Question 1:
(see full question) A seven year old has just been admitted to the unit for excessive
ost appropriate action?
vomiting. Based on the available chart data, what is the nurse’s m
10/15/16
0730
Vital Signs Record
T: 104.9° F (40.5° C)
P: 98
RR: 30
Lab Values
Serum Potassium: 3.1 mmol/L
Serum Sodium: 128 mmol/L
Nurse’s Note
Skin flushed and warm to touch; good turgor; petechiae noted over entire trunk
You
selected:Assess the child’s neurological status
Correct
Explanation:
Since fever, seizures, vomiting, and petechiae are signs of meningitis, the nurse should promptly assess the
child’s neurological status and report the findings to the provider. ... (more)
Remediation:
Meningitis, pediatric
Question 2:
(see full question) A 3-month-old infant with meningococcal meningitis has just been
admitted to the pediatric unit. Which nursing intervention has the h ighest priority?
You selected:obtaining history information
from the parents
Incorrect
Correct response:
instituting droplet precautions
Explanation:
Instituting droplet precautions is the priority for a newly admitted infant with meningococcal meningitis.
Acetaminophen may be ordered, but administering it does not take priority ... (more)
Remediation:
Meningitis, pediatric
Droplet precautions
, Question 3:
(see full question) A child with meningitis is to receive 1,000 mL of dextrose 5% in
normal saline over 12 hours. At what rate in milliliters per hour should the nurse set the pump? Round your
answer to the nearest whole number.
You selected:83
Correct
Explanation:
1,000 mL/12 hours = 83 mL/hour
Remediation:
Calculating and setting an IV drip rate
Question 4:
(see full question) A 7-year-old has been diagnosed with bacterial meningitis. Who
should receive chemoprophylaxis?
You selected:all household contacts and close contacts
Correct
Explanation:
Chemoprophylaxis should be given to household contacts and close contacts only. To prevent community
outbreaks, chemoprophylaxis with rifampin 600 mg twice a day for 2 days or a si ... (more)
Remediation:
Meningitis, pediatric
Meningitis, pediatric, care planning
Question 5:
(see full question) A client admitted with bacterial meningitis must be transported to
the radiology department for a repeat computed tomography scan of the head. His level of consciousness is
decreased, and he requires nasopharyngeal suctioning before transport. Which infection control measures are
best when caring for this client?
You selected:Put on gloves, a mask, and eye protection during suctioning, and then apply a
mask to the client's face for transport.
Correct
Explanation:
Bacterial meningitis is spread through contact with infected droplets. The nurse should wear gloves, a mask,
and eye protection when suctioning the client. Additionally, the client ... (more)
Remediation:
, Meningitis
Oxygenation: Nasopharyngeal Suctioning
Question 6:
(see full question) A child with meningococcal meningitis is being admitted to the
pediatric unit. In preparation for the child's arrival, the nurse should f irst?
You selected:institute droplet precautions.
Correct
Explanation:
The child with meningococcal meningitis requires droplet precautions for at least the first 24 hours after
effective therapy is initiated to reduce the risk of transmission to othe ... (more)
Remediation:
Meningitis, pediatric
The Chain of Infection
Question 7:
(see full question) 2/10/2017
2100
18-year-old college student presents to the emergency department with a severe headache and onset of
bizarre behavior that started approximately five hours ago. Client is oriented to person, but not place or time.
Physical assessment includes petechiae. Oral temperature is 104° F (40° C). HR: 128/bpm. RR: 24/min, O2:
95% on room air. Lumbar puncture ordered. Client is being evaluated for bacterial meningitis.
What is the most important action by the nurse?
You selected:Administer an analgesic per order
Incorrect
Correct response: Obtaining IV access
in preparation of antibiotic administration
Explanation:
This client’s rapid course, and petechiae suggest that she is at risk for a fulminant presentation of meningitis,
which can include circulatory collapse. Intravenous access may b ... (more)
Remediation:
Meningitis
Question 8:
, (see full question) A preschool-age child has just been admitted to the pediatric unit
with a diagnosis of bacterial meningitis. What is the nurse’s priority intervention?
You selected:Monitor temperature every
four hours
Incorrect
Correct response:
Decrease environmental stimulation
Explanation:
A child with the diagnosis of meningitis is more comfortable in an environment with decreased stimuli. Noise
and bright lights would stimulate this child and cause the child to cry ... (more)
Remediation:
Meningitis, pediatric
Question 9:
(see full question) A 6-year-old child has tested positive for West Nile virus infection.
The nurse suspects the child has the severe form of the disease when she recognizes which signs and
symptoms? You
selected:Fever, muscle weakness, and change in mental status
Correct
Explanation:
Severe West Nile virus infection (also called West Nile encephalitis or West Nile meningitis) affects the central
nervous system and may cause headache, neck stiffness, fever, musc ... (more)
Remediation:
West Nile encephalitis
West Nile encephalitis
Question 10:
(see full question) Which sign should lead the nurse to suspect that a child with
meningitis has developed disseminated intravascular coagulation?
