A patient who has a history of a transient ischemic attack (TIA) has an order for aspirin 160 mg daily. When the nurse is administering medications, the patient says, 'I don’t need the aspirin today. I don’t have a fever.' Which action should the nurse take?

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Question 1 of 5

A patient who has a history of a transient ischemic attack (TIA) has an order for aspirin 160 mg daily. When the nurse is administering medications, the patient says, 'I don’t need the aspirin today. I don’t have a fever.' Which action should the nurse take?

Correct Answer: C

Rationale: Aspirin is ordered to prevent stroke in patients who have experienced TIAs. Documentation of the patient's refusal to take the medication is an inadequate response by the nurse. There is no need to clarify the order with the health care provider. The aspirin is not ordered to prevent aches and pains.

Question 2 of 5

A 62-year-old male presents with headache, nausea, and vomiting. These symptoms occurred a few hours after returning from the grocery store. He has a history of hypertension treated with lisinopril, and type 2 diabetes mellitus treated with metformin. His temperature is 100.2°F (38°C), blood pressure 176/102 mmHg, pulse is 96/min, and respirations are 19/min. On physical exam, there is dysarthia, left-sided weakness and sensory loss. Noncontrast head CT is shown. Which of the following is most likely the cause of this patient's clinical presentation?

Correct Answer: A

Rationale: Acute headache, nausea, vomiting, and focal deficits (dysarthria, left-sided weakness/sensory loss) with hypertension suggest a hypertensive intracerebral hemorrhage, a common stroke etiology. Amyloid angiopathy typically affects the elderly with lobar hemorrhages, aneurysms cause subarachnoid hemorrhage, and malformations present variably.

Question 3 of 5

A 9-year-old female patient is brought to the pediatrician because she says 'a heart is in my head.' She reports bilateral headaches of pulsating quality, nausea, and has vomited 4 times. Her headache began approximately 6 hours ago, and says that lights worsen her symptoms. Her eyes are red teary and she reports nasal congestion. She is in the 4th grade, and does exceptionally well in school; her mother notes she was a colicky baby and is prone to car sickness She has a cat a home that scratched her face earlier today. She is sitting on the exam table wearing sunglasses. She does not appear severely ill. Vitals signs are stable, and there are no focal neurological deficits. Which of the following is most likely the diagnosis?

Correct Answer: B

Rationale: Pulsating bilateral headache with nausea, photophobia, and vomiting in a child with a motion sickness history suggests migraine. Corneal abrasion causes unilateral pain, tension headache lacks nausea, and seizures involve altered consciousness.

Question 4 of 5

A 37-year-old African American woman presents to the emergency department with pain and vision loss in her right eye. These symptoms progressively worsened over the course of hours. She also reports muscle weakness and sensory changes in both upper extremities. This has never happened before. The patient has a history of ulcerative colitis treated with oral 5-aminosalicylate, and hypertension that is adequately controlled on hydrochlorothiazide. On physical exam, she has a visual acuity of 20/20 in the left eye and 20/200 on the right, a right relative afferent pupil defect, and symmetric motor and sensory deficits more pronounced in the upper extremity. An MRI of brain was normal. MRI spinal cord was obtained with findings shown to the right. Which of the following is most likely the diagnosis?

Correct Answer: D

Rationale: Unilateral optic neuritis (vision loss, RAPD) with spinal cord symptoms (weakness, sensory loss) and normal brain MRI suggest neuromyelitis optica spectrum disorder (NMOSD), often with longitudinally extensive transverse myelitis. MS typically shows brain lesions.

Question 5 of 5

Nerve impulses are picked up by a neuron's (nerve cell):

Correct Answer: A

Rationale: Dendrites are the branched extensions of a neuron that receive incoming nerve impulses from other neurons or sensory receptors.

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