the nurse is assessing a client with suspected meningitis which finding is indicative of meningeal irritation
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Nursing Elites

ATI LPN

ATI PN Adult Medical Surgical 2019

1. When assessing a client with suspected meningitis, which finding is indicative of meningeal irritation?

Correct answer: D

Rationale: Both Brudzinski's sign and Kernig's sign are classic signs of meningeal irritation, commonly associated with meningitis. Brudzinski's sign is positive when flexing the neck causes involuntary flexion of the hips and knees due to irritation of the meninges. Kernig's sign is positive when there is pain and resistance with knee extension after hip flexion, indicating meningeal irritation or inflammation. The Babinski reflex, mentioned in choice B, is a test used to assess upper motor neuron damage and is not specific to meningitis. Therefore, choices A and C are the correct options as they are indicative of meningeal irritation in a suspected case of meningitis.

2. An elderly female client comes to the clinic for a regular check-up. The client tells the nurse that she has increased her daily doses of acetaminophen (Tylenol) for the past month to control joint pain. Based on this client's comment, what previous lab values should the nurse compare with today's lab report?

Correct answer: B

Rationale: When a client increases their daily doses of acetaminophen for joint pain, it raises concerns about possible liver damage due to acetaminophen overdose. LDH (Lactate Dehydrogenase) levels can indicate liver function, so comparing today's levels with previous ones can help assess for liver damage caused by acetaminophen overuse.

3. After a client with ascites due to liver cirrhosis undergoes a paracentesis, what should the nurse do post-procedure?

Correct answer: B

Rationale: Post-paracentesis, monitoring the client's blood pressure and heart rate is crucial as it helps in early detection of potential complications such as hypotension or bleeding. This close observation enables timely intervention and ensures the client's safety.

4. A client with left-sided heart failure is experiencing dyspnea and orthopnea. Which position should the nurse place the client in to relieve these symptoms?

Correct answer: A

Rationale: Placing the client in High Fowler's position is beneficial for individuals with left-sided heart failure experiencing dyspnea and orthopnea. This position helps to reduce venous return, decrease preload, and enhance respiratory function, thereby relieving the symptoms mentioned. Choice B, the supine position, is not recommended as it may exacerbate dyspnea and orthopnea by increasing preload. Choice C, the Trendelenburg position, is incorrect as it involves the feet being positioned higher than the head, which is not suitable for heart failure patients. Choice D, the Sims' position, is a lateral position used for rectal examination and is not indicated for relieving dyspnea and orthopnea in heart failure.

5. What is an important teaching point for a patient prescribed dabigatran for atrial fibrillation?

Correct answer: B

Rationale: The correct teaching point for a patient prescribed dabigatran is not to crush or chew the capsules. Doing so can alter the absorption of the medication, increasing the risk of bleeding. It is important for patients to swallow the capsules whole to ensure proper delivery of the medication.

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