NCM 109 MIDTERMS EVALUATION EXAM
QUESTIONS AND ANSWERS 2024 WITH
COMPLETE SOLUTION
You are a student nurse making their clinical rotation at the pediatric ward of
Grey - Sloan Memorial Hospital. You have a 5 year old male
patient diagnosed with bacterial meningitis, during your rounds, the patient's
mother asked "How did my child acquire this illness?" As a
bright student nurse, you know that your response is correct if you answered
which of the following?
A. "Bacterial meningitis is acquired through skin to skin contact from a person
that is infected with the disease."
B. "Bacterial meningitis can spread from person to person by respiratory
droplets or throat secretions."
C. "Bacterial meningitis can be acquired through contaminated food or water
sources."
D. "Bacterial meningitis is transmitted through fecal - oral route, especially in
settings with poor sanitation such as those in
low lying areas." Ans✔👌- B. "Bacterial meningitis can spread from person to
person by respiratory droplets or throat secretions."
RATIONALE:
- Bacterial meningitis is highly contagious and primarily transmitted through
arespiratory adroplets aexpelled awhen aan ainfected aperson acoughs, asneezes, aor
atalks. aThese adroplets acan abe ainhaled aby aothers, aleading ato ainfection. aClose
acontact awith
,an ainfected aperson, aespecially ain acrowded asettings, aincreases athe arisk aof
atransmission.
As aa astudent awith avast aknowledge aof aNCM a109 aand aMicrobiology aand
aParasitology, ayou aare acorrect awith ayour aunderstanding aof aBacterial
Meningitis aif ayou aknew athat athe afollowing aare athe acommon acausative aagents
aof aBacterial aMeningitis aEXCEPT:
A. Neisseria aMeningitidis
B. Streptococcus aPneumoniae
C. Haemophilus aInfluenzae
D. Trichinella aSpiralis a Ans✔👌- aD. aTrichinella aSpiralis
Rationale:
- Trichinella aSpiralis ais aa aparasitic ainfection acaused aby aroundworms.
aTrichinella aspiralis aspecies ais athe acommon acause aof ahuman adisease aand
ainfection aoccurs aafter athe aingestion aof araw aor aundercooked apork. aA,B, aand aC
aare athe acommon acausative aagents aof abacterial ameningitis.
Which aof athe afollowing aNursing aDiagnosis aregarding aBacterial aMeningitis ais athe
amost apriority?
A. Risk afor aInfection
B. Risk afor aIneffective aCerebral aTissue aPerfusion
C. Risk afor aPhysical aTrauma
D. Acute aPain a Ans✔👌- aB. aRisk afor aIneffective aCerebral aTissue aPerfusion
,While athe aother anursing adiagnoses a(Risk afor aInfection, aRisk afor aPhysical
aTrauma, aand aAcute aPain) aare aimportant aconsiderations ain athe acare aof aa
apatient awith abacterial ameningitis, aaddressing athe arisk afor aineffective acerebral
atissue aperfusion atakes aprecedence adue ato aits apotential afor asevere aand
aimmediate aconsequences aon aneurological afunction aand apatient aoutcomes.
aIneffective acerebral atissue aperfusion acan aresult ain aischemia, ahypoxia, aand
aneuronal adamage, aleading ato apermanent aneurological adeficits aor aeven
adeath. a. aWithout aadequate acerebral aperfusion, athe abrain acannot areceive
asufficient aoxygen aand anutrients, awhich acan alead ato airreversible abrain
adamage awithin aa ashort atimeframe.
You aare aa anurse aworking ain athe aEmergency aDepartment aof aOLMCMC, aa
apatient awalks ain awith acomplaints aof aSevere aHeadache, aSensitivity ato
Light, aStiff aNeck, aand aCranial aNerve aPalsies. aYou asuspected athat athe apatient
amay ahave abacterial ameningitis. aWhich aof athe afollowing aphysical
assessment asigns acould asupport ayour asuspicion aof abacterial ameningitis?
