NR572: WEEK 5 (FINAL) : NEUROLOGICAL: TEST QUESTIONS
WITH CORRECT ANSWERS
1) What is the classic symptoms triad of meningitis? -- Answer ✔✔ fever, nuchal
rigidity, and headache
2) Physical exam findings for meningitis? -- Answer ✔✔ - diffuse erythematous
maculopapular rash that rapidly transforms into petechiae, typically seen in clients
with meningococcal meningitis.
- Altered level of consciousness (drowsiness to coma)
- Seizures
- Positive Kernig's sign
- Positive Brudzinski's sign
- Signs of increased intracranial pressure (ICP), including papilledema,
deteriorating level of consciousness, decerebrate posturing, and sixth
nerve palsies
3) What is bacterial meningitis? -- Answer ✔✔ Bacterial meningitis is an acute
purulent infection within the subarachnoid space (SAS).
4) What is viral meningitis? -- Answer ✔✔ An acute inflammation of the meninges
and CSF often caused by Enteroviruses
, 5) Risk factors for BACTERIAL meningitis? -- Answer ✔✔ young adults >20
coexisting acute or chronic pneumococcal sinusitis or otitis media alcoholism,
diabetes, splenectomy, hypogammaglobulinemia, complement deficiency head
trauma with basilar skull fracture and cerebrospinal fluid (CSF) rhinorrhea
6) Nuchal rigidity -- Answer ✔✔ ("stiff neck") is the pathognomonic sign of
meningeal irritation and is present when the neck resists passive flexion.
7) What physical exams assess for meningeal irritation? -- Answer ✔✔ Kernig's and
Brudzinski's signs are also classic signs of meningeal irritation.
8) Signs of increased ICP -- Answer ✔✔ deteriorating or reduced level of
consciousness, papilledema, dilated poorly reactive pupils sixth nerve palsies
decerebrate posturing the Cushing reflex (bradycardia, hypertension, and
irregular respirations)
9) Cerebrospinal Fluid (CSF) Abnormalities in Bacterial Meningitis -- Answer ✔✔
Opening pressure >180 mmh2o
White blood cells 10/μl to 10,000/μl; neutrophils predominate
Red blood cells -Absent in nontraumatic tap
Glucose<2.2 mmol/L (<40 mg/dl)
CSF/serum glucose<0.4
Protein>0.45 g/L (>45 mg/dl)
Gram's stain Positive in >60%
Culture-Positive in >80%
PCR-Detects bacterial DNA
10) CSF in bacterial meningitis -- Answer ✔✔ Glucose; “ Protein; ‘
Neutrophils; ‘ Pressure; cloudy‘
11) CSF in viral meningitis -- Answer ✔✔ Normal Glucose; +/- Protein; ‘
Lymphocytes‘
WITH CORRECT ANSWERS
1) What is the classic symptoms triad of meningitis? -- Answer ✔✔ fever, nuchal
rigidity, and headache
2) Physical exam findings for meningitis? -- Answer ✔✔ - diffuse erythematous
maculopapular rash that rapidly transforms into petechiae, typically seen in clients
with meningococcal meningitis.
- Altered level of consciousness (drowsiness to coma)
- Seizures
- Positive Kernig's sign
- Positive Brudzinski's sign
- Signs of increased intracranial pressure (ICP), including papilledema,
deteriorating level of consciousness, decerebrate posturing, and sixth
nerve palsies
3) What is bacterial meningitis? -- Answer ✔✔ Bacterial meningitis is an acute
purulent infection within the subarachnoid space (SAS).
4) What is viral meningitis? -- Answer ✔✔ An acute inflammation of the meninges
and CSF often caused by Enteroviruses
, 5) Risk factors for BACTERIAL meningitis? -- Answer ✔✔ young adults >20
coexisting acute or chronic pneumococcal sinusitis or otitis media alcoholism,
diabetes, splenectomy, hypogammaglobulinemia, complement deficiency head
trauma with basilar skull fracture and cerebrospinal fluid (CSF) rhinorrhea
6) Nuchal rigidity -- Answer ✔✔ ("stiff neck") is the pathognomonic sign of
meningeal irritation and is present when the neck resists passive flexion.
7) What physical exams assess for meningeal irritation? -- Answer ✔✔ Kernig's and
Brudzinski's signs are also classic signs of meningeal irritation.
8) Signs of increased ICP -- Answer ✔✔ deteriorating or reduced level of
consciousness, papilledema, dilated poorly reactive pupils sixth nerve palsies
decerebrate posturing the Cushing reflex (bradycardia, hypertension, and
irregular respirations)
9) Cerebrospinal Fluid (CSF) Abnormalities in Bacterial Meningitis -- Answer ✔✔
Opening pressure >180 mmh2o
White blood cells 10/μl to 10,000/μl; neutrophils predominate
Red blood cells -Absent in nontraumatic tap
Glucose<2.2 mmol/L (<40 mg/dl)
CSF/serum glucose<0.4
Protein>0.45 g/L (>45 mg/dl)
Gram's stain Positive in >60%
Culture-Positive in >80%
PCR-Detects bacterial DNA
10) CSF in bacterial meningitis -- Answer ✔✔ Glucose; “ Protein; ‘
Neutrophils; ‘ Pressure; cloudy‘
11) CSF in viral meningitis -- Answer ✔✔ Normal Glucose; +/- Protein; ‘
Lymphocytes‘
