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

Correct Answer: D

Rationale: The correct answer is D, Both A and C. Brudzinski's sign and Kernig's sign are both indicative of meningeal irritation. Brudzinski's sign is when flexion of the neck causes involuntary flexion of the hip and knee. Kernig's sign is when there is resistance or pain with knee extension after hip flexion. These signs suggest inflammation of the meninges, commonly seen in meningitis. Babinski reflex (choice B) is not specific to meningitis and is related to upper motor neuron dysfunction. Therefore, the correct answer is D as it includes the two most relevant signs for meningeal irritation, while the other choices are not directly associated with this condition.

Correct Answer: A

Rationale: The correct answer is A: Encourage daily walking. Bradykinesia in Parkinson's disease refers to slowness of movement. Walking helps improve coordination, balance, and overall mobility in clients with Parkinson's. It promotes muscle strength and flexibility, counteracting the effects of bradykinesia. Walking also stimulates dopamine release, which is reduced in Parkinson's. Choice B is incorrect as thickened liquids are for dysphagia, not bradykinesia. Choice C is incorrect as meal frequency does not directly address bradykinesia. Choice D is incorrect as adaptive utensils help with fine motor skills, not slowness of movement.

Correct Answer: B

Rationale: The correct answer is B: Notify the healthcare provider. A prolonged aPTT of 90 seconds indicates the client is at risk for bleeding due to excessive anticoagulation from heparin therapy. The nurse should notify the healthcare provider immediately to adjust the dosage or consider discontinuing heparin to prevent bleeding complications. Increasing the heparin infusion rate (A) would worsen the risk of bleeding. Applying pressure to the injection site (C) is not appropriate in this situation. Administering protamine sulfate (D) is the antidote for heparin overdose, but it is not the first action to take in this scenario.

Correct Answer: C

Rationale: The correct answer is C: Episodes of cyanosis and pallor in the fingers. Raynaud's phenomenon is characterized by vasospasms of small arteries, leading to reduced blood flow and color changes in the digits. Cyanosis (bluish discoloration) and pallor (pale color) are common during episodes. Thickened and hardened skin (A) is associated with scleroderma. Painless ulcers on the fingertips (B) are seen in advanced stages of systemic sclerosis. Red, scaly patches on the hands (D) are indicative of psoriasis, not Raynaud's phenomenon.

Correct Answer: B

Rationale: The correct answer is B: Apply lotion to the skin. Pruritus in cirrhosis is often due to dry skin. Applying lotion helps hydrate the skin, reducing itching. Acetaminophen (A) can worsen liver damage. High-protein diet (C) is not directly related to pruritus relief. Warm bath (D) may further dry the skin.

Correct Answer: B

Rationale: The correct answer is B: Prothrombin time (PT) and international normalized ratio (INR). Warfarin works by inhibiting vitamin K-dependent clotting factors, affecting the PT and INR. Monitoring these levels helps assess the effectiveness of warfarin in preventing clot formation. Platelet count (A) assesses clotting ability but not the effectiveness of warfarin. Activated partial thromboplastin time (C) assesses intrinsic pathway clotting factors, not affected by warfarin. Fibrinogen level (D) assesses the final step of clot formation, not specific to warfarin effectiveness.

Correct Answer: B

Rationale: The correct answer is B: LDL of 200 mg/dL. Elevated LDL levels are a major risk factor for CAD and require immediate intervention. Atorvastatin (Lipitor) is used to lower LDL levels. High LDL contributes to plaque buildup in arteries. A: Total cholesterol of 180 mg/dL is within the normal range and doesn't require immediate intervention. C: Triglycerides of 150 mg/dL are also within the normal range and don't pose an immediate risk. D: HDL of 40 mg/dL is considered low, but it is not as critical as high LDL levels in the context of CAD.

Correct Answer: C

Rationale: The correct answer is C: Improved hemoglobin levels. Epoetin alfa is a medication used to treat anemia in patients with chronic renal failure by stimulating red blood cell production. Improved hemoglobin levels indicate that the medication is effective in addressing the anemia associated with renal failure. Increased urine output (A) is not a direct outcome of epoetin alfa therapy. Decreased blood pressure (B) and stable potassium levels (D) are not specific indicators of the medication's effectiveness in treating anemia.

Correct Answer: B

Rationale: The correct action for the nurse to take first is to place the client in a high Fowler's position (Choice B). This position helps improve lung expansion and oxygenation by reducing pressure on the diaphragm and improving ventilation. With severe shortness of breath and pink, frothy sputum, the priority is to optimize respiratory function. Administering morphine sulfate (Choice A) may be indicated later for pain and anxiety but is not the immediate priority. Initiating continuous ECG monitoring (Choice C) is important but not as urgent as addressing the respiratory distress. Preparing the client for intubation (Choice D) should be considered if respiratory distress worsens, but initial interventions should focus on improving oxygenation through positioning.