. An adolescent has just had a generalized seizure and collapsed in the school nurse's office. When should the nurse call 911?
The child is confused and cannot remember anything regarding the seizure.
The child fell at the onset of the seizure
The seizure lasts more than 5 minutes.
The child is sleepy and lethargic after the seizure
The Correct Answer is C
A. The child is confused and cannot remember anything regarding the seizure: Postictal confusion is normal after a seizure and does not require emergency services.
B. The child fell at the onset of the seizure: Falls can occur with seizures, but unless there is a suspected injury or prolonged seizure activity, calling 911 is unnecessary.
C. The seizure lasts more than 5 minutes: A seizure lasting more than 5 minutes is considered status epilepticus and is a medical emergency requiring immediate intervention.
D. The child is sleepy and lethargic after the seizure: Postictal sleepiness is a common and expected phase after a generalized seizure.
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Correct Answer is D
Explanation
A. Decreased pressure and cloudy cerebrospinal fluid with a high protein level. Meningitis usually causes increased intracranial pressure, not decreased.
B. Clear cerebrospinal fluid with a high protein and low glucose. Clear CSF is typically seen in viral meningitis, but bacterial meningitis more often causes cloudy CSF.
C. Cloudy cerebrospinal fluid with a low protein and low glucose. While glucose is low in bacterial meningitis, protein is typically elevated due to the infection.
D. Cloudy cerebrospinal fluid with a high protein and low glucose levels. This finding is consistent with bacterial meningitis, where the CSF is cloudy, protein is elevated due to inflammation, and glucose is low because bacteria consume glucose.
Correct Answer is D
Explanation
A. Haemophilus Influenza Type B (HIB) Vaccine and TDAP. HIB vaccine reduces the incidence of meningitis caused by Haemophilus influenzae, but TDAP does not target pathogens responsible for meningitis.
B. Inactivated polio vaccine (IPV) and Pneumococcal Conjugate Vaccine (PCV). IPV prevents polio but has no impact on meningitis incidence. PCV is correct for preventing Streptococcus pneumoniae meningitis.
C. DTAP and Varicella Vaccine. DTAP does not prevent bacterial meningitis, and varicella vaccine prevents chickenpox, not meningitis.
D. Pneumococcal Conjugate Vaccine (PCV) and Haemophilus Type B (HIB Vaccine). These vaccines directly prevent bacterial meningitis caused by Streptococcus pneumoniae and Haemophilus influenzae, which were previously leading causes of meningitis in children.