A nurse is assessing a I-month-old infant at a pediatric office. Which of the following findings requires a referral for further care?
Femoral head remains in the acetabulum during the Barlow maneuver
Symmetric gluteal and thigh skin folds
Equal leg length
Limited hip abduction
The Correct Answer is D
Rationale:
A. Femoral head remains in the acetabulum during the Barlow maneuver: This is a normal finding, indicating that the hip joint is stable and not dislocated.
B. Symmetric gluteal and thigh skin folds: Symmetry suggests normal hip alignment and absence of hip dysplasia.
C. Equal leg length: Equal leg length is expected and indicates no hip dislocation.
D. Limited hip abduction: Limited abduction in a 1-month-old may indicate developmental dysplasia of the hip (DDH). In DDH, the femoral head does not fully seat in the acetabulum, restricting outward movement. Early diagnosis prevents long-term complications such as gait abnormalities or limb-length discrepancy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Percussion is performed before palpation but after auscultation to prevent altering bowel sounds.
B. Palpation is the final step in abdominal assessment because it can stimulate bowel activity, changing the characteristics of bowel sounds. The correct sequence is: Inspection → Auscultation → Percussion → Palpation.
C. Auscultation occurs before percussion and palpation to assess bowel sounds accurately without interference.
D. Inspection is always performed first to observe for contour, symmetry, scars, or distention before any manipulation of the abdomen.
Correct Answer is B
Explanation
A. Sneezing is a mild symptom unrelated to acute chest syndrome.
B. Substernal retractions indicate respiratory distress, a hallmark of acute chest syndrome, which is a life-threatening complication of sickle-cell disease caused by sickling in the pulmonary vasculature. This leads to hypoxia, chest pain, fever, and respiratory failure if untreated.
C. Hematuria may occur with sickling in renal capillaries but is not an emergency.
D. A low-grade fever is common in infection or inflammation but does not indicate acute chest syndrome by itself.
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