Which diagnostic test is the most definitive test used to detect meningitis?
CBC
Urinalysis
CT scan
Lumbar puncture
The Correct Answer is D
A. CBC: A CBC can indicate infection (elevated white blood cell count), but it is not specific for meningitis.
B. Urinalysis: Urinalysis is not relevant for diagnosing meningitis.
C. CT scan: A CT scan can detect complications like increased intracranial pressure but does not diagnose meningitis directly.
D. Lumbar puncture: A lumbar puncture allows direct analysis of CSF for glucose, protein, white blood cells, and organisms, which is definitive for diagnosing meningitis.
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Correct Answer is C
Explanation
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.
Correct Answer is D
Explanation
A. "I promise I won't tell anyone about this.": This is inappropriate as nurses are mandated reporters and must inform authorities when abuse is suspected.
B. "Let's discuss what you have told me with your family members.": Involving the alleged abuser(s) directly can put the child at greater risk and is inappropriate.
C. "Your family is bad for doing this to you.": Judging or labeling the family is unprofessional and could make the child feel conflicted or guilty.
D. "It is not your fault that this happened.": This response reassures the child, alleviating feelings of guilt and fostering trust, while remaining supportive and professional.