A nurse is planning care for a newly admitted adolescent client who has bacterial meningitis. Which of the following instructions is appropriate for the nurse to include in the plan of care?

Assist the client to a supine position.

Recommend prophylactic acyclovir for the client's family.

Initiate droplet precautions for the client.

Perform a Glasgow Coma Scale every 24 hr.

Answer and Explanation

The Correct Answer is C

A. Assist the client to a supine position: There is no requirement to maintain a supine position for bacterial meningitis. Clients are often more comfortable with the head of the bed elevated to reduce intracranial pressure and promote comfort. Supine positioning alone does not prevent disease transmission or improve outcomes.

B. Recommend prophylactic acyclovir for the client's family: Acyclovir is an antiviral medication and is not effective against bacterial infections. Family members may require prophylactic antibiotics if exposed, but antiviral therapy is inappropriate for bacterial meningitis.

C. Initiate droplet precautions for the client: Bacterial meningitis, particularly Neisseria meningitidis, can be transmitted via respiratory droplets. Implementing droplet precautions, including the use of masks and limiting close contact, protects healthcare staff and other clients from infection. This is a standard and critical infection control measure.

D. Perform a Glasgow Coma Scale every 24 hr: Clients with bacterial meningitis are at risk for rapid neurological changes. Performing a Glasgow Coma Scale only once every 24 hours is insufficient. Neurological status should be monitored more frequently to promptly identify deterioration.

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Correct Answer is C

Explanation

A. Compulsive attention to details: This behavior is more characteristic of obsessive-compulsive personality disorder, not antisocial personality disorder. It reflects a need for order and control rather than disregard for others.

B. Avoids interacting with others: Social withdrawal is typical of avoidant personality disorder. Clients with antisocial personality disorder generally seek interactions they can exploit, rather than avoiding social contact.

C. Uses others for personal gain: Exploiting others for personal benefit is a hallmark of antisocial personality disorder. Clients often display deceitfulness, manipulativeness, and a lack of regard for the rights or feelings of others, consistent with this diagnosis.

D. Socially awkward in group situations: Social awkwardness may be seen in schizoid or schizotypal personality disorders. Clients with antisocial personality disorder usually engage socially in a confident or charming manner when it serves their goals, rather than showing awkwardness.

A. A client who has a burn requiring a sterile dressing change B. A client who had an appendectomy 6 hr ago and has diminished bowel sounds C. A client who received a chemotherapy treatment and reports nausea D. A client who has hypothyroidism and is stuporous

Correct Answer is D

Explanation

A. A client who has a burn requiring a sterile dressing change: While burn care is important to prevent infection and promote healing, a dressing change is not immediately life-threatening. This task can be safely addressed after assessing clients with higher-priority acute risks.

B. A client who had an appendectomy 6 hr ago and has diminished bowel sounds: Diminished bowel sounds are common in the immediate postoperative period and do not usually indicate an emergent problem. This client requires ongoing monitoring, but there is no acute threat to life at this time.

C. A client who received a chemotherapy treatment and reports nausea: Nausea following chemotherapy is uncomfortable and should be managed promptly, but it is not immediately life-threatening. Interventions such as antiemetics can be provided after more urgent needs are addressed.

D. A client who has hypothyroidism and is stuporous: Stupor in a client with hypothyroidism may indicate myxedema or severe hypothyroid crisis, which can be life-threatening due to risk of respiratory depression, cardiovascular compromise, or altered mental status. This client requires immediate assessment and intervention, making them the highest priority.

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A nurse is planning care for a newly admitted adolescent client who has bacterial meningitis. Which of the following instructions is appropriate for the nurse to include in the plan of care?

Nursing Test Bank

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