Encephalitis (not on exam)

Question 1

What is the most common cause of acute nonepidemic viral encephalitis?
A. Measles virus
B. Herpes simplex virus (HSV)
C. Cytomegalovirus
D. Varicella-zoster virus
Answer: B. Herpes simplex virus (HSV)

Answer 1

Rationale: HSV is the most frequent cause of acute nonepidemic viral encephalitis.

Question 2

Which virus is primarily transmitted by mosquitoes and can cause epidemic encephalitis?
A. Cytomegalovirus
B. West Nile virus
C. Influenza virus
D. Epstein-Barr virus

Answer 2

Answer: B. West Nile virus
Rationale: West Nile virus is spread by mosquitoes and is a major cause of epidemic encephalitis.

Question 3

What is a typical early symptom of encephalitis?
A. Bradycardia
B. Nausea
C. Hypotension
D. Jaundice

Answer 3

Answer: B. Nausea
Rationale: Early symptoms of encephalitis include fever, headache, nausea, and vomiting.

Question 4

Which diagnostic test is most accurate for detecting West Nile virus?
A. Lumbar puncture
B. CT scan
C. Blood test for viral RNA
D. EEG

Answer 4

Answer: C. Blood test for viral RNA
Rationale: The best diagnostic test for West Nile virus is a blood test that detects viral RNA.

Question 5

What is the first-line antiviral drug used to treat HSV encephalitis?
A. Ganciclovir
B. Oseltamivir
C. Acyclovir
D. Ribavirin

Answer 5

Answer: C. Acyclovir
Rationale: Acyclovir is the primary antiviral used to treat HSV-related encephalitis.

Question 6

Which of the following is a primary nursing intervention for patients with encephalitis?
A. Elevate the head of the bed 90 degrees
B. Administer diuretics
C. Seizure precautions
D. Encourage early ambulation

Answer 6

Answer: C. Seizure precautions
Rationale: Seizures are a common complication of encephalitis, so implementing seizure precautions is essential.

Question 7

In which population is West Nile virus encephalitis most common during late summer?
A. Children under 10
B. Pregnant women
C. Adults over 50
D. Athletes

Answer 7

Answer: C. Adults over 50
Rationale: Adults over 50 are at increased risk of West Nile virus encephalitis in the late summer and fall.

Question 8

What is the most effective method of preventing mosquito-borne encephalitis?
A. Yearly vaccination
B. Early antibiotic therapy
C. Mosquito control and repellents
D. Wearing long sleeves in winter

Answer 8

Answer: C. Mosquito control and repellents
Rationale: Prevention focuses on limiting mosquito breeding and exposure using repellents.

Question 9

Which neurological complication is most associated with encephalitis?
A. Myasthenia gravis
B. Guillain-Barré syndrome
C. Seizures
D. Parkinsonism

Answer 9

Answer: C. Seizures
Rationale: Seizures are a common CNS manifestation of encephalitis due to inflammation and neuronal irritation.

Question 10

When should acyclovir be initiated for maximum benefit in HSV encephalitis?
A. After coma develops
B. At time of fever onset only
C. Before onset of coma
D. After two weeks of symptoms

Answer 10

Answer: C. Before onset of coma
Rationale: Starting acyclovir early, before coma develops, significantly reduces mortality in HSV encephalitis.

Question 11

Which imaging method is commonly used to detect inflammation in the brain in encephalitis?
A. Chest x-ray
B. MRI
C. Colonoscopy
D. Mammogram

Answer 11

Answer: B. MRI
Rationale: MRI provides detailed images of the brain and is useful for detecting inflammation in encephalitis.

Question 12

What is a common symptom during day 2–3 of encephalitis progression?
A. Polyuria
B. Changes in mental status
C. Hyperglycemia
D. Bradycardia

Answer 12

Answer: B. Changes in mental status
Rationale: CNS symptoms like confusion, altered LOC, and behavioral changes typically begin around day 2–3.

Question 13

What type of virus causes cytomegalovirus encephalitis?
A. Arbovirus
B. Retrovirus
C. Herpesvirus
D. Poxvirus

Answer 13

Answer: C. Herpesvirus
Rationale: Cytomegalovirus belongs to the herpesvirus family and may cause encephalitis in immunocompromised patients.

Question 14

What is a common clinical sign of advanced encephalitis?
A. Hyperactivity
B. Coma
C. Skin rash
D. Dry mouth

Answer 14

Answer: B. Coma
Rationale: Encephalitis may progress to coma as inflammation severely affects brain function.

Question 15

What role does PCR testing play in diagnosing encephalitis?
A. Confirms bacterial meningitis
B. Screens liver enzymes
C. Detects viral genetic material
D. Identifies electrolyte imbalances

Answer 15

Answer: C. Detects viral genetic material
Rationale: PCR is used to detect viral DNA or RNA, including HSV and West Nile virus.

Question 16

A patient with suspected West Nile encephalitis presents with fever and headache. What is the next step?
A. Administer antibiotics
B. Order viral RNA blood test
C. Begin CPR
D. Refer to a dentist

Answer 16

Answer: B. Order viral RNA blood test
Rationale: The viral RNA test is used to confirm West Nile infection in encephalitis.

Question 17

What is a key risk factor for cytomegalovirus encephalitis?
A. Pregnancy
B. AIDS
C. Diabetes
D. Hypertension

Answer 17

Answer: B. AIDS
Rationale: Cytomegalovirus encephalitis most commonly occurs in immunocompromised individuals such as those with AIDS.

