Moderate

A patient suddenly develops facial drooping, weakness of the right arm and difficulty speaking. The bedside blood glucose is normal. Which action should the nurse take first?

Correct answer: B. Record the last known well time and activate the stroke pathway

  • A. Give food and allow the patient to sleep
  • B. Record the last known well time and activate the stroke pathway
  • C. Administer an oral sedative to reduce anxiety
  • D. Ask the patient to walk to assess balance

Explanation

Sudden focal neurological deficits suggest an acute stroke, so the last known well time and urgent stroke assessment are essential for treatment decisions. Oral intake and walking may create aspiration or falls risk, and sedation can obscure neurological changes.

Submitted by a TestUstad contributor and published by the TestUstad editorial teamLast updated
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About Critical Care and Emergency Nursing

Covers rapid assessment and stabilisation of patients with airway obstruction, respiratory failure, shock, cardiac arrest, sepsis, poisoning and major electrolyte disturbances. It includes triage, the ABCDE approach, cardiopulmonary resuscitation, ventilator and monitor care, emergency medicines and distinguishing life-threatening deterioration from stable illness.

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