Which interventions would the nurse include in the plan of care for a patient with a diagnosis of bacterial meningitis?

Maintain the patient in a flat, supine position

Restrain the patient in bed.

Reduce the patient's environmental stimuli as much as possible

Increase the patient's fluid intake

Answer and Explanation

The Correct Answer is C

A.   A flat supine position is not recommended for patients with meningitis; they should be kept at a 30- degree angle to reduce ICP.

B.   Restraining the patient is unnecessary unless there is an immediate risk of harm, and it can cause distress.
C.   Reducing environmental stimuli helps minimize discomfort and risk of seizures, especially in meningitis, which causes hypersensitivity to light and sound.
D.   Fluid intake should be monitored carefully. Excessive fluids may increase ICP in a patient with meningitis.

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Correct Answer is C

Explanation

A. Ambulation may worsen the condition as it could increase swelling or spread infection.
B. This may increase swelling and should generally be avoided in cellulitis.
C. This helps to improve circulation and reduce swelling in cellulitis.
D. Wrapping the foot tightly could exacerbate swelling and discomfort.

A. Movement of the eye in the sideward direction occurs, with neck extension B. When flexing the neck, eye movement is in the upward direction C. Movement of the eye is in the opposite direction of the turned head D. When extending the neck, eye movement is in the downward direction

Correct Answer is C

Explanation

A. The oculocephalic reflex test should cause the eyes to move in the opposite direction to the head turn, indicating intact brainstem function.
B. Movement of the eyes in an upward direction upon neck flexion indicates an abnormal response, suggesting a lesion.
C. A lesion could result in abnormal eye movement, as the eyes should move opposite to head movement.
D. Eye movement in the downward direction during neck extension is not a normal response and suggests a brainstem issue.

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Which interventions would the nurse include in the plan of care for a patient with a diagnosis of bacterial meningitis?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse will include which intervention for the patient newly admitted with cellulitis of the right foot?

Correct Answer is C

Explanation

After performing an assessment of the oculocephalic reflex, the nurse suspects that the patient has an intracranial lesion. Which patient behavior supports the nurse's assessment findings?

Correct Answer is C

Explanation

Which method of measurement is the gold standard for obtaining intracranial pressures?

For the patient after a craniotomy, which intracranial pressure (ICP) reading would the nurse report immediately to the healthcare provider?

Which term would the nurse use to document a patient who is comatose from a head injury and display flexion of the arms, wrists, and fingers, as well as adduction of the upper extremities?

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?

A nurse is caring for a client who has increased intracranial pressure and has a worsening neurologic condition. Which of the following cues should the nurse recognize as a worsening condition? (Select All that Apply.)

A nurse is teaching a client who has diabetes mellitus about diabetic retinopathy. Which of the following statements should the nurse make to the client?

A nurse is caring for a client who has had a stroke involving the right hemisphere. Which of the following alterations in function should the nurse expect?

A nurse admits a client who has a subarachnoid hemorrhage and increased intracranial pressure (ICP). Which of the following medications should the nurse expect to administer to decrease ICP?