A patient is brought to the ER with complaints of stiff neck, headache, sensitivity to light, lethargy and fever of 104.5 F for the past 6 hours. The nurse would be concerned with which of the following additional finding?

Positive Kernig's sign

Red raised rash to chest and face

Negative Brudzinski's sign

Negative Babinski's sign

Answer and Explanation

The Correct Answer is A

A. A positive Kernig’s sign (pain and resistance when attempting to extend the knee with the hip flexed) is a classic indicator of meningeal irritation, which, in the presence of fever, headache, neck stiffness, photophobia, and lethargy, strongly suggests meningitis. This finding requires immediate attention because bacterial meningitis can progress rapidly and become life-threatening.

B. While a petechial or purpuric rash may be seen in meningococcal meningitis, a general red raised rash is nonspecific and not the most urgent additional finding compared with a positive Kernig’s sign. Its absence does not rule out meningitis.

C. A negative Brudzinski’s sign (no involuntary hip/knee flexion when the neck is flexed) does not rule out meningitis, especially in early or mild cases. A positive Kernig’s sign is a more sensitive early indicator in this scenario.

D. A negative Babinski’s sign is normal and does not indicate neurological compromise in this context. Its presence or absence is not immediately relevant to the acute presentation of suspected meningitis.

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Correct Answer is B

Explanation

A. Deficiency of Factor IX is responsible for hemophilia B, also called Christmas disease. Like hemophilia A, it is X-linked recessive and primarily affects males, but treatment and factor replacement differ because Factor IX is administered instead of Factor VIII. Misidentifying the factor could lead to inappropriate treatment.

B. Hemophilia A results from a deficiency of Factor VIII, a key protein in the intrinsic pathway of the coagulation cascade. Factor VIII works with Factor IX to activate Factor X, ultimately converting prothrombin to thrombin and fibrinogen to fibrin, forming a stable clot. Without sufficient Factor VIII, the child experiences: Prolonged bleeding after minor cuts or injuries, Spontaneous bleeding episodes, often into joints (hemarthroses) or muscles, Easy bruising, Nosebleeds and prolonged bleeding after dental procedures, Potential life-threatening bleeding if untreated. Factor VIII replacement therapy is the cornerstone of treatment, either prophylactically or during acute bleeding episodes. Education includes proper administration, activity precautions, and early recognition of bleeding.

C. Factor X deficiency is a rare coagulation disorder unrelated to hemophilia A. Deficiency causes bleeding tendencies but involves a different pathway and treatment approach.

D. Stuart-Prower factor refers to Factor X, also not involved in hemophilia A. Confusing this could delay correct treatment and risk severe bleeding.

A. eye opening. B. sensory response. C. verbal response. D. motor response.

Correct Answer is B

Explanation

A. Eye opening is a core component of the Glasgow Coma Scale (GCS) and is assessed to determine the level of consciousness. Scores range from 1 (no eye opening) to 4 (spontaneous eye opening).

B. Sensory response is not directly assessed in the Glasgow Coma Scale. While neurological exams may include sensory testing (e.g., pain, touch, temperature), the GCS specifically evaluates eye opening, verbal response, and motor response.

C. Verbal response is a main component of the GCS, assessing the patient’s ability to speak coherently and appropriately. Scores range from 1 (no verbal response) to 5 (oriented conversation).

D. Motor response is a key part of the GCS, evaluating purposeful or reflexive movements. Scores range from 1 (no motor response) to 6 (obeys commands).

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A patient is brought to the ER with complaints of stiff neck, headache, sensitivity to light, lethargy and fever of 104.5 F for the past 6 hours. The nurse would be concerned with which of the following additional finding?

Nursing Test Bank

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Correct Answer is B

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A patient is brought to the ER with complaints of stiff neck, headache, sensitivity to light, lethargy and fever of 104.5 F for the past 6 hours. The nurse would be concerned with which of the following additional finding?