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 D
Explanation
Choice A reason: Warfarin does not primarily prevent platelet aggregation. It is an anticoagulant that inhibits the synthesis of vitamin K-dependent clotting factors, which are necessary for blood clot formation. Although it affects the clotting process, it does not have a direct impact on platelets.
Choice B reason: Heparin does not have a longer half-life compared to warfarin. In fact, heparin has a relatively short half-life, which allows for rapid adjustments in dosing. This characteristic makes it suitable for acute management of conditions like deep vein thrombosis (DVT), where immediate anticoagulation is necessary.
Choice C reason: Heparin does not necessarily have fewer adverse effects compared to warfarin. Both medications have potential side effects and risks. Heparin can cause bleeding, heparin-induced thrombocytopenia (HIT), and other complications, while warfarin also carries a risk of bleeding and requires careful monitoring due to its interactions with foods and other medications.
Choice D reason: The onset of warfarin is slower than heparin. Heparin works rapidly to anticoagulate the blood and is often used for immediate management of conditions like DVT. Warfarin, on the other hand, takes several days to reach its full anticoagulant effect as it gradually reduces the levels of clotting factors. Therefore, patients are typically started on heparin for immediate effect and then transitioned to warfarin for long-term anticoagulation.
Correct Answer is B
Explanation
Choice A reason: Amphotericin B is typically administered intravenously because it is poorly absorbed from the gastrointestinal tract and thus not suitable for oral administration. It is used to treat severe systemic fungal infections and is known for its potential nephrotoxicity and other adverse effects.
Choice B reason: Azoles, such as fluconazole and itraconazole, generally have lower toxicity compared to amphotericin B. They are often used as first-line treatments for many fungal infections due to their safer side effect profile. Azoles work by inhibiting the synthesis of ergosterol, an essential component of fungal cell membranes, and are available in both oral and intravenous formulations, making them more versatile in their use.
Choice C reason: While amphotericin B does have some drug interactions, it is not typically known for significantly increasing the levels of many other drugs. Instead, the primary concern with amphotericin B is its potential for nephrotoxicity and other direct adverse effects on the patient.
Choice D reason: Both amphotericin B and azoles are considered broad-spectrum antifungal agents. Amphotericin B is effective against a wide range of fungi, including many that are resistant to other antifungal agents. Azoles are also broad-spectrum and are used to treat a variety of fungal infections, but they generally have a better safety profile than amphotericin B.
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