A. Negative aBrudzinski aTest
B. Positive aKernig's aSign
C. Positive aInflammation aof athe aMcBurney's aPoint
D. Decreased aCN8 aFunction a Ans✔👌- aB. aPositive aKernig's aSign
Rationale:
- Kernig's asign ais aa aphysical aexam afinding awhere athere ais apain aand
aresistance ato apassive aextension aof athe aknee awith athe ahip
flexed aat a90 adegrees. aIt aindicates ameningeal airritation aand ais aoften apositive ain
acases aof ameningitis. aTherefore, aa apositive
Kernig's asign awould asupport athe asuspicion aof abacterial ameningitis.
, Nurse aToni aprovides aeducation ato athe amother aof apatient aPaye adiagnosed awith
abacterial ameningitis. aAll aof athe afollowing astatements aconfirm
that athe apatient aunderstands aher adiagnosis aEXCEPT:
A. "Bacterial ameningitis ais athe ainflammation aof athe ameninges, athe
aprotective amembrane athat asurrounds athe abrain aand aspinal
cord."
B. "Bacterial ameningitis acan alead ato aserious acomplications aincluding aseptic
ashock, acerebral aedema aand aincreased aintracranial
pressure."
C. "There ais ano acurrent atreatment afor abacterial ameningitis aand ait ashould
aresolve awithin a7-10 adays."
D. "My aheadache aand astiff aneck apain aare acaused aby airritability aof athe acervical
aand aspinal anerves." a Ans✔👌- aC. a"There ais ano acurrent atreatment afor
abacterial ameningitis aand ait ashould aresolve awithin a7-10 adays."
Rationale:
- Bacterial ameningitis ais aa aserious acondition athat arequires aprompt amedical
atreatment awith aantibiotics. aOption aC ais aincorrect abecause ait astates athat
athere ais ano acurrent atreatment afor abacterial ameningitis aand asuggests athat ait
ashould aresolve awithin a7-10 adays, awhich ais ainaccurate aand apotentially
adangerous amisinformation.
Monica, aRachel, aand aPhoebe aare astudent anurses aworking ain athe apediatric
aneurology adepartment aand aare areviewing athe aanatomy aand
physiology aof athe anervous asystem afor atheir aupcoming aPNLE. aThe anurses aare
acorrect awhen athey astated athat athe apurpose aof athe ablood abrain
barrier ais:
QUESTIONS AND ANSWERS 2024 WITH
COMPLETE SOLUTION
You are a student nurse making their clinical rotation at the pediatric ward of
Grey - Sloan Memorial Hospital. You have a 5 year old male
patient diagnosed with bacterial meningitis, during your rounds, the patient's
mother asked "How did my child acquire this illness?" As a
bright student nurse, you know that your response is correct if you answered
which of the following?
A. "Bacterial meningitis is acquired through skin to skin contact from a person
that is infected with the disease."
B. "Bacterial meningitis can spread from person to person by respiratory
droplets or throat secretions."
C. "Bacterial meningitis can be acquired through contaminated food or water
sources."
D. "Bacterial meningitis is transmitted through fecal - oral route, especially in
settings with poor sanitation such as those in
low lying areas." Ans✔👌- B. "Bacterial meningitis can spread from person to
person by respiratory droplets or throat secretions."
RATIONALE:
- Bacterial meningitis is highly contagious and primarily transmitted through
arespiratory adroplets aexpelled awhen aan ainfected aperson acoughs, asneezes, aor
atalks. aThese adroplets acan abe ainhaled aby aothers, aleading ato ainfection. aClose
acontact awith
,an ainfected aperson, aespecially ain acrowded asettings, aincreases athe arisk aof
atransmission.
As aa astudent awith avast aknowledge aof aNCM a109 aand aMicrobiology aand
aParasitology, ayou aare acorrect awith ayour aunderstanding aof aBacterial
Meningitis aif ayou aknew athat athe afollowing aare athe acommon acausative aagents
aof aBacterial aMeningitis aEXCEPT:
A. Neisseria aMeningitidis
B. Streptococcus aPneumoniae
C. Haemophilus aInfluenzae
D. Trichinella aSpiralis a Ans✔👌- aD. aTrichinella aSpiralis
Rationale:
- Trichinella aSpiralis ais aa aparasitic ainfection acaused aby aroundworms.
aTrichinella aspiralis aspecies ais athe acommon acause aof ahuman adisease aand
ainfection aoccurs aafter athe aingestion aof araw aor aundercooked apork. aA,B, aand aC
aare athe acommon acausative aagents aof abacterial ameningitis.
