A 15-year old adolescent is brought to the emergency department by his parents. The adolescent is febrile with chills that started suddenly. He states, "I had a sinus infection and sore throat a couple of days ago." The nurse suspects bacterial meningitis based on which findings? Select THREE that apply
Right leg pain
RLQ abdominal pain 7/10
Negative Brudzinski's
Severe Headache
Vomiting
Photophobia
Correct Answer : D,E,F
Rationale:
A. Right leg pain: Right leg pain is not typically related to bacterial meningitis. It is more commonly associated with musculoskeletal or neurological issues localized to the limb and does not contribute to the diagnosis of meningitis.
B. RLQ abdominal pain 7/10: Right lower quadrant abdominal pain is usually linked to gastrointestinal conditions such as appendicitis or other abdominal pathologies. This symptom does not correlate with the systemic or neurological symptoms seen in meningitis.
C. Negative Brudzinski's: A negative Brudzinski’s sign indicates the absence of meningeal irritation. Since meningeal inflammation is a key feature of bacterial meningitis, a negative sign makes the diagnosis less likely.
D. Severe Headache: Severe headache is a classic symptom of bacterial meningitis caused by inflammation of the meninges and increased intracranial pressure. This symptom often accompanies fever and neck stiffness, signaling central nervous system involvement.
E. Vomiting: Vomiting occurs in meningitis due to increased intracranial pressure and systemic illness. It is a common nonspecific symptom reflecting the severity of the infection and the body’s response to it.
F. Photophobia: Photophobia, or sensitivity to light, results from meningeal irritation in meningitis. It is a hallmark sign and frequently accompanies headache and neck stiffness in affected patients.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["2400"]
Explanation
Calculation:
Dose per administration = 400 mg.
- Calculate the number of doses in one 24-hour period.
Number of doses = Total hours / Frequency of administration
= 24 hours / 4 hours/dose
= 6 doses.
- Calculate the total milligrams (mg) the child will receive in a 24-hour period.
Total mg = Dose per administration (mg) x Number of doses
= 400 mg x 6 doses
= 2400 mg.
Correct Answer is A
Explanation
Rationale:
A. Encourage peers to call and visit when the adolescent's condition allows: Social connections are vital for adolescents’ emotional well-being and identity development. Encouraging peer interaction helps reduce feelings of isolation and supports coping during hospitalization.
B. Ask the parents how the adolescent usually copes in new situations: While parents can provide useful information, involving the adolescent directly respects their growing autonomy and helps tailor interventions to their personal coping style.
C. Discourage questions and concerns about the effects of the illness on the adolescent's appearance: Adolescents are often highly concerned about body image. Discouraging these concerns can damage trust and hinder open communication.
D. Be sure the adolescent wears a hospital gown or pajamas throughout the hospitalization: Adolescents typically desire privacy and autonomy, including control over their clothing. Allowing them to wear their own clothes when possible promotes dignity and comfort.
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