A nurse is caring for an adolescent who was brought to the emergency department (ED) with a high fever, headache, and neck stiffness. The nurse reviews the adolescent's cerebrospinal fluid (CSF) analysis results and notes the following:
- WBC count 300 cells/microliter (normal range: 0 to 10 cells/microliter)
- Protein 45 mg/dL (normal range: 15 to 45 mg/dL)
- Glucose 40 mg/dL (normal range: 50 to 75 mg/dL)
- Color Turbid (normal: clear and colorless)
The nurse should suspect that the adolescent has which of the following conditions?
Bacterial meningitis.
Viral meningitis.
Encephalitis.
Brain abscess.
The Correct Answer is A
Choice A reason: Bacterial meningitis is a probable condition, as it is an infection of the membranes that cover the brain and spinal cord, caused by various bacteria, such as Streptococcus pneumoniae, Neisseria meningitidis, or Haemophilus influenzae. The adolescent has many signs and symptoms of bacterial meningitis, such as fever, headache, and neck stiffness.
Choice B reason: Viral meningitis is not a likely condition, as it is an infection of the membranes that cover the brain and spinal cord, caused by various viruses, such as enteroviruses, herpes simplex virus, or mumps virus. The adolescent has some signs and symptoms of viral meningitis, such as fever, headache, and neck stiffness, but they are usually less severe than bacterial meningitis.
Choice C reason: Encephalitis is not a probable condition, as it is an inflammation of the brain tissue, usually caused by viral infections, such as herpes simplex virus, West Nile virus, or rabies virus. The adolescent has some signs and symptoms of encephalitis, such as fever, headache, and altered mental status, but they are usually accompanied by focal neurological deficits, such as seizures, paralysis, or cranial nerve palsies.
Choice D reason: Brain abscess is not a definite condition, as it is a collection of pus within the brain tissue, usually caused by bacterial infections that spread from other parts of the body, such as the ear, sinus, or lung. The adolescent has some signs and symptoms of brain abscess, such as fever, headache, and altered mental status, but they are usually accompanied by focal neurological deficits, such as seizures, paralysis, or cranial nerve palsies.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: This test measures the level of antibodies that the body produces against the streptolysin O enzyme, which is produced by some strains of streptococcal bacteria. A high level of ASO titer indicates that the child had a recent streptococcal infection, which may trigger rheumatic fever in some cases.
Choice B reason: This test does not directly indicate if the child has rheumatic fever. Rheumatic fever is a complication of untreated or inadequately treated streptococcal infection, which causes inflammation of the heart, joints, skin, and brain. The diagnosis of rheumatic fever is based on clinical criteria, such as the presence of carditis, polyarthritis, chorea, erythema marginatum, or subcutaneous nodules.
Choice C reason: This test does not confirm if the child has immunity to streptococcal bacteria. Immunity is the ability of the body to resist or fight off an infection. A high level of ASO titer does not mean that the child is immune to streptococcal bacteria, but rather that the child was exposed to them recently.
Choice D reason: This test does not indicate if the child has a therapeutic blood level of an aminoglycoside. Aminoglycosides are a class of antibiotics that are used to treat serious bacterial infections, such as endocarditis or septicemia. The blood level of an aminoglycoside is measured by a different test, called a peak and trough level, which determines the effectiveness and safety of the drug.
Correct Answer is A
Explanation
Choice A reason: The American format for writing dates is month/day/year, so 2/20/2024 is the correct way to write the date February 20, 2024.
Choice B reason: The European format for writing dates is day/month/year, so 20/2/2024 is not the correct way to write the date in the American format.
Choice C reason: The ISO format for writing dates is year/month/day, so 2024/2/20 is not the correct way to write the date in the American format.
Choice D reason: This is an invalid format for writing dates, as there is no month with 20 days.
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