You selected:hemorrhagic skin rash
Correct
Explanation:
Disseminated intravascular coagulation is characterized by skin petechiae and a purpuric skin rash caused by
spontaneous bleeding into the tissues. An abnormal coagulation phenomen ... (more)
(see full question) A seven year old has just been admitted to the unit for excessive
ost appropriate action?
vomiting. Based on the available chart data, what is the nurse’s m
10/15/16
0730
Vital Signs Record
T: 104.9° F (40.5° C)
P: 98
RR: 30
Lab Values
Serum Potassium: 3.1 mmol/L
Serum Sodium: 128 mmol/L
Nurse’s Note
Skin flushed and warm to touch; good turgor; petechiae noted over entire trunk
You
selected:Assess the child’s neurological status
Correct
Explanation:
Since fever, seizures, vomiting, and petechiae are signs of meningitis, the nurse should promptly assess the
child’s neurological status and report the findings to the provider. ... (more)
Remediation:
Meningitis, pediatric
Question 2:
(see full question) A 3-month-old infant with meningococcal meningitis has just been
admitted to the pediatric unit. Which nursing intervention has the h ighest priority?
You selected:obtaining history information
from the parents
Incorrect
Correct response:
instituting droplet precautions
Explanation:
Instituting droplet precautions is the priority for a newly admitted infant with meningococcal meningitis.
Acetaminophen may be ordered, but administering it does not take priority ... (more)
Remediation:
Meningitis, pediatric
Droplet precautions
, Question 3:
(see full question) A child with meningitis is to receive 1,000 mL of dextrose 5% in
normal saline over 12 hours. At what rate in milliliters per hour should the nurse set the pump? Round your
answer to the nearest whole number.
You selected:83
Correct
Explanation:
1,000 mL/12 hours = 83 mL/hour
Remediation:
Calculating and setting an IV drip rate
Question 4:
(see full question) A 7-year-old has been diagnosed with bacterial meningitis. Who
should receive chemoprophylaxis?
You selected:all household contacts and close contacts
Correct
Explanation:
Chemoprophylaxis should be given to household contacts and close contacts only. To prevent community
outbreaks, chemoprophylaxis with rifampin 600 mg twice a day for 2 days or a si ... (more)
Remediation:
Meningitis, pediatric
Meningitis, pediatric, care planning
Question 5:
(see full question) A client admitted with bacterial meningitis must be transported to
the radiology department for a repeat computed tomography scan of the head. His level of consciousness is
decreased, and he requires nasopharyngeal suctioning before transport. Which infection control measures are
best when caring for this client?
You selected:Put on gloves, a mask, and eye protection during suctioning, and then apply a
mask to the client's face for transport.
Correct
Explanation:
Bacterial meningitis is spread through contact with infected droplets. The nurse should wear gloves, a mask,
and eye protection when suctioning the client. Additionally, the client ... (more)
Remediation:
, Meningitis
Oxygenation: Nasopharyngeal Suctioning
Question 6:
(see full question) A child with meningococcal meningitis is being admitted to the
pediatric unit. In preparation for the child's arrival, the nurse should f irst?
You selected:institute droplet precautions.
Correct
Explanation:
The child with meningococcal meningitis requires droplet precautions for at least the first 24 hours after
effective therapy is initiated to reduce the risk of transmission to othe ... (more)
Remediation:
Meningitis, pediatric
The Chain of Infection
Question 7:
(see full question) 2/10/2017
2100
18-year-old college student presents to the emergency department with a severe headache and onset of
bizarre behavior that started approximately five hours ago. Client is oriented to person, but not place or time.
Physical assessment includes petechiae. Oral temperature is 104° F (40° C). HR: 128/bpm. RR: 24/min, O2:
95% on room air. Lumbar puncture ordered. Client is being evaluated for bacterial meningitis.
What is the most important action by the nurse?
You selected:Administer an analgesic per order
Incorrect
Correct response: Obtaining IV access
in preparation of antibiotic administration
Explanation:
This client’s rapid course, and petechiae suggest that she is at risk for a fulminant presentation of meningitis,
which can include circulatory collapse. Intravenous access may b ... (more)
Remediation:
Meningitis
Question 8:
, (see full question) A preschool-age child has just been admitted to the pediatric unit
with a diagnosis of bacterial meningitis. What is the nurse’s priority intervention?
You selected:Monitor temperature every
four hours
Incorrect
Correct response:
Decrease environmental stimulation
Explanation:
A child with the diagnosis of meningitis is more comfortable in an environment with decreased stimuli. Noise
and bright lights would stimulate this child and cause the child to cry ... (more)
Remediation:
Meningitis, pediatric
Question 9:
(see full question) A 6-year-old child has tested positive for West Nile virus infection.
The nurse suspects the child has the severe form of the disease when she recognizes which signs and
symptoms? You
selected:Fever, muscle weakness, and change in mental status
Correct
Explanation:
Severe West Nile virus infection (also called West Nile encephalitis or West Nile meningitis) affects the central
nervous system and may cause headache, neck stiffness, fever, musc ... (more)
Remediation:
West Nile encephalitis
West Nile encephalitis
Question 10:
(see full question) Which sign should lead the nurse to suspect that a child with
meningitis has developed disseminated intravascular coagulation?
You selected:hemorrhagic skin rash
Correct
Explanation:
Disseminated intravascular coagulation is characterized by skin petechiae and a purpuric skin rash caused by
spontaneous bleeding into the tissues. An abnormal coagulation phenomen ... (more)
