A patient presents to a primary care provider reporting fever, headache, nuchal rigidity, and decreased consciousness. History includes a previously treated sinusitis. Which medical diagnosis is best supported by this assessment data?
Seizures with auras
Parkinson's disease
Bacterial meningitis
Migraines
The Correct Answer is C
Choice A reason: Seizures with auras can involve symptoms such as sensory disturbances before the seizure event, but they do not typically present with fever, nuchal rigidity (stiff neck), or decreased consciousness. These symptoms suggest an infectious or inflammatory process, not a seizure disorder.
Choice B reason: Parkinson's disease is a neurodegenerative disorder characterized by tremors, stiffness, and bradykinesia (slowness of movement). It does not present with acute fever, headache, nuchal rigidity, or altered consciousness, nor is it associated with a history of sinusitis. The symptoms described are more indicative of an infectious condition rather than a chronic degenerative disease.
Choice C reason: Bacterial meningitis is an infection of the protective membranes covering the brain and spinal cord (meninges). It is characterized by symptoms such as fever, severe headache, nuchal rigidity, and altered consciousness. The history of sinusitis suggests a possible route of infection, as bacteria from the sinuses can spread to the meninges. The clinical presentation strongly supports the diagnosis of bacterial meningitis, which is a medical emergency requiring prompt treatment.
Choice D reason: Migraines can cause severe headaches and may be accompanied by nausea, vomiting, and sensitivity to light and sound. However, they do not typically cause fever, nuchal rigidity, or decreased consciousness. The presence of fever and neck stiffness suggests an infectious etiology rather than a primary headache disorder like migraines.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: The superficial veins of the arm are not a common source of emboli that cause pulmonary embolism. While blood clots can form in the superficial veins, they are less likely to travel to the lungs compared to clots formed in the deep veins of the legs.
Choice B reason: Emboli originating from the left ventricle typically travel to systemic circulation, potentially causing strokes or other systemic embolic events, rather than pulmonary embolism. Pulmonary embolism results from a clot traveling to the pulmonary arteries, which is more likely to originate from the venous system, specifically the deep veins.
Choice C reason: Deep veins of the leg, such as those in the calf and thigh, are the most common source of emboli that cause pulmonary embolism. Blood clots, known as deep vein thrombosis (DVT), can form in these veins and dislodge, traveling through the venous system and the right side of the heart to the pulmonary arteries. This can result in a pulmonary embolism, causing symptoms such as severe chest pain and shortness of breath.
Choice D reason: Systemic arteries do not typically lead to pulmonary embolism, as emboli from these arteries would travel to various parts of the systemic circulation, not the pulmonary arteries. Pulmonary embolism is primarily associated with emboli originating from the venous system, particularly the deep veins of the legs.
Correct Answer is C
Explanation
Choice A reason: Severe hypotension is associated with prerenal acute kidney injury, not postrenal. Prerenal acute kidney injury results from decreased blood flow to the kidneys due to conditions like severe hypotension, leading to reduced kidney perfusion.
Choice B reason: Acute tubular necrosis (ATN) is a form of intrinsic or intrarenal acute kidney injury, not postrenal. ATN is typically caused by prolonged ischemia or exposure to nephrotoxic agents, which directly damage the kidney tubules.
Choice C reason: Postrenal acute kidney injury is caused by an obstruction in the urinary tract that prevents urine from leaving the kidneys, leading to increased pressure and kidney damage. Bilateral kidney stones partially blocking the flow of urine can cause such an obstruction, leading to postrenal acute kidney injury.
Choice D reason: Glomerulonephritis is a type of intrinsic or intrarenal acute kidney injury, not postrenal. It involves inflammation and damage to the glomeruli, the filtering units within the kidneys, and is not typically caused by an obstruction in the urinary tract.
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