A nurse is assessing a client with suspected bacterial meningitis. Which of the following findings should the nurse expect?

Choice A reason: Nuchal rigidity, or neck stiffness, is a hallmark of bacterial meningitis due to meningeal inflammation irritating the spinal nerves and muscles. This causes resistance to neck flexion, often accompanied by fever, headache, and photophobia. It reflects the inflammatory response to bacterial invasion of the meninges, a critical diagnostic sign. Choice B reason: Hypoactive deep tendon reflexes are not typical in bacterial meningitis. The condition causes central nervous system irritation, often leading to hyperactive reflexes due to meningeal inflammation. Hypoactive reflexes may occur in peripheral neuropathies or late-stage neurological diseases, not in acute meningitis, where irritability and hyperreflexia are more common. Choice C reason: Bradycardia is not expected in bacterial meningitis. The systemic inflammatory response and fever typically cause tachycardia as the body compensates for infection and increased metabolic demand. Bradycardia may occur in late stages with increased intracranial pressure, but it is not a primary or early finding in meningitis. Choice D reason: Increased appetite is not associated with bacterial meningitis. The condition causes systemic symptoms like fever, headache, and nausea, often leading to anorexia due to inflammation and discomfort. Increased metabolic demand exists, but patients typically experience reduced appetite, making this an unlikely finding in acute bacterial meningitis.