A nurse is assessing a newborn who has developmental dysplasia of the hip (DDH). Which of the following findings should the nurse expect?
Inwardly turned foot on the affected side
Absent plantar reflexes
Lengthened thigh on the affected side
Asymmetric thigh folds
The Correct Answer is D
Choice A reason:
Inwardly turned foot on the affected side: An inwardly turned foot, also known as metatarsus adductus, is not typically associated with developmental dysplasia of the hip (DDH). This condition is more related to foot positioning and alignment rather than hip dysplasia.
Choice B reason:
Absent plantar reflexes: The plantar reflex, also known as the Babinski reflex, is usually present in newborns and indicates normal neurological function. An absent plantar reflex is not a common finding in DDH and would more likely suggest a neurological issue.
Choice C reason:
Lengthened thigh on the affected side: In DDH, the affected thigh is often shorter, not longer, due to the displacement of the femoral head from the acetabulum. This can lead to a noticeable difference in leg length.
Choice D reason:
Asymmetric thigh folds: Asymmetric thigh folds are a common sign of DDH. When the hip is dislocated or subluxated, it can cause uneven skin folds on the thighs and buttocks. This asymmetry is a key indicator that prompts further investigation, such as an ultrasound or X-ray.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason:
“The cause might be too short or infrequent feedings.”: Newborns typically lose weight in the first few days after birth, which is normal. However, if the weight loss is significant, it could be due to inadequate feeding. Breastfed newborns should be fed 8-12 times in 24 hours to ensure they are getting enough milk. Short or infrequent feedings can lead to insufficient intake, resulting in weight loss2. Ensuring proper latch and feeding techniques can help address this issue.
Choice B reason:
“It is due to the newborn’s loss of the influence of the maternal hormones.”: While maternal hormones do influence the newborn, their loss is not a primary cause of significant weight loss. The initial weight loss is more related to fluid loss and the transition to breastfeeding.
Choice C reason:
“This might be related to your baby having 3 stools a day.”: Frequent stools are common in newborns, especially those who are breastfed. While it can contribute to weight loss, it is usually not the main cause of significant weight loss. Monitoring the baby’s feeding and ensuring they are getting enough milk is more critical.
Choice D reason:
“You might want to offer water supplements between feedings.”: Offering water supplements to a newborn is not recommended, especially for breastfed babies. Breast milk provides all the necessary hydration and nutrients. Introducing water can interfere with breastfeeding and reduce the baby’s intake of breast milk, potentially leading to further weight loss.
Correct Answer is A
Explanation
Choice A reason:
A respiratory rate of 48 breaths per minute is within the expected reference range for a newborn. The normal respiratory rate for newborns typically falls between 30 and 60 breaths per minute. This rate ensures that the newborn is receiving adequate oxygen to support their metabolic needs and is a sign of healthy lung function.
Choice B reason:
A respiratory rate of 22 breaths per minute is below the expected reference range for a newborn. Such a low rate may indicate respiratory depression or other underlying issues that require immediate medical attention. Newborns have higher metabolic rates and smaller lung capacities, necessitating a faster breathing rate to meet their oxygen demands.
Choice C reason:
A respiratory rate of 100 breaths per minute is above the expected reference range for a newborn. This condition, known as tachypnea, can be a sign of respiratory distress or other complications such as infection, transient tachypnea of the newborn (TTN), or congenital heart defects. It is essential to monitor and address any causes of elevated respiratory rates to ensure the newborn’s well-being.
Choice D reason:
A respiratory rate of 110 breaths per minute is significantly above the expected reference range for a newborn. This extreme tachypnea is a critical indicator of severe respiratory distress or other serious conditions that require immediate medical intervention. Prompt assessment and treatment are necessary to prevent further complications and ensure the newborn’s health.
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