Nokea
A nurse is planning care for a child with acute bacterial meningitis. Based on the mode of transmission of this infection, which of the following would be included in the plan of care?
- A. No precautions are required as long as antibiotics have been started
- B. Maintain enteric precautions
- C. Maintain respiratory isolation precautions for at least 24 hours after the initiation of antibiotics
- D. Maintain neutropenic precautions
Correct Answer: C
Rationale: Respiratory isolation precautions are necessary for at least 24 hours after starting antibiotics to prevent the spread of bacterial meningitis, which is transmitted through respiratory droplets. This precaution protects healthcare workers and other patients from exposure to the infectious agent.
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The presence of Parkinsonism suggests damage to the following:
- A. caudate nucleus
- B. black substance
- C. cerebellar
- D. frontal lobe
Correct Answer: B
Rationale: Black substance (substantia nigra) is the correct answer because Parkinsonism is characterized by the degeneration of dopaminergic neurons in the substantia nigra. This leads to the classic symptoms of tremor, bradykinesia, and rigidity due to the loss of dopamine in the basal ganglia, which regulates movement.
To elicit a Plantar reflex:
- A. Gently tap the Achilles tendon
- B. Stroke the lateral aspect of the sole of the foot from heel to ball
- C. Present a noxious odor to a person
- D. Observe the person walking heel to toe
Correct Answer: B
Rationale: The Plantar reflex is elicited by stroking the lateral aspect of the sole of the foot from the heel to the ball of the foot with a blunt object. This tests the integrity of the corticospinal tract. A normal response in adults is plantar flexion of the toes.
Which of the following lifestyle factors is the strongest predictor of stroke risk?
- A. cigarette smoking
- B. alcohol consumption
- C. taking illicit drugs
- D. obesity
Correct Answer: A
Rationale: Cigarette smoking is a major risk factor for stroke, as it contributes to the development of atherosclerosis (narrowing and hardening of arteries) and increases the likelihood of blood clots. Quitting smoking significantly reduces stroke risk.
When assessing the motor function of a patient, the nurse should:
- A. Observe for muscle strength, coordination, and movement symmetry.
- B. Check the patient's heart rate.
- C. Inspect the patient's joint range of motion.
- D. Measure the patient's blood pressure.
Correct Answer: A
Rationale: Motor function assessment involves evaluating muscle strength, coordination, and symmetry. Heart rate, joint range of motion, and blood pressure are not directly related to motor function.
When the patient has a rapidly growing brain tumor, what slows expansion of cerebral brain tissue into the adjacent hemisphere?
- A. Ventricles
- B. Falx cerebri
- C. Arachnoid layer
- D. Tentorium cerebella
Correct Answer: B
Rationale: The falx cerebri limits the expansion of brain tissue into adjacent hemispheres.