A 2-week-old infant is seen in the well-baby clinic. As a nurse is assessing the client, which finding would present as a sign of congenital hip dysplasia?

Examining for the presence of any flexion of the hips when the infant is lying on the abdomen.

Extension of the legs while stimulating the infant to exhibit the stepping reflex.

Negative Babinski reflexes of both feet.

Asymmetrical gluteal folds and unequal leg length.

Answer and Explanation

The Correct Answer is D

Choice A rationale:

Examining for the presence of any flexion of the hips when the infant is lying on the abdomen is a method to assess for Ortolani and Barlow signs, which indicate hip dislocation, not hip dysplasia.

Choice B rationale:

Extension of the legs while stimulating the stepping reflex is a normal developmental response and is not specific to hip dysplasia.

Choice C rationale:

The Babinski reflex is related to neurological development and not directly linked to hip dysplasia.

Choice D rationale:

Asymmetrical gluteal folds and unequal leg length are common findings in congenital hip dysplasia. Hip dysplasia involves improper formation of the hip joint, leading to instability and deformity of the hip socket, which can result in these physical characteristics.

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Correct Answer is C

Explanation

Choice A rationale:

Placing the infant on her left side with a pillow supporting her back after feeding is appropriate as it prevents aspiration and reflux due to gravity.

Choice B rationale:

Covering the cast with a towel to prevent accidental soiling is a sensible action, ensuring the cast remains clean and dry.

Choice C rationale:

The mother using the football hold to position the infant securely to one side might hinder the cast's stability and could potentially cause discomfort or displacement.

Choice D rationale:

Supporting both the infant's head and cast when leaning her forward for burping is essential to maintain the cast's integrity and to prevent strain on the infant's body.

A. "My child will likely experience long-term complications, such as difficulty eating.”. B. "A few hours after surgery, my child will receive small, frequent feedings of Pedialyte.”. C. "My child will most likely have a small incision from the laparoscopic surgery.”. D. "I can breastfeed my child if the Pedialyte feedings are tolerated after 24 hours.".

Correct Answer is A

Explanation

Choice A rationale:

The statement "My child will likely experience long-term complications, such as difficulty eating”. indicates a misunderstanding about the postoperative care following a pyloromyotomy. Pyloromyotomy is a surgical procedure to treat pyloric stenosis, and the goal is to relieve the obstruction causing feeding difficulties. Long-term complications such as difficulty eating are not expected outcomes. The rationale behind this is that pyloromyotomy aims to improve feeding and resolve the obstruction, leading to improved eating habits.

Choice B rationale:

The statement "A few hours after surgery, my child will receive small, frequent feedings of Pedialyte”. is correct. After a pyloromyotomy, it's important to gradually reintroduce feeding. This statement demonstrates the caregiver's understanding of the postoperative feeding plan, which typically involves starting with clear fluids like Pedialyte.

Choice C rationale:

The statement "My child will most likely have a small incision from the laparoscopic surgery”. is incorrect. Pyloromyotomy is usually performed with a small incision, but it is not typically done laparoscopically. Instead, an open surgical approach is more common due to the nature of the procedure. Laparoscopy is not the usual method for this surgery.

Choice D rationale:

The statement "I can breastfeed my child if the Pedialyte feedings are tolerated after 24 hours”. is incorrect. After a pyloromyotomy, it's essential to follow a gradual feeding progression under medical guidance. Breastfeeding can be reintroduced gradually as the child tolerates oral feedings, but it's not solely dependent on 24 hours of Pedialyte tolerance.

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A 2-week-old infant is seen in the well-baby clinic. As a nurse is assessing the client, which finding would present as a sign of congenital hip dysplasia?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A 6-month-old patient with a plaster spica cast is being breastfed by her mother. Which action by the mother should the nurse question?

Correct Answer is C

Explanation

Which statement indicates a child's family needs further instruction about the postoperative care following a pyloromyotomy?

Correct Answer is A

Explanation

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