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A nurse is collecting data from an 8-month-old infant who has increased intracranial pressure (ICP). Which of the following manifestations should the nurse expect?

A.

Insomnia

B.

Positive Babinski reflex

C.

Bulging fontanel

D.

Low-pitched cry

Answer and Explanation

The Correct Answer is C

A. Insomnia: Infants with increased ICP are more likely to be lethargic than to have insomnia.

 

B. Positive Babinski reflex: A positive Babinski reflex is normal in infants under 2 years and does not indicate ICP.

 

C. Bulging fontanel: A bulging fontanel is a classic sign of increased ICP due to the accumulation of fluid or swelling inside the skull.

 

D. Low-pitched cry: Infants with ICP typically have a high-pitched cry, not a low-pitched one.


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View Related questions

Correct Answer is ["A","C","E"]

Explanation

A. Febrile episode: Fever is a common trigger for febrile seizures in children, especially between 6 months and 5 years.

B. Low blood lead levels: Elevated, not low, blood lead levels can increase the risk of seizures due to neurotoxicity.

C. Sodium imbalance: Both hyponatremia and hypernatremia can cause seizures by disrupting neuronal function.

D. Presence of diphtheria: Diphtheria does not directly increase the risk of seizures. Neurological complications are rare and secondary.

E. Hypoglycemia: Low blood sugar levels deprive the brain of energy, which can lead to seizures.

Correct Answer is ["B","D","E"]

Explanation

A. Clear CSF: Clear CSF is typically seen in viral meningitis or normal findings, not bacterial meningitis.

B. Cloudy CSF: Cloudy CSF indicates the presence of infection and is characteristic of bacterial meningitis.

C. Negative gram stain: A negative gram stain indicates the absence of bacterial pathogens, which is not consistent with bacterial meningitis.

D. Decreased glucose content: Bacteria consume glucose, leading to decreased glucose levels in bacterial meningitis.

E. Positive gram stain: A positive gram stain confirms the presence of bacterial organisms in the CSF, supporting a diagnosis of bacterial meningitis.

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