A nurse suspects that a client admitted for treatment of bacterial meningitis is experiencing increased intracranial pressure (ICP). Which of the following assessment findings by the nurse supports this suspicion?

Choice A reason: Nuchal rigidity is a hallmark sign of meningeal irritation and is commonly seen in bacterial meningitis. However, it does not directly indicate increased intracranial pressure. It reflects inflammation of the meninges rather than a rise in pressure within the skull. Choice B reason: Photophobia, or sensitivity to light, is also a classic symptom of meningitis due to irritation of the meninges. Like nuchal rigidity, it does not signify increased ICP but rather the inflammatory process affecting the central nervous system. Choice C reason: Restlessness is a clinical indicator of increased ICP. It reflects altered mental status and early neurological changes due to pressure on the brain tissue. As ICP rises, cerebral perfusion decreases, leading to agitation, confusion, and eventually decreased consciousness. Choice D reason: A positive Kernig’s sign is another sign of meningeal irritation, elicited by pain during extension of the knee when the hip is flexed. It is diagnostic for meningitis but not specific to increased ICP.