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 C

Explanation

Rationale:
A. Remain 0.3 m (1 ft) away from children: Clients receiving radioactive iodine therapy are advised to maintain a greater distance—typically 1 to 2 meters (3 to 6 feet)—from children and pregnant women for several days to limit radiation exposure.

B. Limit the time spent around women who are pregnant to 10 min daily: Clients should actually avoid close contact with pregnant women entirely for several days post-treatment, not merely limit contact time, to prevent radiation exposure to the fetus.

C. Use disposable utensils for meals: After radioactive iodine therapy, clients may excrete small amounts of radiation in saliva and other bodily fluids. Using disposable utensils helps prevent contaminating shared household items and protects others from exposure.

D. Use an absorbent pad if incontinent: While using precautions to manage bodily fluids is important, this instruction is relevant only if the client is incontinent. It is not a universal teaching point for all clients undergoing radioactive iodine therapy.

A. "Lie down after meals." B. "Elevate the head of the bed while sleeping." C. "Eat a snack 1 hour before going to bed." D. "Eat three large meals each day."

Correct Answer is B

Explanation

Rationale:
A. "Lie down after meals.": Lying down after eating increases the risk of gastric contents refluxing into the esophagus due to gravity. Clients with GERD should remain upright for at least 2 to 3 hours after meals to minimize symptoms.
B. "Elevate the head of the bed while sleeping.": Elevating the head of the bed by 6 to 8 inches helps prevent nighttime reflux by using gravity to reduce backward flow of stomach acid into the esophagus, which is a key strategy in GERD management.
C. "Eat a snack 1 hour before going to bed.": Eating close to bedtime can exacerbate GERD symptoms by increasing gastric volume and acid production, especially when the client lies down soon after eating. A longer gap between the last meal and sleep is advised.
D. "Eat three large meals each day.": Large meals increase gastric pressure and acid production, worsening reflux symptoms. Clients with GERD should eat smaller, more frequent meals to reduce gastric distension and minimize acid reflux episodes.

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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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