A patient presents with severe headache, photophobia, and neck stiffness. On examination, there is nuchal rigidity and positive Kernig and Brudzinski signs. Which of the following neurological conditions is most likely responsible for these symptoms?

Correct Answer: C

Rationale: The correct answer is C: Meningitis. The patient's symptoms of severe headache, photophobia, neck stiffness, nuchal rigidity, and positive Kernig and Brudzinski signs are classic signs of meningitis. Meningitis is an inflammation of the meninges surrounding the brain and spinal cord, leading to these specific neurological symptoms. Migraine headache (A) typically presents with a throbbing headache, nausea, and sensitivity to light and sound, but does not typically cause neck stiffness or positive meningeal signs. Cluster headache (B) is characterized by severe unilateral headache with autonomic symptoms like tearing or nasal congestion, but does not typically cause neck stiffness or positive meningeal signs. Subarachnoid hemorrhage (D) presents with sudden severe headache often described as "the worst headache of my life," and may cause neck stiffness, but typically does not present with photophobia or positive meningeal signs like Kernig and Brudzinski signs.

Correct Answer: D

Rationale: The correct answer is D: Trigeminal neuralgia. This condition is characterized by recurrent, severe, stabbing pain in the trigeminal nerve distribution triggered by touch, chewing, or cold exposure. The key feature is the characteristic lancinating pain, which is not typical of migraine (choice A), cluster headache (choice B), or tension-type headache (choice C). Migraine typically presents with pulsating, moderate to severe headache associated with nausea and sensitivity to light and sound. Cluster headache is characterized by severe, unilateral pain around the eye associated with autonomic symptoms. Tension-type headache presents with bilateral, pressing or tightening pain without specific triggers. Therefore, based on the description of the symptoms in the question, trigeminal neuralgia is the most likely diagnosis.

Correct Answer: C

Rationale: The correct answer is C because positioning oneself at eye level helps the patient see the nurse's facial expressions and lip movements, aiding in communication. Speaking clearly and slowly allows the patient to better understand. Speaking loudly can distort sound and may not be necessary. Avoiding visual aids or gestures limits communication channels. Speaking quickly can overwhelm the patient and hinder comprehension.

Correct Answer: B

Rationale: The correct answer is B because the nurse's role is to address the holistic needs of the patient, including financial concerns. Providing information about financial assistance programs and resources shows empathy and supports the patient in making informed decisions. Choice A is incorrect because dismissing the patient's concerns can lead to a breakdown in trust and communication. Choice C is incorrect as ignoring the patient's concerns is not addressing the patient's needs. Choice D is incorrect because financial concerns are valid and should be considered in decision-making.

Correct Answer: B

Rationale: The correct answer is B because actively listening, acknowledging the patient's concerns, and working towards rebuilding trust through transparency and reliability are essential steps in addressing distrust. By validating the patient's experiences and actively involving them in the process, the nurse can foster a supportive and trusting relationship. Choice A is incorrect because dismissing the patient's concerns can further damage trust and undermine the patient's feelings. Choice C is incorrect as ignoring the distrust can lead to a breakdown in communication and trust. Choice D is incorrect because telling the patient to trust the healthcare system without addressing their concerns is dismissive and unhelpful.