A nurse is caring for a client admitted with meningitis. The student nurse asks, "I know that the client has a lot of edemas in the brain, but what causes it?" Which of the following responses from the nurse best answers the student's question?

"Cerebral edema is caused by osmotic cerebral edema."

"Cerebral edema is caused by whole body inflammation which affects the brain the most."

"Cerebral edema is caused by the by-products of the pathogen that causes the meningitis."

"Cerebral edema is caused by cerebrospinal fluid flowing from the intraventricular space to the interstitial area of the brain."

Answer and Explanation

The Correct Answer is C

A. Osmotic edema refers to fluid shifts due to changes in osmotic gradients (as seen in conditions like hyponatremia), not the inflammatory process of meningitis.

B. While inflammation is a key part of the body's response in meningitis, the edema is not a result of generalized whole-body inflammation. The edema is more directly linked to local inflammatory reactions in the brain triggered by the pathogen’s by-products.

C. Bacterial cell walls, endotoxins, and other components released by the bacteria directly stimulate inflammation, causing the breakdown of the BBB and allowing fluid and inflammatory cells to leak into the brain tissue.

D. This description is more aligned with the pathophysiology of conditions like hydrocephalus rather than meningitis. In meningitis, cerebral edema is primarily due to the inflammatory response, not abnormal CSF flow.

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Correct Answer is B

Explanation

Choice A Reason:

Chronic obstructive pulmonary disease (COPD) is inappropriate.COPD is a chronic lung disease characterized by airflow limitation. While COPD does not directly cause spinal stenosis, some individuals with COPD may have comorbidities or risk factors, such as osteoporosis or degenerative changes in the spine, which can contribute to spinal stenosis.

Choice B Reason:

Laminectomy is appropriate. A laminectomy is a surgical procedure used to decompress the spinal cord or nerves by removing the lamina (back part of the vertebra). While a laminectomy can be a treatment option for spinal stenosis, it is not a risk factor for developing the condition.

Choice C Reason:

Hysterectomy is inappropriate. Hysterectomy, the surgical removal of the uterus, is not directly associated with spinal stenosis. However, certain conditions or factors leading to a hysterectomy, such as pelvic tumors or endometriosis, may indirectly contribute to spinal stenosis if they cause changes in the spine or affect posture.

Choice D Reason:

Hyperthyroidism is appropriate. Hyperthyroidism, a condition characterized by excessive production of thyroid hormones, is not a known risk factor for spinal stenosis.

A. Temperature 36.3° C (97.4° F) B. Respirations 12/min C. Blood pressure 184/88 mm Hg D. Heart rate 54/min E. Calcium level 7.0 mg/dL

Correct Answer is ["A","D"]

Explanation

Choice A Reason:

Temperature 36.3°C (97.4°F) is correct. Hypothermia is a characteristic finding in neurogenic shock due to the loss of sympathetic control over temperature regulation and peripheral vasodilation. This can lead to heat loss from the skin surface and a decrease in core body temperature.

Choice B Reason:

Respirations 12/min is incorrect. Respiratory rate is usually not significantly affected in neurogenic shock. However, individuals with high cervical or upper thoracic spinal cord injuries may experience respiratory compromise due to paralysis of respiratory muscles, but this is not a typical feature of neurogenic shock.

Choice C Reason:

Incorrect: Neurogenic shock typically results inhypotension(low blood pressure) due to vasodilation. The given blood pressure reading is elevated, which is not consistent with neurogenic shock.

Choice D Reason:

Heart rate 54/min is correct. Bradycardia is a common finding in neurogenic shock due to unopposed parasympathetic activity resulting from the loss of sympathetic tone. The heart rate may be slow and may decrease further over time.

Choice E Reason:

Calcium level 7.0 mg/dL is incorrect, Calcium levels are not directly related to neurogenic shock. Neurogenic shock primarily involves the loss of sympathetic tone and the resulting hemodynamic changes, rather than alterations in calcium metabolism.

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A nurse is caring for a client admitted with meningitis. The student nurse asks, "I know that the client has a lot of edemas in the brain, but what causes it?" Which of the following responses from the nurse best answers the student's question?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has spinal stenosis. Which of the following conditions should the nurse recognize as a risk factor for spinal stenosis?

Correct Answer is B

Explanation

A nurse is assessing a client who has a spinal cord injury. Which of the following assessment findings should the nurse expect with neurogenic shock? (Select all that apply.) (Select All that Apply.)

Correct Answer is ["A","D"]

Explanation

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