ESTUDYR
NCLEX-Style Case Study: Pediatric Meningitis
Client Scenario (Applies to all items)
The nurse in the pediatric emergency department cares for a 6-year-old female client.
Health History, Assessment, and Vital Signs:
A 6-year-old child presents with her mother, who reports the child has had a high fever,
headache, vomiting, and sensitivity to light for 2 days. The mother states the child has
become increasingly irritable and difficult to arouse.
On assessment, the child demonstrates nuchal rigidity (neck stiffness) and cries when her
neck is flexed. A purplish rash is noted on the trunk and extremities.
Vital signs on arrival:
Temperature: 39.5°C (103.1°F)
Heart rate: 138/min
Respiratory rate: 30/min
Blood pressure: 88/54 mmHg
Item 1 of 6
Question:
Click to select the findings that require immediate follow-up by the nurse.
(Select all that apply)
Fever
Headache
Nuchal rigidity
Photophobia
Lethargy/difficulty arousing
Petechial or purpuric rash
Vomiting
Correct Answers:
, ESTUDYR
Nuchal rigidity
Photophobia
Lethargy/difficulty arousing
Petechial or purpuric rash
Rationale:
These findings indicate possible bacterial meningitis, a medical emergency.
Nuchal rigidity → meningeal irritation
Photophobia → neurological involvement
Lethargy → decreased level of consciousness
Petechial rash → possible meningococcal infection and risk of sepsis
Fever, headache, and vomiting are expected but are less critical than neurological
deterioration and signs of systemic infection.
Item 2 of 6
Question:
For each finding, indicate whether it is most consistent with meningitis, viral illness, or
migraine.
Finding Meningitis Viral Illness Migraine
Fever ☐ ☐ ☐
Nuchal rigidity ☐ ☐ ☐
Photophobia ☐ ☐ ☐
Vomiting ☐ ☐ ☐
Petechial rash ☐ ☐ ☐
Correct Answers:
Fever → Meningitis, Viral illness
Nuchal rigidity → Meningitis
Photophobia → Meningitis, Migraine
Vomiting → All three
Petechial rash → Meningitis
Rationale:
Meningitis is characterized by meningeal irritation (neck stiffness) and may include a
petechial rash in meningococcal cases.
NCLEX-Style Case Study: Pediatric Meningitis
Client Scenario (Applies to all items)
The nurse in the pediatric emergency department cares for a 6-year-old female client.
Health History, Assessment, and Vital Signs:
A 6-year-old child presents with her mother, who reports the child has had a high fever,
headache, vomiting, and sensitivity to light for 2 days. The mother states the child has
become increasingly irritable and difficult to arouse.
On assessment, the child demonstrates nuchal rigidity (neck stiffness) and cries when her
neck is flexed. A purplish rash is noted on the trunk and extremities.
Vital signs on arrival:
Temperature: 39.5°C (103.1°F)
Heart rate: 138/min
Respiratory rate: 30/min
Blood pressure: 88/54 mmHg
Item 1 of 6
Question:
Click to select the findings that require immediate follow-up by the nurse.
(Select all that apply)
Fever
Headache
Nuchal rigidity
Photophobia
Lethargy/difficulty arousing
Petechial or purpuric rash
Vomiting
Correct Answers:
, ESTUDYR
Nuchal rigidity
Photophobia
Lethargy/difficulty arousing
Petechial or purpuric rash
Rationale:
These findings indicate possible bacterial meningitis, a medical emergency.
Nuchal rigidity → meningeal irritation
Photophobia → neurological involvement
Lethargy → decreased level of consciousness
Petechial rash → possible meningococcal infection and risk of sepsis
Fever, headache, and vomiting are expected but are less critical than neurological
deterioration and signs of systemic infection.
Item 2 of 6
Question:
For each finding, indicate whether it is most consistent with meningitis, viral illness, or
migraine.
Finding Meningitis Viral Illness Migraine
Fever ☐ ☐ ☐
Nuchal rigidity ☐ ☐ ☐
Photophobia ☐ ☐ ☐
Vomiting ☐ ☐ ☐
Petechial rash ☐ ☐ ☐
Correct Answers:
Fever → Meningitis, Viral illness
Nuchal rigidity → Meningitis
Photophobia → Meningitis, Migraine
Vomiting → All three
Petechial rash → Meningitis
Rationale:
Meningitis is characterized by meningeal irritation (neck stiffness) and may include a
petechial rash in meningococcal cases.