Which aof athe afollowing aNursing aDiagnosis aregarding aBacterial aMeningitis ais athe
amost apriority?
A. Risk afor aInfection
B. Risk afor aIneffective aCerebral aTissue aPerfusion
C. Risk afor aPhysical aTrauma
D. Acute aPain a Ans✔👌- aB. aRisk afor aIneffective aCerebral aTissue aPerfusion
,While athe aother anursing adiagnoses a(Risk afor aInfection, aRisk afor aPhysical
aTrauma, aand aAcute aPain) aare aimportant aconsiderations ain athe acare aof aa
apatient awith abacterial ameningitis, aaddressing athe arisk afor aineffective acerebral
atissue aperfusion atakes aprecedence adue ato aits apotential afor asevere aand
aimmediate aconsequences aon aneurological afunction aand apatient aoutcomes.
aIneffective acerebral atissue aperfusion acan aresult ain aischemia, ahypoxia, aand
aneuronal adamage, aleading ato apermanent aneurological adeficits aor aeven
adeath. a. aWithout aadequate acerebral aperfusion, athe abrain acannot areceive
asufficient aoxygen aand anutrients, awhich acan alead ato airreversible abrain
adamage awithin aa ashort atimeframe.
You aare aa anurse aworking ain athe aEmergency aDepartment aof aOLMCMC, aa
apatient awalks ain awith acomplaints aof aSevere aHeadache, aSensitivity ato
Light, aStiff aNeck, aand aCranial aNerve aPalsies. aYou asuspected athat athe apatient
amay ahave abacterial ameningitis. aWhich aof athe afollowing aphysical
assessment asigns acould asupport ayour asuspicion aof abacterial ameningitis?
A. Negative aBrudzinski aTest
B. Positive aKernig's aSign
C. Positive aInflammation aof athe aMcBurney's aPoint
D. Decreased aCN8 aFunction a Ans✔👌- aB. aPositive aKernig's aSign
Rationale:
- Kernig's asign ais aa aphysical aexam afinding awhere athere ais apain aand
aresistance ato apassive aextension aof athe aknee awith athe ahip
flexed aat a90 adegrees. aIt aindicates ameningeal airritation aand ais aoften apositive ain
acases aof ameningitis. aTherefore, aa apositive
Kernig's asign awould asupport athe asuspicion aof abacterial ameningitis.
, Nurse aToni aprovides aeducation ato athe amother aof apatient aPaye adiagnosed awith
abacterial ameningitis. aAll aof athe afollowing astatements aconfirm
that athe apatient aunderstands aher adiagnosis aEXCEPT:
A. "Bacterial ameningitis ais athe ainflammation aof athe ameninges, athe
aprotective amembrane athat asurrounds athe abrain aand aspinal
cord."
B. "Bacterial ameningitis acan alead ato aserious acomplications aincluding aseptic
ashock, acerebral aedema aand aincreased aintracranial
pressure."
C. "There ais ano acurrent atreatment afor abacterial ameningitis aand ait ashould
aresolve awithin a7-10 adays."
D. "My aheadache aand astiff aneck apain aare acaused aby airritability aof athe acervical
aand aspinal anerves." a Ans✔👌- aC. a"There ais ano acurrent atreatment afor
abacterial ameningitis aand ait ashould aresolve awithin a7-10 adays."
Rationale:
- Bacterial ameningitis ais aa aserious acondition athat arequires aprompt amedical
atreatment awith aantibiotics. aOption aC ais aincorrect abecause ait astates athat
athere ais ano acurrent atreatment afor abacterial ameningitis aand asuggests athat ait
ashould aresolve awithin a7-10 adays, awhich ais ainaccurate aand apotentially
adangerous amisinformation.
Monica, aRachel, aand aPhoebe aare astudent anurses aworking ain athe apediatric
aneurology adepartment aand aare areviewing athe aanatomy aand
physiology aof athe anervous asystem afor atheir aupcoming aPNLE. aThe anurses aare
acorrect awhen athey astated athat athe apurpose aof athe ablood abrain
barrier ais:
