A 1-month-old infant is seen in a clinic and is diagnosed with developmental dysplasia of the hip (DDH). On assessment, the nurse understands that which finding would be noted in this condition?

Limited range of motion in the affected hip

Symmetry of the gluteal skinfolds when the infant is placed prone and the legs are extended

Negative Barlow test

Unaffected leg is pale and cool

Answer and Explanation

The Correct Answer is A

A. Developmental dysplasia of the hip (DDH) often presents with a limited range of motion in the affected hip, particularly in abduction.

B. Asymmetry of the gluteal skinfolds, not symmetry, is a typical finding in DDH. This asymmetry is due to the improper alignment of the hip joint.

C. A positive Barlow test, where the hip can be dislocated by adduction and posterior pressure, is indicative of DDH. A negative Barlow test would suggest the absence of DDH.

D. A pale and cool leg is not a common finding in DDH. This would be more indicative of a circulatory problem, not hip dysplasia.

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Correct Answer is A

Explanation

A. An upper gastrointestinal series is commonly used to diagnose gastroesophageal reflux (GER), which can cause symptoms like spitting up and crying after feedings, leading to failure to thrive. This test helps visualize the esophagus, stomach, and duodenum for abnormalities.

B. A biopsy of the small intestine is typically done to diagnose celiac disease, which is less likely in this clinical scenario.

C. An ultrasound is used to diagnose pyloric stenosis, which presents with projectile vomiting and is less consistent with the described symptoms.

D. A lower gastrointestinal series is used to detect intestinal blockages, which are not suggested by the symptoms of spitting up and crying immediately after feeding.

A. When hearing a loud noise, the infant cries and extends both arms and legs. B. When stroking the outer edge of the sole of the infant's foot, the toes fan upward and out. C. When infant's head is turned to one side, extension of the same side arm and leg occurs. D. When stroking the cheek, the infant turns toward that side of stimulation.

Correct Answer is B

Explanation

A. The Moro reflex, where the infant cries and extends both arms and legs in response to a loud noise, typically disappears by 4-6 months of age and would not be expected at 8 months.

B. The Babinski reflex, where the toes fan upward and out when the outer edge of the sole is stroked, is normal in infants and usually disappears by 12-24 months of age.

C. The tonic neck reflex (fencing reflex) typically disappears around 4-6 months of age, so it would not be expected in an 8-month-old.

D. The rooting reflex, where the infant turns their head toward the side of stimulation when the cheek is stroked, typically disappears by 3-4 months of age.

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A 1-month-old infant is seen in a clinic and is diagnosed with developmental dysplasia of the hip (DDH). On assessment, the nurse understands that which finding would be noted in this condition?

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