A nurse is caring for a client admitted with meningitis. The student nurse asks, "I know that the client has a lot of edemas in the brain, but what causes it?" Which of the following responses from the nurse best answers the student's question?

"Cerebral edema is caused by osmotic cerebral edema."

"Cerebral edema is caused by whole body inflammation which affects the brain the most."

"Cerebral edema is caused by the by-products of the pathogen that causes the meningitis."

"Cerebral edema is caused by cerebrospinal fluid flowing from the intraventricular space to the interstitial area of the brain."

Answer and Explanation

The Correct Answer is C

A. Osmotic edema refers to fluid shifts due to changes in osmotic gradients (as seen in conditions like hyponatremia), not the inflammatory process of meningitis.

B. While inflammation is a key part of the body's response in meningitis, the edema is not a result of generalized whole-body inflammation. The edema is more directly linked to local inflammatory reactions in the brain triggered by the pathogen’s by-products.

C. Bacterial cell walls, endotoxins, and other components released by the bacteria directly stimulate inflammation, causing the breakdown of the BBB and allowing fluid and inflammatory cells to leak into the brain tissue.

D. This description is more aligned with the pathophysiology of conditions like hydrocephalus rather than meningitis. In meningitis, cerebral edema is primarily due to the inflammatory response, not abnormal CSF flow.

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Correct Answer is D

Explanation

Choice A Reason:

Myelogram is not appropriate. This imaging test involves injecting contrast dye into the spinal canal to visualize the spinal cord and nerve roots. While it may help identify certain spinal cord abnormalities, it is not typically used as a primary diagnostic tool for multiple sclerosis.

Choice B Reason:

Brain natriuretic peptide (BNP) is not appropriate. This blood test measures the level of BNP, a hormone produced by the heart, which can be elevated in conditions such as heart failure. It is not used in the diagnosis of multiple sclerosis.

Choice C Reason:

Troponin level is not appropriate. Troponin is a protein released into the bloodstream during a heart attack or other heart-related conditions. This test is used to diagnose heart muscle damage and is not relevant to the diagnosis of multiple sclerosis.

Choice D Reason:

Lumbar puncture is appropriate. Also known as a spinal tap, a lumbar puncture involves collecting cerebrospinal fluid (CSF) from the spinal canal for analysis. In the diagnosis of multiple sclerosis, analysis of CSF can help identify certain abnormalities, such as an elevated level of immunoglobulin G (IgG) or the presence of oligoclonal bands, which are often indicative of inflammation in the central nervous system. Therefore, a lumbar puncture is commonly ordered to assist with the diagnosis of multiple sclerosis.

A. "You must experiment with your body to find out what stimulation is enjoyable after your injury." B. "You will not be able to have an intimate relationship with anyone after a spinal cord injury." C. "You should not feel undesirable after your injury. You are still nice-looking." D. "Clients who have a spinal cord injury are not aroused by touch around the groin area."

Correct Answer is A

Explanation

Choice A Reason:

"You must experiment with your body to find out what stimulation is enjoyable after your injury." This statement encourages the client to explore their body and discover what types of sexual stimulation are enjoyable and pleasurable for them post-injury. It promotes self-discovery and empowerment in sexual expression, which can be important for sexual satisfaction and intimacy.

Choice B Reason:

"You will not be able to have an intimate relationship with anyone after a spinal cord injury." This statement is incorrect and defeatist. It can create unnecessary feelings of hopelessness and despair in the client. Individuals with spinal cord injuries can still have intimate relationships and engage in sexual activity with partners, albeit with potential adjustments or accommodations.

Choice C Reason:

"You should not feel undesirable after your injury. You are still nice-looking. “While it's important to address body image concerns and reassure the client about their physical appearance, this statement may not directly address sexual stimulation or intimacy. However, it can help promote self-confidence and positive self-esteem, which are important aspects of sexuality and relationships.

Choice D Reason:

"Clients who have a spinal cord injury are not aroused by touch around the groin area." This statement is inaccurate and dismissive of the individual's potential for sexual arousal and pleasure. Sensation and arousal can vary among individuals with spinal cord injuries, and touch around the groin area may still be arousing for some individuals, depending on the level and extent of injury.

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A nurse is caring for a client admitted with meningitis. The student nurse asks, "I know that the client has a lot of edemas in the brain, but what causes it?" Which of the following responses from the nurse best answers the student's question?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is being evaluated for multiple sclerosis. Which of the following tests should the nurse anticipate the provider will order to assist with diagnosis?

Correct Answer is D

Explanation

A nurse is teaching a client who has a spinal cord injury about sexual stimulation. Which of the following statements by the nurse should be included in the teaching?

Correct Answer is A

Explanation

A nurse is caring for a client who has chronic migraine headaches. The client asks the nurse if it could be a cerebral aneurysm. Which of the follow responses should the nurse use?

A nurse is caring for a client who has multiple sclerosis. Which of the following assessment findings should the nurse anticipate with this client? (Select All that Apply.)

A nurse is assessing a client who has multiple sclerosis. The client reports that, since the onset of the disease, there are times when their symptoms are active and then followed by a period with no symptoms. Which of the following types of multiple sclerosis does this pattern indicate?

A nurse is discussing factors that can lead to obstructive sleep apnea with a group of older adults. Which of the following factors should the nurse include in the teaching? Select all that apply.Loss

A nurse is planning care for a client who has multiple sclerosis and is receiving methylprednisolone. Which of the following adverse effects should the nurse anticipate? (Select all that apply.)

Which of the following risk factors is associated with a client having a higher risk of experiencing status asthmaticus?

A client who has a history of migraines comes into the clinic reporting "tingling of the face" and blind spots in the eyes. Which of the following phases of a migraine is the client experiencing?

A nurse is caring for an older adult client in the emergency department who sustained a head injury due to a fall. Which of the following are common reasons for head injuries in older adults? (Select All that Apply.)