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. "If I can keep my HbA1c less than 6.5% (less than 7%), I will be cured of diabetes.": Maintaining an HbA1c below 7% is important for managing type 1 diabetes and reducing complications, but it does not eliminate the disease. Type 1 diabetes is a lifelong condition due to permanent loss of insulin production.

B. "I will check my blood sugar level before exercising.": Blood glucose monitoring before physical activity is essential to prevent hypoglycemia. Exercise lowers blood sugar levels, and clients with type 1 diabetes must assess their levels beforehand to determine if carbohydrate intake or insulin adjustment is needed.

C. "I should have my eyes checked every 2 years.": Clients with type 1 diabetes should have a comprehensive dilated eye exam annually, not every two years, to monitor for diabetic retinopathy, a common microvascular complication.

D. "I should soak my feet daily in warm, soapy water.": Soaking the feet is not recommended because it can lead to skin maceration and increase the risk of infection. Gentle washing and thorough drying—especially between the toes—are safer practices for foot care.

A. An audible pleural friction rub B. Tracheal deviation from the midline C. Refractory hypoxemia D. Bloody expectorant when coughing

Correct Answer is C

Explanation

Rationale:
A. An audible pleural friction rub: A pleural friction rub is typically heard in conditions involving pleural inflammation, such as pleurisy or pericarditis. It is not a defining feature of acute respiratory distress syndrome, which primarily involves alveolar damage and pulmonary edema.

B. Tracheal deviation from the midline: Tracheal deviation is usually associated with a tension pneumothorax or large pleural effusion. ARDS does not typically cause tracheal shift, as it affects the lungs diffusely rather than exerting pressure on one side.

C. Refractory hypoxemia: This is a hallmark of ARDS. It refers to hypoxemia that does not improve significantly with supplemental oxygen due to impaired gas exchange from widespread alveolar-capillary membrane damage, leading to severe ventilation-perfusion mismatch.

D. Bloody expectorant when coughing: Hemoptysis (bloody sputum) can occur in various respiratory conditions but is not a characteristic manifestation of ARDS. In ARDS, secretions are more likely to be frothy and pink-tinged if pulmonary edema is present.

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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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