Which finding in an analysis of cerebrospinal fluid (CSF) is consistent with a diagnosis of bacterial meningitis?
CSF appears cloudy.
CSF pressure is decreased.
Few leukocytes are present.
Glucose level is increased compared with blood.
The Correct Answer is A
Choice A rationale
Cerebrospinal fluid (CSF) appearing cloudy or turbid is highly consistent with bacterial meningitis because the high concentration of white blood cells (pleocytosis), specifically neutrophils, and bacteria present in the CSF cause the fluid to lose its normal clear, colorless appearance. This visual change is a strong immediate indicator of severe infection.
Choice B rationale
In bacterial meningitis, the large accumulation of exudate, inflammation, and increased vascular permeability within the central nervous system usually leads to increased CSF production and decreased reabsorption, resulting in elevated or increased CSF pressure, not decreased pressure. Decreased pressure is rarely associated with acute bacterial infection.
Choice C rationale
An analysis consistent with bacterial meningitis typically shows a significantly elevated number of leukocytes (pleocytosis), especially polymorphonuclear neutrophils, reflecting the body's aggressive inflammatory response to the bacterial invasion. Few leukocytes (a normal range is 0-5 mononuclear cells/mm³) would be inconsistent with a bacterial infection.
Choice D rationale
Bacterial meningitis is characterized by bacteria consuming glucose for energy, leading to a markedly decreased CSF glucose level (hypoglycorrhachia), which is often less than 40 mg/dL or less than two-thirds of the concurrent blood glucose level. An increased glucose level in the CSF is usually not a finding in this condition.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Neutropenia is defined as an abnormally low number of neutrophils, typically an absolute neutrophil count (ANC) below 1,500 cells/mm³ for children, and often < 500 cells/mm³ following chemotherapy. Neutrophils are the primary defense against bacterial and fungal infections. A severely reduced count significantly compromises the child's immune response, making the risk for systemic infection the most immediate and life-threatening priority nursing diagnosis.
Choice B rationale
While chemotherapy can cause thrombocytopenia (low platelet count, normal range 150,000–450,000/mm³), which leads to a risk for hemorrhage, the problem described is specifically neutropenia (low neutrophil count, normal range 1,500–8,000/mm³). Therefore, the priority related to a low white cell count is the risk for overwhelming infection, not necessarily bleeding risk.
Choice C rationale
Chemotherapy can cause stomatitis, dry skin, and mucosal damage, leading to altered skin and mucous membrane integrity, which further increases the risk of infection. However, the direct consequence of neutropenia is a systemic immune deficit, making the risk for infection a broader and higher-priority diagnosis than just local skin breakdown.
Choice D rationale
Changes in physical appearance (like hair loss or weight changes) and the effects of illness can lead to disturbance in body image. This is an important psychosocial nursing diagnosis. However, in Maslow's hierarchy of needs, physiological needs (like preventing life-threatening infection due to neutropenia) must take priority over psychosocial needs.
Correct Answer is ["1.5"]
Explanation
Step 1 is to convert the ordered dose from grams to milligrams to match the available concentration. 0.5 grams × (1000 milligrams ÷ 1 gram) = 500 milligrams.
Step 2 is to calculate the volume to administer using the available concentration. 500 milligrams ÷ (330 milligrams ÷ 1 milliliter) = 1.51515. milliliters.
Step 3 is to round the calculated volume to the tenths place as required. The nurse will administer 1.5 milliliters.
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