Which of the following is the most common complication of CVA?

AIIMS Rishikesh NO - 2019

Medical & Surgical Nursing

Hard

Appeared in: AIIMS Rishikesh NO - 2019

Explanation

The question asks for the most common complication, but the options are risk factors. Interpreting the question's intent, we must identify the most significant risk factor.
Uncontrolled hypertension is the leading modifiable risk factor for both ischemic and hemorrhagic stroke.
According to clinical guidelines, controlling hypertension is the single most important key to preventing a CVA.
Chronic high blood pressure exerts excessive force on the walls of the cerebral arteries, leading to damage, atherosclerosis, and an increased likelihood of rupture or occlusion.

Option B: While the use of oral contraceptive pills, especially older, higher-estrogen formulations, is a risk factor for stroke, it is not nearly as common or potent as hypertension. The risk is most significant when combined with other factors like smoking or migraines.
Option C: Uncontrolled diabetes and obesity are major risk factors for CVA, primarily by accelerating atherosclerosis (hardening of the arteries). However, hypertension is considered a more direct and powerful risk factor.
Option D: Regular, moderate exercise is protective against stroke. While extremely strenuous exertion can be a rare trigger for a cardiovascular event in a predisposed individual, it is not a common risk factor and certainly not a complication.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Risk Factors for Cerebrovascular Accident (CVA) as background academic context rather than a clinical decision trigger.
A nurse's primary role in stroke prevention is identifying and managing hypertension through regular screenings, patient education on lifestyle modifications (diet, exercise), and ensuring medication adherence.
In the post-stroke setting, nurses are responsible for tight blood pressure control to prevent hemorrhagic transformation of an ischemic stroke or a recurrent stroke.
What if? If a patient with uncontrolled hypertension also has atrial fibrillation, the risk of stroke increases exponentially. The nursing priority would then expand to include education and management of anticoagulation therapy in addition to antihypertensive medications.

How to Approach the Question

First, identify the core subject: Cerebrovascular Accident (CVA) or stroke.
Next, analyze the question's lead-in: "most common complication".
Then, carefully review the options. Notice that all options (hypertension, OCPs, diabetes, obesity) are well-known causes or risk factors, not effects or complications of a stroke (like aphasia or hemiplegia).
Recognize the discrepancy. The question is likely flawed and intends to ask for the 'most common risk factor'.
Based on this interpretation, evaluate the options to determine which is the single most significant risk factor for CVA.
Recall or deduce from clinical knowledge that hypertension is universally cited as the number one modifiable risk factor for stroke, making it the best answer among the choices.

Concept Tested & Keywords

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