age 1 of 218
NSG 430 EXAM 4 STUDY GUIDE 2025/2026
ACCURATE QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES || 100% GUARANTEED
PASS <RECENT VERSION>
meningitis .......Answer.........Inflammation of the meninges
- Bacterial most often caused by streptococcus pneumoniae (ear
infection, sinus infection, head trauma, dental therapy, etc)
S/S: Sudden onset headache, Kernig's sign (90 degree hip
flexion followed by straighten of leg causes pain), Brudzinski's
sign (flexion of the neck causes flexion of the hips and knees),
fever, confusion, irritability, skin rashes
,age 2 of 218
Diagnostics: CBC, CRP, blood cultures, lumbar puncture (cloudy
CSF abnormal, WBC and protein may be elevated, decreased
glucose in bacterial meningitis)
Management: Droplet precautions at least for 24 hours,
supportive care for viral infections, anti-seizure medications,
seizure precautions, steroids, monitor/decrease ICP
lumbar puncture .......Answer.........- Requires informed consent
- Ask patient to empty bladder (must lay flat for 1 hour after)
- Positioning: Lateral recumbent preferred (can measure CSF
pressure)
- Tripod or orthopneic position if LR contraindicated (higher risk
of disc herniation, cannot measure CSF pressure)
- Strict sterile technique
,age 3 of 218
- Contraindicated in increased ICP if space-occupying lesions
Post-op care:
- Occlusive dressing (do not remove)
- Monitor for bleeding or CSF leakage
- Supine x 1 hour
- Push fluids to prevent headache
- Monitor I&O
- Alert provider immediately if leakage (may use blood patch)
Nursing considerations: Bedrest as ordered, monitor VS, quiet
and nonstimulating environment, antipyretics, antibiotics,
analgesics, seizure precautions, monitor for increased ICP,
, age 4 of 218
isolation precautions, elevate HOB 30 degrees and avoid neck
flexion and extreme hip flexion
Prevention: Vaccine, prophylactic abx for close exposure
- EBP recommends checking a head CT before a lumbar puncture
to rule out space occupying lesion
brain tumors .......Answer.........- Classified as benign or malignant
and primary or secondary
- Most commonly secondary tumors in the brain
S/S: Headache (severe, especially upon awakening),
papilledema (swelling of optic disc), seizures, increased ICP,
unequal pupil size, bradycardia, HTN, N/V, hemiparesis, altered
mentation
Diagnostics: Neurological exam, EEG, LP, MRI, PET scan, biopsy
NSG 430 EXAM 4 STUDY GUIDE 2025/2026
ACCURATE QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES || 100% GUARANTEED
PASS <RECENT VERSION>
meningitis .......Answer.........Inflammation of the meninges
- Bacterial most often caused by streptococcus pneumoniae (ear
infection, sinus infection, head trauma, dental therapy, etc)
S/S: Sudden onset headache, Kernig's sign (90 degree hip
flexion followed by straighten of leg causes pain), Brudzinski's
sign (flexion of the neck causes flexion of the hips and knees),
fever, confusion, irritability, skin rashes
,age 2 of 218
Diagnostics: CBC, CRP, blood cultures, lumbar puncture (cloudy
CSF abnormal, WBC and protein may be elevated, decreased
glucose in bacterial meningitis)
Management: Droplet precautions at least for 24 hours,
supportive care for viral infections, anti-seizure medications,
seizure precautions, steroids, monitor/decrease ICP
lumbar puncture .......Answer.........- Requires informed consent
- Ask patient to empty bladder (must lay flat for 1 hour after)
- Positioning: Lateral recumbent preferred (can measure CSF
pressure)
- Tripod or orthopneic position if LR contraindicated (higher risk
of disc herniation, cannot measure CSF pressure)
- Strict sterile technique
,age 3 of 218
- Contraindicated in increased ICP if space-occupying lesions
Post-op care:
- Occlusive dressing (do not remove)
- Monitor for bleeding or CSF leakage
- Supine x 1 hour
- Push fluids to prevent headache
- Monitor I&O
- Alert provider immediately if leakage (may use blood patch)
Nursing considerations: Bedrest as ordered, monitor VS, quiet
and nonstimulating environment, antipyretics, antibiotics,
analgesics, seizure precautions, monitor for increased ICP,
, age 4 of 218
isolation precautions, elevate HOB 30 degrees and avoid neck
flexion and extreme hip flexion
Prevention: Vaccine, prophylactic abx for close exposure
- EBP recommends checking a head CT before a lumbar puncture
to rule out space occupying lesion
brain tumors .......Answer.........- Classified as benign or malignant
and primary or secondary
- Most commonly secondary tumors in the brain
S/S: Headache (severe, especially upon awakening),
papilledema (swelling of optic disc), seizures, increased ICP,
unequal pupil size, bradycardia, HTN, N/V, hemiparesis, altered
mentation
Diagnostics: Neurological exam, EEG, LP, MRI, PET scan, biopsy
