The nurse is conducting a physical examination of a child with suspected developmental dysplasia of the hip. Which finding would help confirm this diagnosis?
A high-pitched "click" is heard with hip flexion or extension.
A distinct "clunk is heard with Barlow and Ortolani maneuvers.
The thigh and gluteal folds are symmetric.
Abduction occurs to 75 degrees and adduction to within 30 degrees (with stable pelvis).
The Correct Answer is B
Rationale:
A. A high-pitched "click" is heard with hip flexion or extension: A soft or high-pitched click may occur in many healthy newborns due to ligament laxity and is not specific to developmental dysplasia of the hip (DDH). It is generally considered a benign finding.
B. A distinct "clunk" is heard with Barlow and Ortolani maneuvers: This is a hallmark finding for DDH. The “clunk” indicates the femoral head is either dislocating from or relocating into the acetabulum during these maneuvers, confirming hip instability and potential dislocation.
C. The thigh and gluteal folds are symmetric: Symmetric skin folds suggest normal hip alignment. Asymmetry of these folds is more concerning for DDH, so symmetry would not confirm the diagnosis.
D. Abduction occurs to 75 degrees and adduction to within 30 degrees (with stable pelvis): This degree of hip motion can be within normal limits, especially in the absence of instability. Restricted abduction is more consistent with DDH in older infants.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Rationale:
- Convert weight to kg:
60 lb ÷ 2.2
= 27.27 kg
- Calculate safe dose range per dose:
Minimum = 10 mg/kg × 27.27 kg
= 272.7 mg
Maximum = 15 mg/kg × 27.27 kg
= 409 mg
Prescribed dose is 400 mg, which falls within the safe range of 273 mg to 409 mg per dose. The dose is safe based on weight.
Correct Answer is C
Explanation
Rationale:
A. "I will give him his ADHD medication with his meals": Stimulant medications for ADHD can sometimes cause gastrointestinal upset, and giving them with food may help minimize this side effect.
B. "I will take my child to the physician every three months for a weight and height check.": Regular monitoring of growth is essential because stimulant medications can decrease appetite and potentially slow growth. A three-month interval is an appropriate follow-up.
C. "I will let him do his homework while he is watching his favorite television show.": Children with ADHD are easily distracted, and doing homework while watching television can make it harder to focus and complete tasks. A quiet, structured environment without competing stimuli supports better concentration and academic performance.
D. "I will stick to the same routine each day after school.": Consistent daily routines help children with ADHD feel secure and maintain focus. Predictable schedules reduce anxiety and behavioral outbursts, while also helping the child manage transitions more effectively.
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