The nurse is caring for a client admitted with a tentative diagnosis of bacterial meningitis. Which diagnostic procedure should be performed?

Correct Answer: B

Rationale: For a client with a tentative diagnosis of bacterial meningitis, a lumbar puncture is the definitive diagnostic procedure. This test allows for the collection of cerebrospinal fluid (CSF) to identify the presence of bacteria, elevated white blood cells, and other markers of infection. Bacterial meningitis is a medical emergency requiring rapid diagnosis and treatment, and the lumbar puncture provides critical information to confirm the diagnosis and guide antibiotic therapy. While blood cultures and imaging like CT or MRI may be supportive, they do not directly confirm bacterial meningitis as effectively as CSF analysis does.

Correct Answer: C

Rationale: For a client with petechiae and ecchymosis, the nurse should review the platelet count. These signs indicate small vessel bleeding, often due to thrombocytopenia (low platelets), impairing clotting. Conditions like ITP or marrow suppression could be causes, and a low count (e.g., <150,000) requires intervention (e.g., transfusion). Hemoglobin and RBCs reflect anemia, not bruising, and WBCs relate to infection, making platelets the critical lab for this presentation.

Correct Answer: B

Rationale: The filtration membrane is a three-layered structure between the blood in glomerular capillaries and the glomerular capsule's interior. It comprises the fenestrated endothelium (allowing small molecules to pass), the basement membrane (a fused basal lamina filtering proteins), and the visceral layer of the capsule (podocytes with filtration slits). This setup filters plasma into the capsule, unlike the proximal tubule (reabsorption) or collecting duct (water adjustment), making B the correct description.

Correct Answer: C

Rationale: Glomerular blood pressure is high due to the anatomical difference where afferent arterioles have larger diameters than efferent arterioles, creating resistance to outflow. This elevates glomerular hydrostatic pressure (around 55 mmHg), driving filtration. Low oncotic pressure or high capsular pressure would reduce filtration, and the basement membrane's thickness doesn't directly affect pressure, making C correct.

Correct Answer: D

Rationale: Glucose reabsorption from the tubular lumen to the proximal tubule cell occurs via secondary active transport using sodium-glucose cotransporters (SGLT). The Na⁺ gradient, maintained by Na⁺/K⁺-ATPase, drives glucose uptake against its gradient, requiring energy indirectly. It's not passive (A, C) or downhill (B), making D correct.