Certified Medical-Surgical Registered Nurse Practice Exam

In managing a patient with an embolic stroke, what is a major concern for nursing intervention?

1. Monitor for signs of deep vein thrombosis

2. Prevention of pressure ulcers

3. Control of blood glucose levels

4. Monitoring neurological status

The correct answer is: Monitoring neurological status

Monitoring neurological status is crucial in managing a patient with an embolic stroke because this type of stroke occurs when a blood clot or other debris travels through the bloodstream to the brain, causing damage and impairing function. Early detection of changes in the patient's neurological status can indicate whether the stroke is worsening or if new complications, such as a secondary stroke, are occurring. This includes assessing the level of consciousness, motor function, speech, and cognitive abilities. Continuous monitoring allows for timely interventions that may improve outcomes or prevent further neurological deterioration. Understanding the degree of impairment not only helps guide treatment decisions but also aids in communicating the patient's needs and progress to the rest of the healthcare team. Although the other options—monitoring for deep vein thrombosis, preventing pressure ulcers, and controlling blood glucose levels—are important aspects of patient care, they are secondary to the urgent need to assess and respond to changes in neurological status following an embolic stroke. The primary goal in immediate stroke management is to ensure quick evaluation and intervention to protect brain tissue and enhance recovery.