Certified Medical-Surgical Registered Nurse Practice Exam

A nurse is assessing a patient with suspected meningitis. Which sign should the nurse be most concerned about?

1. Low-grade fever

2. Stiff neck

3. Severe photophobia

4. Rash

The correct answer is: Severe photophobia

Severe photophobia, or sensitivity to light, is a concerning sign in a patient with suspected meningitis because it often indicates irritation of the meninges, which could be due to an infectious process. Meningitis can lead to increased intracranial pressure and neurological complications, and photophobia suggests potential inflammation affecting the brain and its protective layers. This symptom can significantly impact the patient's comfort and ability to function, and it often accompanies other serious signs of meningitis, such as headache and altered mental status. Therefore, the presence of severe photophobia in conjunction with other symptoms raises red flags for the nurse, indicating the urgency for further evaluation and management. Low-grade fever is common in many conditions and, while it can be related to meningitis, it is less specific. Stiff neck is indicative of meningitis and warrants attention, but severe photophobia can reflect more advanced irritation of the central nervous system. A rash may be seen in certain types of meningitis, particularly bacterial, but severe photophobia is generally considered a more pronounced and urgent concern given its implications for the central nervous system's involvement.