P.A.S.S questions - help needed!

I'm working thru the P.A.S.S online review and I keep bumping my head against questions like this one, where I pick the wrong answer. I don't always agree with their rationales and I need to know if it is my thinking that is skewed here!!

The question is:

When planning care for a child suspected of having bacterial meningitis, the nurse's first priority should be to:

1. Offer cool, clear fluids

2. Administer the antipyretic, per MD's order

3. Administer the antibiotic, per MD's order

4. Check vital signs and perform neurological examination.

Which one would you pick and why?

I'll post my (wrong) answer and their right one with rationale in a little while.

Thanks

Elleann

I would choose #4. As they had drilled into us..Assess, assess, assess

that is the same one I would pick but I looked hard at #2 as well but my final answer (did I just hear Regis?) would be #4. number 1 and 2 are kinda the same so I would have eliminated those.

AmyD

...I would choose number 4. Reason: Apart from assessing first because it's always the first thing to do, the information in the stem of the question shows that some kind of assessment has been done but it's incomplete. So, you need to validate that before implementing because think about it, what would be the outcome if you decide to offer fluids or give the prescribed meds? By validating your suspicions through VS and neuro assesment, you'll be able to implement better, I mean as far as knowing the right thing to do.... that's what i think, what's the answer? ...:)

now that I have had time to think about it , isn't Bact. meningitis treated with antibiotics even when just suspected? mmmm? maybe I change my answer,...................or am I reading into the question???

The question is:

When planning care for a child suspected of having bacterial meningitis, the nurse's first priority should be to:

1. Offer cool, clear fluids

2. Administer the antipyretic, per MD's order

3. Administer the antibiotic, per MD's order

4. Check vital signs and perform neurological examination.

Which one would you pick and why?

I am going w/# 4.... Assess, Assess, Assess is what I was taught...I would want to know the VS,LOC among other things,...then isolation/antibiotics & antipyretic, hydration, I&O's.

when planning care for a child suspected of having bacterial meningitis, the nurse's first priority should be to:

1. offer cool, clear fluids

2. administer the antipyretic, per md's order

3. administer the antibiotic, per md's order

4. check vital signs and perform neurological examination.

which one would you pick and why?

you have to take care of the cause, not the symptom.

i'm going with this answer after going through 4,000 questions in the saunders comprehensive cd & 1,200 questions of the saunders q&a book.

btw, i took the nclex 3 days ago and most of the questions are not even similar to the questions in the review books.

i don't know if i passed.

so what's the right answer?

now that I have had time to think about it , isn't Bact. meningitis treated with antibiotics even when just suspected? mmmm? maybe I change my answer,...................or am I reading into the question???

It is & isolation for 24 hrs I think but....I think you would need to assess 1st because of possible ICP & seizures????? I may be way off!

...LOL...I now see why Elleann asked this question! I went over this question over and over again and have chosen my FINAL answer...serious......Although i may have other strong reasons why #4 is the right answer, i see that it doen't apply to this particular question considering the infectious nature... With safety at the back of my head, i think the priority nursing action would be to adminster the prescribed antibiotics and also take repiratory isolation precautions first (until it's ruled out) before doing any other thing. If the disease is not that infectious, I would go ahead and validate by assessment first before implementing...but with bac. meningitis, I would take my precautions initially...

By the way, thanx for bringing this up Elleann, I love to think! This type of Q brings out your critical thinking skills...Quite easy but also easy to miss..

I also choose #4. I have difficulty with tests in general and answering questions; but, the way I looked at this question was, "what is the worse thing that can happen to this child?" You know with bacterial meningitis the vital signs and neuro status could be affected. So, what's the MOST important (I think it says "nurse first priority") would the nurse do? Thanks for posting the question.

#4. that's my story and I'm stickin' to it