Question 18

What should a nurse do when a patient with encephalitis begins to seize?
A. Apply wrist restraints
B. Leave and call for help
C. Stay with the patient and protect from injury
D. Lower the bed completely flat

Answer 18

Answer: C. Stay with the patient and protect from injury
Rationale: Protecting the patient from injury and staying at the bedside are essential seizure management actions.

Question 19

What medication may be prescribed prophylactically in severe encephalitis cases to prevent seizures?
A. Gabapentin
B. Valacyclovir
C. Phenytoin
D. Metronidazole

Answer 19

Answer: C. Phenytoin
Rationale: Phenytoin and similar antiseizure medications may be used prophylactically in severe cases.

Question 20

Why is supportive care critical in encephalitis?
A. Because the condition is psychosomatic
B. Because there are no treatments available
C. Because treatment focuses on managing symptoms and preventing complications
D. Because patients are usually not contagious

Answer 20

Answer: C. Because treatment focuses on managing symptoms and preventing complications
Rationale: Most viral encephalitis cases require supportive care to manage systemic and neurologic symptoms.

Question 21

Which mosquito control measure is most effective at the community level?
A. Encourage wearing dark clothes
B. Spraying perfume
C. Eliminating standing water
D. Increasing humidity indoors

Answer 21

Answer: C. Eliminating standing water
Rationale: Removing standing water helps reduce mosquito breeding and lowers the risk of mosquito-borne encephalitis.

Question 22

What season sees the highest number of West Nile virus cases in the U.S.?
A. Winter
B. Early spring
C. Late summer
D. Mid-winter

Answer 22

Answer: C. Late summer
Rationale: West Nile virus cases increase in late summer due to high mosquito activity.

Question 23

What is a potential complication of untreated HSV encephalitis?
A. Kidney failure
B. Blindness
C. Permanent neurological damage
D. GERD

Answer 23

Answer: C. Permanent neurological damage
Rationale: HSV encephalitis can cause significant and permanent neurologic sequelae if untreated.

Question 24

Which of the following is NOT a typical symptom of encephalitis?
A. Amnesia
B. Dysphasia
C. Muscle hypertrophy
D. Personality changes

Answer 24

Answer: C. Muscle hypertrophy
Rationale: Muscle hypertrophy is not associated with encephalitis. Neurologic and cognitive changes are typical.

Question 25

What is the primary goal of nursing care for patients with encephalitis? A. Cure the virus B. Reduce blood pressure C. Support vital functions and prevent complications D. Administer chemotherapy

Answer 25

Answer: C. Support vital functions and prevent complications Rationale: Supportive care is the mainstay of encephalitis management due to limited antiviral treatments.

Question 26

Which of the following patients is at highest risk for severe complications from encephalitis? A. 25-year-old with seasonal allergies B. 50-year-old with asthma C. 68-year-old with AIDS D. 15-year-old athlete

Answer 26

Answer: C. 68-year-old with AIDS Rationale: Immunocompromised individuals, like those with AIDS, are more susceptible to severe complications.

Question 27

What finding should the nurse report immediately in a patient with encephalitis? A. Slight headache B. Increased drowsiness and inability to answer questions C. Mild tremors D. Nausea

Answer 27

Answer: B. Increased drowsiness and inability to answer questions Rationale: A decline in mental status could indicate worsening brain inflammation and needs immediate attention.

Question 28

What type of isolation precaution is required for viral encephalitis? A. Airborne B. Droplet C. Standard D. Contact

Answer 28

Answer: C. Standard Rationale: Encephalitis generally requires standard precautions unless caused by a specific pathogen needing more.

Question 29

What activity should encephalitis patients avoid during recovery? A. Sleeping 8 hours per night B. Bright lights and loud sounds C. Gentle stretching D. Using sunscreen

Answer 29

Answer: B. Bright lights and loud sounds Rationale: CNS sensitivity may be heightened, and stimuli like light and sound can aggravate symptoms.

Question 30

Which lab result would support a diagnosis of West Nile encephalitis? A. Positive blood culture B. Low platelet count C. Viral RNA positive D. Elevated cholesterol

Answer 30

Answer: C. Viral RNA positive Rationale: Detection of West Nile RNA in the blood confirms the diagnosis.

Question 31

What is the initial symptom that often prompts evaluation for encephalitis? A. Hair loss B. Diarrhea C. Fever and headache D. Joint stiffness

Answer 31

Answer: C. Fever and headache Rationale: These nonspecific symptoms are common early indicators of encephalitis.

Question 32

What part of the body is primarily affected in encephalitis? A. Liver B. Brain C. Lungs D. Kidneys

Answer 32

Answer: B. Brain Rationale: Encephalitis is an inflammation of the brain tissue.

Question 33

What feature distinguishes encephalitis from meningitis? A. Fever B. Headache C. Mental status changes D. Neck stiffness

Answer 33

Answer: C. Mental status changes Rationale: While both may present similarly, encephalitis more prominently affects mental status and consciousness.

Question 34

Which insect is most commonly associated with viral encephalitis in the U.S.? A. Tick B. Housefly C. Mosquito D. Bee

Answer 34

Answer: C. Mosquito Rationale: Mosquitoes transmit many viruses that can cause encephalitis, such as West Nile.

Question 35

Why is prompt treatment of HSV encephalitis essential? A. To prevent dehydration B. To limit contagiousness C. To reduce mortality and neurologic damage D. To avoid vision loss

Answer 35

Answer: C. To reduce mortality and neurologic damage Rationale: Early treatment significantly improves outcomes and reduces permanent brain damage.