A nurse is collecting data from a 4-month-old infant who has meningitis. Which of the following manifestations should the nurse expect?

Constipation

Depressed anterior fontanel

Presence of the rooting reflex

High-pitched cry

Answer and Explanation

The Correct Answer is D

D. A high-pitched cry, often described as a "crying in pain" or "irritable cry," can be a characteristic sign of meningitis in infants. The cry may sound different from the infant's usual cry and may be associated with irritability, discomfort, or pain. It can be indicative of increased intracranial pressure and neurological irritation caused by the inflammation of the meninges.

A. Constipation is not typically associated with meningitis in infants. Meningitis is an inflammation of the membranes surrounding the brain and spinal cord, which can cause symptoms such as fever, irritability, poor feeding, vomiting, and lethargy.

B. A depressed anterior fontanel (sunken soft spot on the baby's head) is not a typical manifestation of meningitis. Meningitis may cause signs of increased intracranial pressure, such as a bulging fontanel, rather than a depressed fontanel.

C. he presence of the rooting reflex is not specific to meningitis. The rooting reflex is a normal reflex present in infants, where they turn their head toward a stimulus (such as stroking the cheek or corner of the mouth) in search of nourishment (typically the breast or bottle).

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Correct Answer is D

Explanation

D. The correct action would be to place the client on NPO (Nothing by Mouth) status, option D. This is because a decreased level of consciousness can increase the risk of aspiration.

A. Liver biopsy is not indicated for suspected meningitis with a decreased level of consciousness. Liver biopsy is a procedure used to obtain a sample of liver tissue for diagnostic purposes, typically to evaluate liver function or diagnose liver diseases.

B. A protective environment (option B) is more related to immunocompromised patients. In the case of decreased level of consciousness, preventing aspiration is key.

C. Dorsal recumbent position refers to lying on the back with the knees flexed. While this position may be suitable for certain medical procedures or examinations, it is not specifically indicated for a client with suspected meningitis and a decreased level of consciousness.

A. "Does anyone smoke in the same house as your daughter?" B. "Has your daughter had a lot of earwax in her ears over the last month?" C. "Has your daughter been king glass of water day?" D. "Does your daughter get water in her ears when you bath her?

Correct Answer is A

Explanation

A. Exposure to environmental tobacco smoke (passive smoking) is a known risk factor for otitis media, as it can irritate the upper respiratory tract and increase susceptibility to respiratory infections, including those affecting the ears.

B. Excessive earwax buildup can sometimes contribute to ear discomfort or hearing problems but it is not a common cause of persistent otitis media. However, it's still important for the nurse to assess for any earwax issues as part of the overall assessment of the child's ear health.

C. Drinking water is generally beneficial for overall health but is not directly linked to otitis media unless there are specific concerns about hydration status or exposure to contaminated water sources.

D. Water entering the ears during bathing is not generally considered a significant risk factor for otitis media, but it can be associated with otitis externa, which is an infection of the outer ear canal.

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A nurse is collecting data from a 4-month-old infant who has meningitis. Which of the following manifestations should the nurse expect?

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Naxlex Comprehensive Predictor Exams

A nurse is assisting with the care of a client who has suspected meningitis and a decrease level of consciousness. Which of the following actions should the nurse take?

Correct Answer is D

Explanation

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Correct Answer is A

Explanation

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