sugar-free snacks and stop smoking.'
Lifestyle modifications (smoking cessation, sugar control) are key in reducing stroke recurrence risk.
If a client's international normalized ratio (INR) is 3.0 while on warfarin for stroke prevention, what should the nurse do?
- A Hold warfarin and administer vitamin K immediately
- B Continue warfarin and notify the provider if bleeding occurs
- C Double the warfarin dose to keep INR higher
- D Switch to aspirin monotherapy
Correct answer: Continue warfarin and notify the provider if bleeding occurs
An INR of 3.0 may be therapeutic depending on indication; the nurse should monitor and report bleeding rather than automatically hold medication.
Which is the most reliable indicator that a client's neurological status is deteriorating post-stroke?
- A Blood pressure of 150/90 mmHg
- B New onset pupillary asymmetry
- C Mild confusion when asked time of day
- D Complaints of dry mouth
Correct answer: New onset pupillary asymmetry
Pupillary asymmetry suggests increased intracranial pressure or herniation risk and is a serious sign requiring immediate action.
A client prescribed clopidogrel after a TIA reports easy bruising. What is the most appropriate action?
- A Reassure the client that bruising is an expected, harmless effect
- B Stop the clopidogrel immediately without further evaluation
- C Notify the provider, as it may indicate increased bleeding risk
- D Apply warm compresses and continue the medication as scheduled
Correct answer: Notify the provider, as it may indicate increased bleeding risk
Easy bruising on clopidogrel may signal increased bleeding risk; the appropriate action is to notify the provider for evaluation rather than ignore it or stop therapy independently.
When a client exhibits slurred speech, right arm drift, and confusion in the ED with no hemorrhage on CT scan and falls within the tPA window, which contraindication would prevent tPA use?
- A Position the affected arm and support it with pillows to prevent edema
- B Tuck the affected arm across the chest while the client is walking
- C Position the affected shoulder in adduction without any pillow support
- D Have the client ignore the weaker arm until strength returns
Correct answer: Position the affected arm and support it with pillows to prevent edema
Elevated blood pressure above guideline limits is a contraindication for thrombolytics until controlled.
For a client with right-sided weakness and a hemiplegic arm post-stroke, what nursing intervention promotes safety and function?
- A MRI of the head performed with contrast
- B Non-contrast CT scan of the head
- C Carotid Doppler ultrasound of the neck
- D Transthoracic echocardiogram of the heart
Correct answer: Non-contrast CT scan of the head
Elevating and supporting the affected arm helps prevent swelling and contractures and promotes mobility.
Which diagnostic test is performed first to distinguish between ischemic vs hemorrhagic stroke?
- A MRI with contrast
- B Non-contrast CT scan of the head
- C Carotid Doppler ultrasound
- D Echocardiogram
Correct answer: Non-contrast CT scan of the head
A non-contrast head CT is the initial imaging to rapidly distinguish hemorrhage from ischemia.
What condition is a client recovering from a left-hemisphere stroke likely experiencing when showing depressive mood, feelings of worthlessness, and sadness?
- A Normal frustration from disability
- B Left-brain syndrome
- C Post-stroke depression
- D Right-brain emotional response
Correct answer: Post-stroke depression
Post-stroke depression is common, especially in clients aware of their deficits, and requires assessment and possible intervention.
Who among these clients is at the highest risk for an ischemic stroke?
- A 30-year-old female on low-dose OCPs with no other history
- B 45-year-old male with hypertension, smoking 1 pack/day and hyperlipidemia
- C 70-year-old male with well-controlled hypertension and no other risk factors
- D 50-year-old female athlete with no comorbidities
Correct answer: 45-year-old male with hypertension, smoking 1 pack/day and hyperlipidemia
Hypertension, smoking and hyperlipidemia are major modifiable risk factors that significantly increase stroke risk.