1.
A nurse is putting together a presentation on meningitis. Which of the following microorganisms has noted been linked to meningitis in humans?
Correct Answer
D. Cl. difficile
Explanation
The microorganism that has not been linked to meningitis in humans among the options provided is Cl. difficile (Clostridium difficile). Meningitis is primarily associated with bacteria such as Streptococcus pneumoniae (S. pneumonia), Haemophilus influenzae (H. influenza), and Neisseria meningitidis (N. meningitidis). Clostridium difficile, on the other hand, is more commonly associated with gastrointestinal infections and antibiotic-associated diarrhea, rather than meningitis.
2.
Patrick, a healthy adolescent has meningitis and is receiving I.V. and oral fluids. The nurse should monitor this client’s fluid intake because fluid overload may cause:
Correct Answer
A. Cerebral edema
Explanation
Fluid overload can cause cerebral edema. Cerebral edema refers to the swelling of the brain due to an excessive accumulation of fluid. When there is an excessive amount of fluid in the body, it can lead to an increase in intracranial pressure, which can cause the brain to swell. This can result in various neurological symptoms and can be life-threatening if not promptly treated. Therefore, it is important for the nurse to monitor the client's fluid intake to prevent fluid overload and the development of cerebral edema.
3.
A 4-month-old who has meningococcal meningitis gets admitted to the pediatric unit. Which of these nursing interventions has the highest priority?
Correct Answer
A. Instituting droplet precautions
Explanation
The highest priority nursing intervention for a 4-month-old with meningococcal meningitis is instituting droplet precautions. Meningococcal meningitis is highly contagious and can spread through respiratory droplets. By implementing droplet precautions, the nurse can help prevent the transmission of the infection to other patients, visitors, and healthcare providers. This includes placing the patient in a private room, wearing personal protective equipment (such as a mask), and educating others about the importance of hand hygiene and respiratory etiquette. Administering acetaminophen, obtaining history information, and orienting the parents are important interventions but do not take precedence over preventing the spread of the infection.
4.
The nurse assesses a patient, and she notes Brudzinski’s sign and also Kernig’s sign. Of which of these following disorders are two classic signs?
Correct Answer
B. Meningitis
Explanation
Meningitis is the correct answer because both Brudzinski's sign and Kernig's sign are classic signs associated with this disorder. Brudzinski's sign refers to the involuntary flexion of the patient's hips and knees when their neck is flexed, indicating meningeal irritation. Kernig's sign is the resistance or pain experienced by the patient when attempting to extend the knee with the hip flexed, also indicating meningeal irritation. These signs are commonly seen in patients with meningitis, an inflammation of the meninges surrounding the brain and spinal cord.
5.
Richard Barnes had been diagnosed with pneumococcal meningitis. What response by the patient shows that he actually understands the precautions that are necessary with this diagnosis?
Correct Answer
B. “Thank goodness. I’ll only be in isolation for 24 hours.”
Explanation
The correct answer indicates that the patient understands the necessary precautions because they are aware that they will only be in isolation for 24 hours. This shows that they are aware of the importance of isolation to prevent the spread of the meningitis bacteria.
6.
The adolescent patient shows symptoms of meningitis: nuchal rigidity, vomiting, fever, and lethargy. How should the following test be prepared by the nurse?
Correct Answer
D. Lumbar puncture.
Explanation
The symptoms described in the question, such as nuchal rigidity, vomiting, fever, and lethargy, are indicative of meningitis. Lumbar puncture is a diagnostic procedure that involves inserting a needle into the spinal canal to collect cerebrospinal fluid (CSF) for analysis. It is the most appropriate test to confirm the diagnosis of meningitis and identify the causative organism. Blood culture, throat and ear culture, and CAT scan may be helpful in certain cases, but they are not the primary tests for diagnosing meningitis.
7.
In children aged 2 months to 3 years, the most common form of meningitis is caused by
Correct Answer
A. HemopHilus influenzae
Explanation
In children aged 2 months to 3 years, the most common form of meningitis is caused by Hemophilus influenzae. This bacterium is a common cause of bacterial meningitis in young children. It can be spread through respiratory droplets and can lead to severe illness if not treated promptly. Vaccination against Hemophilus influenzae has significantly reduced the incidence of meningitis caused by this bacterium in children.
8.
Dexamethasone improves mortality in meningococcal meningitis.
Correct Answer
B. False
Explanation
Dexamethasone is a corticosteroid that is commonly used to reduce inflammation in various conditions. However, in the case of meningococcal meningitis, studies have shown that the use of dexamethasone does not improve mortality rates. In fact, it is not recommended as routine treatment for meningococcal meningitis. Therefore, the statement that dexamethasone improves mortality in meningococcal meningitis is false.
9.
A client gets admitted having a diagnosis of meningitis that is caused by Neisseria meningitides. Which type of isolation precautions should the nurse institute?
Correct Answer
B. Droplet precautions
Explanation
Droplet precautions should be instituted because Neisseria meningitides is transmitted through respiratory droplets. These precautions include wearing a mask, maintaining a distance of at least 3 feet from the client, and using a private room or cohorting with clients who have the same infection. Standard precautions should also be followed, which include hand hygiene, wearing gloves, and using appropriate personal protective equipment when necessary. Contact precautions are not necessary for this specific infection, as it is not primarily transmitted through direct contact. Airborne precautions are also not necessary, as the infection is not transmitted through the airborne route.
10.
A 4-year-old girl gets admitted with pneumococcal meningitis. Recently she returned from a holiday 2 days before. What should you treat her with?
Correct Answer
D. Cefotaxime and vancomycin
Explanation
The correct treatment for pneumococcal meningitis in a 4-year-old girl who recently returned from a holiday is cefotaxime and vancomycin. Pneumococcal meningitis is commonly caused by Streptococcus pneumoniae, and cefotaxime and vancomycin are effective antibiotics against this bacteria. Cefotaxime is a third-generation cephalosporin that covers a wide range of bacteria, including Streptococcus pneumoniae, while vancomycin is effective against methicillin-resistant Staphylococcus aureus (MRSA) which can also cause meningitis. Therefore, the combination of cefotaxime and vancomycin provides broad-spectrum coverage against the likely pathogens causing the infection.