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

[Elleann]

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

[cardiacRN2006, ADN, RN]

I'll only agree that you need a different review book. That one sucks. I have never seen questions worded like that.

Move on to Saunders!

[truern]

I JUST finished the Kaplan review and had a similar question about a rape case in the ED. We were told not only could she not wash, she couldn't eat or drink.

So much for P.A.S.S.

[RITA2007]

I think the priority for the nurse is to administer the ordered antibiotic. Bacterial meningitis can KILL in 6 hours!! ANTIBIOTIC

What is their answer?

[EricJRN, MSN, RN]

I think the priority for the nurse is to administer the ordered antibiotic. Bacterial meningitis can KILL in 6 hours!! ANTIBIOTIC

What is their answer?

Although I'm (as my avatar states) a really green nurse and I've done some pretty silly things, it has never taken me six hours to get a BP.

(Sorry - must be in a sarcastic mood tonight. Seriously though, how can you monitor a pt for adverse reactions without establishing some baselines?)

[Elleann]

Eric, have to say I love the tent flap quote. :-)

On a more serious note, the answer to the question was given a while back, Katie. PASS indeed said to give the antibiotic first, then do all the other stuff.