A nurse is assessing a client who was brought into the emergency room following a seizure. The nurse suspects the client may have meningococcal meningitis when assessment findings include nuchal rigidity and a petechial rash. After implementing droplet precautions, which of the following actions should the nurse initiate next?

Administer an antipyretic.

Complete a vascular assessment.

Assess the cranial nerves.

Decrease environmental stimuli.

Answer and Explanation

The Correct Answer is C

Choice A reason:

Administering an antipyretic can help reduce fever, which is a common symptom of meningococcal meningitis. However, this action does not address the immediate need to assess the extent of neurological impairment. While fever management is important, it is not the first priority in this situation.

Choice B reason:

Completing a vascular assessment is important to evaluate the client’s circulatory status, especially if there are signs of septicemia. However, in the context of suspected meningococcal meningitis, the priority is to assess the neurological status to determine the extent of central nervous system involvement. This will guide further treatment and interventions.

Choice C reason:

Assessing the cranial nerves is crucial in a client with suspected meningococcal meningitis. This assessment helps determine the extent of neurological impairment and can provide critical information about the progression of the disease. Early identification of neurological deficits can guide immediate and appropriate interventions to prevent further complications.

Choice D reason:

Decreasing environmental stimuli can help reduce discomfort for the client, especially if they are experiencing photophobia or other sensory sensitivities. However, this action does not address the immediate need to assess the client’s neurological status. It is a supportive measure that can be implemented after more critical assessments are completed.

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Correct Answer is C

Explanation

Choice A reason:

Inserting a padded tongue blade into the client’s mouth is not recommended and can be dangerous. During a seizure, there is a risk of causing injury to the client’s mouth or teeth, and it can also obstruct the airway. The correct approach is to ensure the client’s safety by preventing injury, not by inserting objects into their mouth.

Choice B reason:

Restraining the client during a seizure is not advised. Restraints can cause additional harm and do not prevent the seizure from occurring. Instead, the focus should be on protecting the client from injury by ensuring a safe environment and allowing the seizure to run its course.

Choice C reason:

Moving objects away from the client is a crucial step in ensuring their safety during a seizure. This action helps prevent the client from hitting or injuring themselves on nearby objects. Creating a safe space around the client is one of the primary goals during a seizure to minimize the risk of injury.

Choice D reason:

Placing the client on their back is not recommended during a seizure. Instead, the client should be placed on their side if possible, to help keep the airway clear and reduce the risk of aspiration. This position also allows for better monitoring of the client’s breathing and overall condition.

A. Epidemiology interprets legislation in the community. B. Epidemiology evaluates the effectiveness of nursing interventions. C. Epidemiology analyzes and examines the root causes of health outcomes. D. Epidemiology defines the burden of disease and determinants of health. E. Epidemiology relates to the health status of a population.

Correct Answer is ["B","C","D","E"]

Explanation

Choice A reason:

While epidemiology provides valuable data that can inform public health policies and legislation, it does not directly interpret legislation. The role of epidemiology is to gather and analyze data on health outcomes, which can then be used by policymakers to create informed legislation. Therefore, this statement does not accurately reflect the primary functions of epidemiology.

Choice B reason:

Epidemiology evaluates the effectiveness of nursing interventions by analyzing data on health outcomes before and after the implementation of specific interventions. This helps determine whether the interventions are successful in improving health and reducing disease incidence. Community health nurses rely on this data to make evidence-based decisions and improve their practice.

Choice C reason:

Epidemiology analyzes and examines the root causes of health outcomes by studying patterns, causes, and effects of health and disease conditions in populations. This analysis helps identify risk factors and underlying causes of diseases, which is essential for developing effective prevention and intervention strategies.

Choice D reason:

Epidemiology defines the burden of disease and determinants of health by quantifying the incidence, prevalence, and impact of diseases within a population. This information is crucial for public health planning and resource allocation, as it highlights the most pressing health issues and their contributing factors.

Choice E reason:

Epidemiology relates to the health status of a population by providing comprehensive data on health trends, disease outbreaks, and overall health outcomes. This information helps community health nurses understand the health needs of their populations and tailor their interventions accordingly.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching the family of a client who has a new diagnosis of epilepsy about actions to take if the client experiences a seizure. Which of the following instructions should the nurse include in the teaching?

Correct Answer is C

Explanation

Which of the following statements indicate the importance of epidemiology to the community health nurse? SELECT ALL THAT APPLY.

Correct Answer is ["B","C","D","E"]

Explanation

A nurse is monitoring a client who had a cerebral aneurysm rupture. Which of the following findings should the nurse identify as a manifestation of increased intracranial pressure (ICP)?

A nurse is caring for a client diagnosed with Trigeminal neuralgia who is suddenly experiencing severe pain on the left side of the face. The nurse identifies which classification of medications is most effective in treating this type of pain?

A nurse is providing care to a client with Myasthenia gravis who has lost 6 kg of weight over the past 2 months. What should the nurse suggest to improve this client’s nutritional status?

A nurse is caring for a client who has experienced a hemorrhagic stroke. Which intervention should the nurse prioritize when providing care to the client?

A nurse is assessing a client who reports a severe headache and stiff neck. The nurse’s assessment reveals positive Kernig’s and Brudzinski’s signs. Which of the following actions should the nurse perform first?

The school nurse identifies 12 students with confirmed cases of influenza A. The families of the children are advised to keep the children home for a minimum of 5 to 7 days. Which of the following is an appropriate action by the nurse?

A nurse advises a client with osteoporosis to have three servings of milk or dairy products daily. Which of the following levels of prevention is being used by the nurse?

The nurse is performing the Romberg test on a client during a neurological assessment. Which of the following best describes the rationale for conducting the Romberg test?