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

Answer and Explanation

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.

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Correct Answer is {"dropdown-group-1":"E","dropdown-group-2":"A"}

Explanation

Seizures: The client’s severe hypertension (BP 166/110 mm Hg), proteinuria (3+), and neurological symptoms (headache) place her at high risk for eclampsia, which is characterized by the onset of seizures in a client with preeclampsia.

Placental abruption: Severe preeclampsia increases the risk of placental abruption, which is the premature separation of the placenta from the uterine wall, especially in clients with high blood pressure.

A. Potassium level B. Sodium level C. Parotid glands D. Hand findings E. Weight

Correct Answer is {"A":{"answers":"A,B"},"B":{"answers":"A,B"},"C":{"answers":"A"},"D":{"answers":"A"},"E":{"answers":"A"}}

Explanation

Bulimia Nervosa:

Low potassium level (3 mEq/L): Frequent self-induced vomiting leads to significant loss of gastric contents, including potassium. Hypokalemia is a common electrolyte disturbance in bulimia and can contribute to cardiac arrhythmias.

Low sodium level (134 mEq/L): Vomiting and fluid shifts associated with purging behaviors can result in mild hyponatremia. This may also be exacerbated by compensatory water intake or laxative use.

Parotid gland swelling: Repeated vomiting stimulates the salivary glands, particularly the parotids, leading to hypertrophy. This is a hallmark physical finding in bulimia nervosa.

Calluses on index and middle fingers (Russell’s sign): These result from repeated trauma due to self-induced vomiting, where the fingers are used to stimulate the gag reflex. This sign is highly specific to bulimia.

Normal BMI (20.7): Clients with bulimia often maintain a normal or slightly elevated BMI due to cycles of binging and purging. Unlike anorexia, extreme weight loss is not typical.

Anorexia Nervosa:

Low potassium level (3 mEq/L): Although more common in bulimia, hypokalemia can occur in anorexia—especially in the purging subtype or due to severe malnutrition and dehydration.

Low sodium level (134 mEq/L): Hyponatremia may result from dehydration, poor intake, or compensatory behaviors such as excessive water consumption. It’s less common but possible in anorexia.

Parotid enlargement is typically associated with bulimia nervosa, not anorexia. It results from repeated stimulation of the salivary glands due to frequent self-induced vomiting. In anorexia nervosa, especially the restricting subtype, vomiting is not a primary behavior, so parotid swelling is uncommon unless purging is involved.

Calluses on the index and middle fingers are caused by mechanical trauma from inducing vomiting. This physical sign is characteristic of bulimia nervosa, where clients often use their fingers to trigger emesis. In anorexia nervosa, particularly the restricting subtype, this behavior is not typical, making this finding inconsistent.

Anorexia nervosa is defined by significantly low body weight, typically a BMI below 18.5. A BMI of 20.7 falls within the normal range, which is inconsistent with the diagnostic criteria for anorexia. Clients with bulimia nervosa often maintain a normal or slightly elevated BMI due to cycles of binging and purging.

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A nurse is assessing a I-month-old infant at a pediatric office. Which of the following findings requires a referral for further care?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is pregnant. Exhibits Drag words from the choices below to fill in each blank in the following sentence. The client is at greatest risk for developing dropdown and dropdown.

Correct Answer is {"dropdown-group-1":"E","dropdown-group-2":"A"}

Explanation

Correct Answer is {"A":{"answers":"A,B"},"B":{"answers":"A,B"},"C":{"answers":"A"},"D":{"answers":"A"},"E":{"answers":"A"}}

Explanation

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