You are caring for a patient with suspected bacterial meningitis. The physician performs a lumbar puncture to extract some cerebral spinal fluid (CSF) for testing.
Which of the following lab results would you expect if the patient does indeed have bacterial meningitis?
Absence of bacteria.
Decreased glucose.
Absence of leukocytes.
Absence of protein.
The Correct Answer is B
Choice A rationale
The presence of bacteria in the cerebrospinal fluid is a hallmark indicator of bacterial meningitis. Therefore, an absence of bacteria would typically rule out a bacterial infection, suggesting either a different etiology or a sterile CSF culture due to prior antibiotic administration.
Choice B rationale
In bacterial meningitis, bacteria consume glucose from the CSF for their metabolic needs. This leads to a characteristic decrease in CSF glucose levels (normal range 40-70 mg/dL or approximately 2/3 of blood glucose). This metabolic activity of the bacteria is a key diagnostic marker.
Choice C rationale
Bacterial meningitis is characterized by a significant inflammatory response within the central nervous system. This response includes a robust influx of leukocytes, predominantly neutrophils, into the cerebrospinal fluid. Therefore, an absence of leukocytes would contradict a diagnosis of bacterial meningitis.
Choice D rationale
The inflammation and increased permeability of the blood-brain barrier associated with bacterial meningitis often lead to an elevated protein concentration in the cerebrospinal fluid (normal range 15-45 mg/dL). Therefore, an absence of protein would be inconsistent with the expected findings.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","E"]
Explanation
Choice A rationale
A positive sputum culture definitively identifies the pathogenic microorganisms responsible for the infection within the lungs. This microbiological evidence is crucial for confirming the presence of pneumonia and guiding appropriate antibiotic therapy, distinguishing VAP from other pulmonary issues.
Choice B rationale
A new fever indicates a systemic inflammatory response, often triggered by an infection. In the context of a ventilated patient, a new onset of fever, particularly above 38°C (100.4°F), strongly suggests the presence of a new infection, such as ventilator-associated pneumonia.
Choice C rationale
An SpO2 of 98% indicates excellent oxygen saturation. While desirable, it does not rule out VAP, as patients can initially maintain good oxygenation despite developing an infection, especially if the pneumonia is localized or mild in its early stages.
Choice D rationale
A respiratory rate of 14 breaths per minute is within the normal range. A normal respiratory rate does not indicate the presence or absence of VAP, as patients with early or localized pneumonia might not exhibit significant changes in their respiratory patterns initially.
Choice E rationale
New infiltrates on a Chest X-Ray indicate areas of consolidation or fluid accumulation within the lung tissue. These radiological findings are highly suggestive of pneumonia, as the inflammatory process associated with infection leads to alveolar filling and opacities visible on imaging.
Correct Answer is D
Explanation
Choice A rationale
Albuterol is a selective beta-2 adrenergic agonist and does not directly suppress the immune response. Corticosteroids are known for their immunosuppressive effects, but Albuterol's primary action is bronchodilation by acting on airway smooth muscle receptors, leading to relaxation and improved airflow without affecting immune cells.
Choice B rationale
While some beta-agonists can have a minor effect on glucose metabolism, leading to slight increases in blood sugar in some individuals, this is not a common or significant side effect associated with typical Albuterol use, especially compared to corticosteroids. Albuterol's primary mechanism involves adenyl cyclase activation, leading to bronchodilation.
Choice C rationale
Mouth sores are not a typical side effect of Albuterol. Oral candidiasis (thrush) can occur with inhaled corticosteroids due to localized immunosuppression and altered oral flora, but Albuterol, being a bronchodilator, does not have this effect. Mouth irritation is possible with any inhaled medication, but not true sores.
Choice D rationale
Albuterol is a beta-2 adrenergic agonist, and while it primarily targets beta-2 receptors in the lungs, it can have some systemic absorption and stimulate beta-1 receptors in the heart, especially with higher doses. This stimulation can lead to an increased heart rate (tachycardia) due to enhanced cardiac contractility and conduction.
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.