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Which behavior is a risk factor for developing and spreading bacterial meningitis?
- A. An upper respiratory infection (URI).
- B. Unprotected sexual intercourse.
- C. Chronic alcohol consumption.
- D. Use of tobacco products.
Correct Answer: A
Rationale: URI (A) increases the risk of bacterial meningitis by facilitating bacterial invasion. Sexual intercourse (B), alcohol (C), and tobacco (D) are not direct risk factors.
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The nurse is caring for the client who has limited intake due to dysphagia following an ischemic stroke. Which serum laboratory result should the nurse review to verify that the client is dehydrated?
- A. Elevated serum creatinine
- B. Elevated blood urea nitrogen
- C. Decreased hemoglobin
- D. Decreased prealbumin
Correct Answer: B
Rationale: The serum creatinine is elevated with renal insufficiency or renal failure. The BUN is elevated when the client is dehydrated due to the lack of fluid volume to excrete waste products. The Hgb is decreased with blood loss or anemia from nutritional deficiencies, not with dehydration. A decreased prealbumin indicates a nutritional deficiency.
Which potential pituitary complication should the nurse assess for in the client diagnosed with a traumatic brain injury (TBI)?
- A. Diabetes mellitus type 2 (DM 2).
- B. Seizure activity.
- C. Syndrome of inappropriate antidiuretic hormone (SIADH).
- D. Cushing's disease.
Correct Answer: C
Rationale: TBI can damage the pituitary, causing SIADH (C), leading to fluid retention and hyponatremia. DM2 (A) is unrelated, seizures (B) are neurological, and Cushing’s (D) is less common post-TBI.
Which intervention is priority for a client with AIDS dementia complex experiencing agitation?
- A. Administer a sedative as prescribed.
- B. Provide a quiet, low-stimulus environment.
- C. Restrain the client to prevent injury.
- D. Encourage group activities to distract the client.
Correct Answer: B
Rationale: A quiet, low-stimulus environment reduces agitation in clients with AIDS dementia complex by minimizing sensory overload.
The nurse is assessing the client following a closed head injury. When applying nailbed pressure, the client’s body suddenly stiffens, the eyes roll upward, and there is an increase in salivation and loss of swallowing reflex. Which observation should the nurse document?
- A. Decerebrate posturing observed
- B. Decorticate posturing observed
- C. Positive Kernig’s sign observed
- D. Seizure activity observed
Correct Answer: D
Rationale: Decerebrate posture involves rigid extension of the arms and legs, downward pointing of the toes, and backward arching of the head. Decorticate posture involves rigidity, flexion of the arms toward the body with the wrists and fingers clenched and held on the chest, and the legs extended. A positive Kernig’s sign is flexing the leg at the hip and then raising the leg into extension. Severe head and neck pain occurs. Body stiffening, eyes rolled upward, increase in salivation, and a loss of swallowing reflex are signs consistent with the tonic phase of a tonic-clonic seizure. This phase is followed by the clonic phase with violent muscle contractions.
The nurse is assessing a client experiencing motor loss as a result of a left-sided cerebrovascular accident (CVA). Which clinical manifestation would the nurse document?
- A. Hemiparesis of the client's left arm and apraxia.
- B. Paralysis of the right side of the body and ataxia.
- C. Homonymous hemianopsia and diplopia.
- D. Impulsive behavior and hostility toward family.
Correct Answer: B
Rationale: A left-sided CVA affects the right side of the body due to the brain's contralateral control. Paralysis or hemiparesis of the right side is a common manifestation, and ataxia (impaired coordination) may also occur. Hemiparesis of the left arm would indicate a right-sided CVA, visual deficits like homonymous hemianopsia are possible but less specific to motor loss, and behavioral changes are not directly related to motor deficits.