Why is the glucose level decreased in the cerebrospinal fluid of patients with bacterial meningitis?
The liver decreases glucose production during infection.
Bacteria consume glucose for their metabolic processes.
The blood-brain barrier prevents glucose from entering the CSF.
The body increases glucose uptake into the bloodstream.
The Correct Answer is B
Analyzing cerebrospinal fluid changes in meningitis requires knowledge of pathophysiology and microbial metabolism. One must understand how pathogens cross the blood-brain barrier and the metabolic requirements of bacteria compared to normal physiological states in the central nervous system during acute infection.
Choice A rationale
Liver glucose production, or gluconeogenesis, is typically increased during the stress of systemic infection due to cortisol and glucagon. A decrease in CSF glucose is a localized metabolic phenomenon within the subarachnoid space rather than hepatic failure.
Choice B rationale
Bacteria and leukocytes in the CSF consume glucose as a primary energy source for metabolism and replication. Normal CSF glucose is 40 to 70 mg/dL, but in bacterial meningitis, this level drops significantly as pathogens utilize it.
Choice C rationale
While the blood-brain barrier is affected during inflammation, it generally becomes more permeable, not less. The low glucose level is not due to a blockage of entry but rather the rapid consumption of glucose once it enters.
Choice D rationale
While systemic glucose uptake might change during illness, it does not explain the specific drop in CSF levels relative to blood levels. The hallmark of bacterial meningitis is the decreased ratio of CSF glucose to serum glucose..
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
The nurse must apply knowledge of pediatric cardiac rehabilitation post-surgical repair of an atrial septal defect. Effective repair restores normal hemodynamics, allowing children to engage in physical activities. Assessment of the child's tolerance is essential to ensure safety during aerobic team sports.
Choice A rationale
Successful surgical closure of an atrial septal defect typically restores normal cardiac function and pulmonary pressures. Once fully recovered, children are encouraged to lead active lives and participate in team sports according to their individual physical stamina and tolerance.
Choice B rationale
Restricting a child to individual sports is medically unnecessary following a successful surgical repair. Unless specific complications like residual pulmonary hypertension exist, there is no physiological reason to forbid team sports, which promote essential social and physical development.
Choice C rationale
Limiting the child to basic activities like bike riding is overly restrictive post-repair. While low-impact activities are safe, most children can resume full athletic participation. Avoiding sports altogether can lead to physical deconditioning and unnecessary psychosocial isolation.
Choice D rationale
Prohibiting all sports participation is incorrect because surgical repair aims to permit a normal lifestyle. Complete restriction is only indicated in rare cases of severe heart failure or significant arrhythmias, which are not standard outcomes for ASD repair.
Correct Answer is D
Explanation
Cellulitis is a deep bacterial infection of the dermis and subcutaneous tissues. Assessment requires identifying signs of skin barrier compromise and localized inflammation, such as erythema, warmth, and edema, to prevent systemic progression like bacteremia or necrotizing fasciitis.
Choice A rationale
Pustules around the mouth often suggest impetigo, a superficial infection typically caused by Staphylococcus aureus or Streptococcus pyogenes. Cellulitis involves deeper tissue layers and presents with diffuse spreading redness rather than localized perioral pustular clusters.
Choice B rationale
Scaly facial patches are indicative of fungal infections like tinea faciei or inflammatory conditions like seborrheic dermatitis. These lack the acute inflammatory markers of cellulitis, which typically presents with intense warmth, tenderness, and non-circumscribed edema.
Choice C rationale
Hyperpigmentation usually results from chronic venous insufficiency, post-inflammatory changes, or endocrine disorders. Cellulitis is an acute infectious process characterized by rapid-onset erythema and swelling rather than stable changes in skin melanin distribution or pigment deposition.
Choice D rationale
Open, weeping lesions provide a portal of entry for bacteria like Group A Streptococcus into the subcutaneous space. This finding necessitates evaluation for secondary cellulitis, as compromised skin integrity is the primary risk factor for infection.
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