A nurse is assessing the lumbar puncture results of an older adult client who has bacterial meningitis. Which of the following laboratory findings should the nurse expect?

Decreased WBC count

Increased glucose

Clear cerebrospinal fluid

Increased protein

Answer and Explanation

The Correct Answer is D

Rationale:
A. Decreased WBC count: Bacterial meningitis causes an inflammatory response, leading to an increased WBC count in the cerebrospinal fluid (CSF), not a decrease. Elevated WBCs indicate the body is fighting infection in the central nervous system.

B. Increased glucose: CSF glucose levels are typically decreased because bacteria consume glucose and impair its transport across the blood-brain barrier. The presence of leukocytes and pathogens in the CSF also contributes to glucose depletion. Elevated glucose is not characteristic of this condition.

C. Clear cerebrospinal fluid: CSF in bacterial meningitis is usually cloudy or turbid due to the accumulation of white blood cells, protein, and bacteria. The change in appearance reflects the severity of the infection and is one of the classic diagnostic signs. Clear CSF would be more consistent with normal or viral findings.

D. Increased protein: A hallmark of bacterial meningitis is elevated CSF protein levels due to increased permeability of the blood-brain barrier and the presence of bacterial and inflammatory proteins. This is an expected finding.

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Correct Answer is B

Explanation

Rationale:

A. Instruct the client to lift no more than 6.8 kg (15 lb) when at home: While it is important to avoid heavy lifting after a lumbar laminectomy, specific weight limits should be prescribed by the provider or physical therapist. Also, this instruction is more appropriate for discharge teaching, not immediate postoperative care.

B. Turn the client by log rolling with a turning sheet: Log rolling maintains spinal alignment and minimizes twisting of the spine, which is critical after spinal surgery. It prevents stress on the operative site and reduces the risk of complications such as spinal cord or nerve injury.

C. Inform the client to shower on the second postoperative day: Showering is usually permitted after surgical wounds have started to seal, but the exact timing depends on the surgeon's orders and the condition of the incision. Automatic showering on day two may not be safe for all clients.

D. Remove sterile adhesive strips before discharge: Sterile adhesive strips (such as Steri-Strips) are typically left in place until they fall off naturally or are removed by a healthcare provider at a follow-up visit. Removing them prematurely can increase infection risk or disrupt healing.

A. Hypernatremia B. Decreased serum osmolality C. Ketones in the urine D. Hypoglycemia

Correct Answer is C

Explanation

Rationale:
A. Hypernatremia: While mild hypernatremia can occur in severe dehydration, it is not a defining or consistent feature of type 1 diabetes. Electrolyte imbalances may vary depending on hydration and glucose levels.

B. Decreased serum osmolality: In type 1 diabetes, serum osmolality is typically increased due to hyperglycemia and the osmotic effect of glucose in the bloodstream, which draws water out of cells and into the vascular space. A decrease would be inconsistent with the expected metabolic state.

C. Ketones in the urine: Ketones in the urine are a hallmark of type 1 diabetes, especially when insulin is deficient. Without insulin, the body breaks down fat for energy, producing ketones as a byproduct, which can be detected in the urine during diabetic ketoacidosis.

D. Hypoglycemia: Hypoglycemia is a complication of diabetes management, often resulting from too much insulin or missed meals. It is not a presenting manifestation of newly diagnosed type 1 diabetes, which typically presents with hyperglycemia and related symptoms.

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A nurse is assessing the lumbar puncture results of an older adult client who has bacterial meningitis. Which of the following laboratory findings should the nurse expect?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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