# Situation: A 64-year-old man is on the rehabilitation ward 10 days after an ischemic stroke in the left cerebral hemisphere. He has right-sided weakness and aphasia. He takes aspirin 80 mg and atorvastatin 40 mg once daily. Before discharge, the nurse reviews his teaching on preventing another stroke. Which statement shows correct understanding?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=630519  
> language: ko  
> subject: Nursing Practice IV — Care of Clients with Problems in Nutrition and Gastrointestinal, Metabolism and Endocrine, Perception and Coordination

## 문제

Situation: A 64-year-old man is on the rehabilitation ward 10 days after an ischemic stroke in the left cerebral hemisphere. He has right-sided weakness and aphasia. He takes aspirin 80 mg and atorvastatin 40 mg once daily.

Before discharge, the nurse reviews his teaching on preventing another stroke. Which statement shows correct understanding?

## 보기

1. "If my arm gets weak again, I will drive myself to the hospital."
2. "I will stop the atorvastatin once my cholesterol is normal."
3. "I can take ibuprofen for my knee pain along with the aspirin."
4. "My blood pressure goal at home is below 130 over 80." **✔ 정답**

**정답: 4**

## 해설

For most people after a stroke or transient ischemic attack, the secondary prevention blood pressure target is below 130/80 mmHg. NSAIDs add bleeding risk with aspirin, new stroke signs call for emergency services rather than self-transport, and statins are continued long term.

## 심화 해설

The secondary prevention blood pressure target
After an ischemic stroke or transient ischemic attack, controlling blood pressure is one of the most effective ways to prevent another stroke. For most people, the secondary prevention target is below 130/80 mmHg. A client who says his home goal is below 130 over 80 has understood the teaching. Lowering blood pressure to below 130/80 mmHg reduces the risk of recurrent stroke. Home monitoring, medicines as prescribed, reduced salt intake, physical activity, and weight control help reach the target.

Other key parts of prevention
Secondary prevention also includes continuing antiplatelet therapy such as aspirin, continuing a statin such as atorvastatin long term, controlling diabetes, stopping smoking, and limiting alcohol. He must know the warning signs of stroke, such as face drooping, arm weakness, speech difficulty, and sudden vision or balance problems, and that these require emergency services immediately. The faster treatment begins, the more brain tissue can be saved.

| Statement | Correct? | Reason |
| --- | --- | --- |
| Drive myself if my arm gets weak | No | Call emergency services immediately |
| Stop atorvastatin once cholesterol is normal | No | Statins continue long term |
| Take ibuprofen with aspirin | No | Adds bleeding and stomach risk |
| Blood pressure goal below 130/80 | Yes | Secondary prevention target |

Why the other statements show misunderstanding
Driving himself to the hospital with new weakness is dangerous: he could lose control of the car, and transport by emergency services allows earlier treatment. Stopping atorvastatin once cholesterol is normal misunderstands the drug's role; a normal level shows the medicine is working, and statins also stabilize plaques. Taking ibuprofen with aspirin increases bleeding and gastrointestinal risk; NSAIDs are avoided unless his provider approves, and safer options for knee pain can be discussed. Watch out! Statements that sound practical often hide a safety error.

Exam takeaway
Discharge teaching after stroke checks understanding of medicines, risk-factor targets, and warning signs. Key point! The usual secondary prevention blood pressure goal after stroke is below 130/80 mmHg; new stroke signs mean calling emergency services.

## 임상 시나리오

Secondary Stroke Prevention TeachingTargets, medicines, and warning signs
Blood pressure target for most people after stroke or transient ischemic attack: below 130/80 mmHg.

Continue aspirin and atorvastatin long term; avoid NSAIDs such as ibuprofen unless approved.

New weakness, facial drooping, or speech difficulty requires emergency services immediately; do not drive yourself.

## 핵심 개념

- **Secondary prevention** — Measures taken after a disease event to prevent recurrence, such as controlling risk factors after a stroke.
- **Antiplatelet therapy** — Drugs such as aspirin that reduce platelet clumping and the risk of arterial clots.
- **Statin** — A cholesterol-lowering drug such as atorvastatin that also stabilizes atherosclerotic plaques.
- **Transient ischemic attack** — A brief episode of neurologic symptoms from temporary loss of blood flow without lasting brain damage.

## 같은 주제 문제

- [Situation: A 68-year-old man is on the medical ward on day 4 after an ischemic stroke in t…](https://mymerci.kr/pages/nclex_q.php?qn_id=630316)
- [Situation: A 68-year-old man is on the medical ward on day 4 after an ischemic stroke in t…](https://mymerci.kr/pages/nclex_q.php?qn_id=630317)
- [Situation: A 68-year-old man is on the medical ward on day 4 after an ischemic stroke in t…](https://mymerci.kr/pages/nclex_q.php?qn_id=630318)
- [Situation: A 68-year-old man is on the medical ward on day 4 after an ischemic stroke in t…](https://mymerci.kr/pages/nclex_q.php?qn_id=630319)
- [Situation: A 72-year-old woman with Parkinson disease for 9 years is admitted to the medic…](https://mymerci.kr/pages/nclex_q.php?qn_id=630320)
- [Situation: A 72-year-old woman with Parkinson disease for 9 years is admitted to the medic…](https://mymerci.kr/pages/nclex_q.php?qn_id=630321)
- [Situation: A 72-year-old woman with Parkinson disease for 9 years is admitted to the medic…](https://mymerci.kr/pages/nclex_q.php?qn_id=630322)
- [Situation: A 72-year-old woman with Parkinson disease for 9 years is admitted to the medic…](https://mymerci.kr/pages/nclex_q.php?qn_id=630323)

---

More free questions: [기출문제](https://mymerci.kr/)

_학습 참고용입니다. 실제 임상은 최신 지침과 소속 기관 프로토콜을 따르세요._