Which symptoms are commonly seen in bacterial meningitis?
Photophobia.
Petechial rash.
Nuchal rigidity.
High-pitched cry.
Seizures.
Correct Answer : A,B,C,E
Choice A rationale
Photophobia, or an extreme sensitivity to light, is a common symptom in meningitis, resulting from the meningeal irritation and inflammation caused by the bacterial infection. The meninges, the protective layers covering the brain and spinal cord, contain pain-sensitive fibers. When inflammation reaches the optic nerve pathways or specific cranial nerves, light perception becomes a painful stimulus.
Choice B rationale
A petechial or purpuric rash is a critical and potentially ominous finding, especially in meningococcemia (caused by Neisseria meningitidis). The rash is caused by endothelial damage and vasculitis as the bacteria and inflammatory mediators enter the bloodstream, leading to small, non-blanching hemorrhages beneath the skin due to capillary leakage and microthrombi formation.
Choice C rationale
Nuchal rigidity (stiffness of the neck), a classic sign, is caused by inflammation of the meninges surrounding the cervical spinal cord. Attempting to flex the neck stretches the irritated meninges, eliciting pain and muscle spasm. This rigidity is often assessed using maneuvers like Brudzinski's or Kernig's signs, indicating meningeal irritation.
Choice D rationale
A high-pitched cry is more commonly associated with increased intracranial pressure (ICP), which can be a complication of severe meningitis, particularly in infants due to hydrocephalus or cerebral edema. While a sign of neurological distress, it is a less direct or specific initial symptom compared to the direct signs of meningeal irritation or systemic infection.
Choice E rationale
Seizures are a frequent complication, particularly in infants and young children with bacterial meningitis. They result from the direct inflammatory irritation of the cerebral cortex by the infectious process, cerebral edema, or vascular changes (e.g., thrombosis, infarcts) associated with severe intracranial infection, causing abnormal electrical activity.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C","D","E"]
Explanation
Choice A rationale
Generalized muscle stiffening, or tonic posturing, is characteristic of tonic-clonic seizures, which involve both cerebral hemispheres and typically include a tonic phase of muscle rigidity followed by a clonic phase of rhythmic jerking. This is not a hallmark of focal impaired awareness seizures.
Choice B rationale
Complete loss of consciousness, meaning unresponsiveness to external stimuli, is characteristic of generalized seizures affecting both hemispheres from the onset. Focal impaired awareness seizures involve a change or impairment of consciousness, not necessarily a complete loss, hence the term "impaired awareness.”.
Choice C rationale
A dreamlike state, often described as déjà vu, fear, or a sense of unreality, is a common experiential alteration that can occur during the onset (aura) or ictal phase of a focal impaired awareness seizure, originating typically from the temporal lobe.
Choice D rationale
Sudden, unprovoked emotional outbursts such as fear, anxiety, or laughing (gelastic seizures) are frequently observed manifestations of focal seizures, especially those originating in the limbic system structures like the amygdala within the temporal lobe, reflecting the seizure's impact on emotional processing centers.
Choice E rationale
Automatisms are involuntary, repetitive, non-purposeful behaviors such as lip smacking, chewing, fidgeting, or walking that occur when a person's awareness is impaired during a seizure. They reflect the focal discharge interfering with cortical control over subcortical motor programs.
Correct Answer is D
Explanation
Choice A rationale
Antibiotics are ineffective as Kawasaki disease is an acute systemic vasculitis, not a bacterial infection, making them inappropriate. Corticosteroids are reserved for patients refractory to initial treatment or with specific complications due to potential side effects and limited evidence of benefit in the acute phase, thus not the immediate priority.
Choice B rationale
Antipyretics, such as acetaminophen, manage fever and discomfort but do not address the underlying systemic inflammation and risk of coronary artery aneurysms. Antihistamines are generally unnecessary unless pruritus or an allergic reaction is present, and they are not central to preventing cardiac complications in this critical phase.
Choice C rationale
Intravenous fluids are important to maintain hydration, especially with prolonged fever, but they are not the definitive treatment for preventing long-term cardiac damage. Morphine is an opioid analgesic, which is typically not required for the pain associated with Kawasaki disease, making it a low priority.
Choice D rationale
Intravenous Immune Globulin (IVIG), 2 g/kg infused over 10-12 hours, is the cornerstone of acute treatment, reducing inflammation and the risk of coronary artery aneurysm formation. High-dose aspirin (80-100 mg/kg/day divided every 6 hours) is used for its anti-inflammatory properties during the acute, febrile phase.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.