A nurse is caring for a group of clients in a medical unit. Which of the following clients is at the highest risk for developing osmotic cerebral edema?

A client with a decreased potassium level

A client with a decreased serum glucose

A client with an increased hemoglobin A1C

A client with an increased creatinine level

None

Answer and Explanation

The Correct Answer is B

Choice A Reason:

A client with a decreased potassium level is incorrect. Hypokalemia (decreased potassium level) can cause various neurological symptoms, but it doesn't directly lead to osmotic cerebral edema.

Choice B Reason:

When plasma glucose levels are rapidly lowered, an osmotic gradient develops between the brain and plasma, which can lead to cerebral edema. Brain cells pull water from the plasma, resulting in widespread edema.

Choice C Reason:

While HbA1c is an important marker of diabetes control and may indicate poor long-term management, it does not directly relate to the acute metabolic derangements (e.g., rapid osmotic shifts, severity of acidosis) that predispose to cerebral edema in DKA.

Choice D Reason:

A client with an increased creatinine level is incorrect. Elevated creatinine levels typically indicate kidney dysfunction or dehydration, but they don't directly cause osmotic cerebral edema.

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

Explanation

Choice A Reason:

Light sensitivity is incorrect. Light sensitivity (photophobia) is not typically a direct manifestation of a ruptured cerebral aneurysm. However, it may occur as a secondary symptom due to other neurological disturbances or increased intracranial pressure.

Choice B Reason:

Loss of consciousness is correct. Loss of consciousness is a common manifestation of a ruptured cerebral aneurysm, particularly if the bleeding leads to significant brain injury or compression of vital brain structures.

Choice C Reason:

A dilated pupil is correct. A dilated pupil (mydriasis) may occur as a result of compression of the oculomotor nerve (cranial nerve III) by the expanding hematoma or increased intracranial pressure following a ruptured cerebral aneurysm.

Choice D Reason:

Visual disturbances is correct. Visual disturbances, such as blurred vision, double vision (diplopia), or loss of vision, may occur due to compression of the optic nerve or damage to visual pathways as a result of the hemorrhage.

Choice E Reason:

Nausea and vomiting is correct. Nausea and vomiting are common symptoms associated with a ruptured cerebral aneurysm, often due to irritation of the meninges and increased intracranial pressure resulting from the bleeding.

Choice F Reason:

Numbness on one side of the face is incorrect. Numbness on one side of the face is not typically a direct manifestation of a ruptured cerebral aneurysm. However, it may occur if the hemorrhage affects specific regions of the brain responsible for sensation or if there is associated compression of cranial nerves.

A. "Cerebral edema is caused by osmotic cerebral edema." B. "Cerebral edema is caused by whole body inflammation which affects the brain the most." C. "Cerebral edema is caused by the by-products of the pathogen that causes the meningitis." D. "Cerebral edema is caused by cerebrospinal fluid flowing from the intraventricular space to the interstitial area of the brain."

Correct Answer is C

Explanation

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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A nurse is caring for a group of clients in a medical unit. Which of the following clients is at the highest risk for developing osmotic cerebral edema?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has a cerebral aneurysm. In the event of a ruptured cerebral aneurysm, which of the following manifestations would be present in the client? (Select All that Apply.)

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

Explanation

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?

Correct Answer is C

Explanation

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