Question 1 of 10
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Which symptoms would the nurse associate with a cerebral neoplasm?
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- Long-term memory loss and paralysisLong-term memory loss and paralysis are not symptoms of a cerebral neoplasm.
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- Loss of muscle strength and paresthesiaWhile loss of muscle strength is a symptom of a cerebral neoplasm, paresthesia is not.
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- Grand mal seizure activity and facial paralysisGrand mal seizure activity and facial paralysis are not symptoms of a cerebral neoplasm.
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- Severe headache that wakes the patient and visual problemsThe symptoms of a cerebral neoplasm depend on location and may appear gradually. Headache awakening the patient is a key sign. Vomiting, visual problems, and other signs of increased intracranial pressure may occur. Approximately 20% to 50% of adults with brain tumors develop seizure activity. Personality changes, disturbances in judgment and memory, loss of muscular strength and coordination, and difficulty speaking clearly are all symptoms of a cerebral neoplasm.
Question 2 of 10
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What manifestation may be the first clinical sign of a brain tumor?
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- SeizuresSeizures are common in patients with brain tumors and may be the first clinical sign to occur.
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- VomitingVomiting can be a sign of increased intracranial pressure and may occur with a brain tumor; however, it may not be the first clinical sign to develop.
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- Visual problemsVisual problems can be a sign of increased intracranial pressure and may occur with a brain tumor; however, they may not be the first clinical signs to develop.
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- Loss of muscle strengthLoss of muscle strength and coordination may occur with a slow-growing brain tumor; however, it may not be the first clinical sign to develop.
Question 3 of 10
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Which statement regarding how infectious organisms enter the cranial vault indicates a need for further education?
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- “Organisms can enter the skull after a craniotomy.”Bacteria are able to enter the cranial cavity after surgery on the brain.
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- “Some bacteria are able to enter the bloodstream and move to the membranes covering the brain and spinal cord.”Some bacteria are able to enter the bloodstream and travel to the brain.
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- “Microorganisms can enter the skull after a lumbar puncture.”Bacteria can be introduced during a lumbar puncture and travel to the brain.
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- “All bacteria can cross the blood-brain barrier.”The blood-brain barrier is one of the tightest barriers in the body and prevents bacteria from crossing into the brain.
Question 4 of 10
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Which specific vaccine would the nurse recommend for a college student who will be residing in a dormitory?
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- ShinglesThe shingles vaccine is recommended for adults 50 years and older to prevent shingles.
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- MeningococcalThe meningitis vaccine is required for most students entering college as they are at higher risk for infection due to their proximity to others.
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- PneumococcalThe pneumococcal vaccine is generally recommended for patients younger than 2 years and adults 65 years and older to protect them from pneumonia.
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- RotavirusRotavirus is a common cause of diarrhea and vomiting and is recommended for infants.
Question 5 of 10
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Which diagnostic test would be performed in a patient with suspected meningitis to determine if there is increased intracranial pressure (ICP)?
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- Gram stainA Gram stain is performed to help identify the causative organism.
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- Lumbar punctureA lumbar puncture is performed to identify the number and type of organisms present in the cerebrospinal fluid; however, it could lead to a brain herniation in a patient with increased ICP.
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- Computed tomography (CT)A CT scan may be done to rule out other causes and determine if there is ICP.
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- Blood cultureA blood culture is done to help identify the causative organism.
Question 6 of 10
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Which medication may be administered when treating a patient with meningitis? Select all that apply. One, some, or all responses may be correct.
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- HydrocodoneHydrocodone is a narcotic and would not be used in a patient with increased intracranial pressure because it is sedating and could impair an accurate neurologic assessment.
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- AcetaminophenAcetaminophen can be safely administered for headache control for patients with meningitis.
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- CarbamazepineCarbamazepine is an anticonvulsant medication that can be used to control seizures that occur as a result of meningitis.
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- NitroprussideNitroprusside is a vasodilator that can activate the vasodilatory cascade and increase intracranial pressure.
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- CeftriaxoneCeftriaxone is an antibiotic commonly used to treat meningitis.
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- DexamethasoneDexamethasone along with antibiotics can help prevent damage from the intense inflammatory response caused by the infection.
Question 7 of 10
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Which statement about viral meningitis indicates a need for further education?
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- “Viral meningitis tends to be milder than bacterial meningitis.”This is a true statement as viral meningitis is the milder form.
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- “A polymerase chain reaction test can diagnose the viral infection.”This is a true statement as a polymerase chain reaction test is used to detect virus-specific deoxyribonucleic acid or ribonucleic acid and diagnose a central nervous system viral infection.
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- “Full recovery generally occurs within 3 to 5 days.”Full recovery from viral meningitis generally occurs within 7 to 10 days.
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- “Symptoms of brain involvement are not common.”This is a true statement as the symptoms signaling brain involvements are uncommon.
Question 8 of 10
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Which statement about the care of a patient with meningitis indicates a need for further education?
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- “Fluid volume overload is common and should be monitored frequently.”Fluid volume deficit, not overload, is common. Intake and output should be monitored closely to prevent dehydration.
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- “Orienting the patient frequently is important.”Confusion can occur with meningitis, so it is important to orient the patient frequently and provide reassurance.
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- “If the disease is not treated early, deafness and visual defects can occur.”If the disease is caught early, the sequelae of meningitis, such as deafness, visual defects, and paralysis, generally will not occur.
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- “It is important to cluster care for this patient.”Care and treatments should be coordinated to allow the patient to rest as much as possible. Sensory input can activate nerve impulses and trigger seizures.
Question 9 of 10
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Which factor would a nurse question when listed by a student as a cause of encephalitis?
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- MeaslesMeasles is a virus that can lead to encephalitis.
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- Deer fliesDeer flies are not known to cause encephalitis; however, they can carry diseases like tularemia.
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- TicksTicks and mosquitoes are known to be vectors for transmission of encephalitis.
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- Herpes simplex 1 (HSV-1)HSV-1 is commonly the cause of non–vector-transmitted encephalitis.
Question 10 of 10
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Which medication would be ordered for a patient with suspected meningitis who presents with herpetic lesions?
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- AcyclovirThe antiviral acyclovir is administered intravenously for patients with herpes simplex 1 encephalitis.
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- DoxycyclineDoxycycline is an antibiotic used to treat infections such as Lyme disease, urinary tract infections, and respiratory tract infections; however, it is not the medication of choice for encephalitis.
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- AspirinAspirin would not be ordered for treatment of herpes simplex 1 encephalitis.
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- FluconazoleFluconazole is an antifungal medication that would be useful when treating a fungal encephalitis.
