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34 a patient being admitted with bacterial meningitis

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34.A patient being admitted with bacterial meningitis has a temperature of 102.5° F(39.2° C) and a severe headache. Which order should the nurse implementfirst?
a.Administer ceftizoxime (Cefizox) 1 g IV.
b.Give acetaminophen (Tylenol) 650 mg PO.c.Use a cooling blanket to lower temperature.d.Swab the nasopharyngeal mucosa for cultures.ANS: DAntibiotic therapy should be instituted rapidly in bacterial meningitis, but cultures must bedone before antibiotics are started. As soon as the cultures are done, the antibiotic should bestarted. Hypothermia therapy and acetaminophen administration are appropriate but can bestarted after the other actions are implemented.DIF:Cognitive Level: Analyze (analysis)REF: 1340OBJ:Special Questions: PrioritizationTOP: Nursing Process:Implementation MSC: NCLEX: Physiological Integrity35.A patient with possible viral meningitis is admitted to the nursing unit after lumbarpuncture was performed in the emergency department. Which action prescribed bythe health care provider should the nurse question?a.Restrict oral fluids to 1000 mL/day.b.Elevate the head of the bed 20 degrees.c.Administer ceftriaxone (Rocephin) 1 g IV every 12 hours.d.Give ibuprofen (Motrin) 400 mg every 6 hours as needed for headache.ANS: AThe patient with meningitis has increased fluid needs, so oral fluids should be encouraged.The other actions are appropriate. Slight elevation of the head of the bed will decreaseheadache without causing leakage of cerebrospinal fluid from the lumbar puncture site.Antibiotics should be administered until bacterial meningitis is ruled out by the cerebrospinalfluid analysis.DIF:Cognitive Level: Apply (application)REF:1340TOP:Nursing Process: ImplementationMSC: NCLEX: Physiological Integrity36.Which action will the public health nurse take to reduce the incidence ofepidemic encephalitis in a community?a.Teach about prophylactic antibiotics after exposure to encephalitis.b.Encourage the use of effective insect repellent during mosquito season.c.Remind patients that most cases of viral encephalitis can be cared for at home.d.Arrange to screen school-age children for West Nile virus during the school year.ANS: BEpidemic encephalitis is usually spread by mosquitoes and ticks. Use of insect repellent iseffective in reducing risk. Encephalitis frequently requires that the patient be hospitalized inan intensive care unit during the initial stages. Antibiotic prophylaxis is not used to preventencephalitis because most encephalitis is viral. West Nile virus is most common in adults overage 50 during the summer and early fall.DIF:Cognitive Level: Apply (application)REF:1342TOP:Nursing Process: PlanningMSC: NCLEX: Health Promotion and Maintenance37.Which question will the nurse ask a patient who has been admitted with a benignoccipital lobe tumor to assess for functional deficits?

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Term
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Tags
Tension pneumothorax, Respiratory distress, pulmonary edema, atelectasis

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