A client with a temperature of 39°C (102.2°F) and a rash is being evaluated. Which condition should the nurse consider?
Meningococcal meningitis.
Urinary tract infection.
Gastroenteritis.
Osteoarthritis.
The Correct Answer is A
Choice A rationale
Meningococcal meningitis can present with a high fever (39°C or 102.2°F) and a rash, indicating a severe bacterial infection.
Choice B rationale
Urinary tract infections typically present with urinary symptoms, not a rash.
Choice C rationale
Gastroenteritis presents with gastrointestinal symptoms, not a rash.
Choice D rationale
Osteoarthritis is a degenerative joint disease and does not cause fever or rash.
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Correct Answer is B
Explanation
Choice A rationale
Nausea and vomiting can be caused by various conditions, including gastrointestinal issues and brain injuries, but they are not specifically indicative of a diffuse brain stem injury.
Choice B rationale
Nuchal rigidity, or neck stiffness, is a classic sign of meningeal irritation, often due to meningeal edema in conditions like meningitis.
Choice C rationale
Bilateral fixed and dilated pupils are more commonly associated with severe brain injury or increased intracranial pressure, not specifically a cerebellar brain attack.
Choice D rationale
Brudzinski’s sign is a physical exam finding indicative of meningeal irritation, commonly seen in bacterial meningitis, not specifically viral meningitis.
Correct Answer is C
Explanation
Choice A rationale
A hemorrhagic brain attack (stroke) is less common than an ischemic brain attack. Ischemic strokes account for the majority of strokes.
Choice B rationale
Thrombolytic drugs are used to treat ischemic strokes, not hemorrhagic strokes. They do not cause hyper-reactive reflexes.
Choice C rationale
A hemorrhagic brain attack requires immediate intervention to prevent further damage. Hemorrhagic strokes involve bleeding in the brain, which can rapidly worsen and cause severe damage.
Choice D rationale
An ischemic brain attack is not necessarily less severe than a hemorrhagic brain attack. Both types of strokes are serious, but hemorrhagic strokes often require more urgent intervention due to the risk of ongoing bleeding.