Which of the following describes the correct procedure for testing for Kernig's sign?
Rotate the neck to one side while observing the eyes moving to the opposite side.
Passively elevate the leg with extended knee while observing for pain, resistance, or flexion.
Stroke the lateral aspect of the sole of the patient's foot and observe for dorsiflexion of the big toe.
Passively flex the patient's neck forward and observe for hip and knee flexion.
The Correct Answer is B
Choice A rationale: Rotating the neck to one side while observing the eyes moving to the opposite side is a procedure for testing for oculocephalic reflex or doll's eye
phenomenon, which indicates brainstem function.
Choice B rationale: This is the correct answer. Kernig's sign is a clinical sign that indicates meningitis, which is an inflammation of the membranes that cover the brain and spinal cord. To test for Kernig's sign, the nurse should flex the patient's hip to 90 degrees and then attempt to extend the knee. A positive Kernig's sign is when the patient
experiences pain in the lower back or hamstring, resists knee extension, or involuntarily flexes the opposite leg.
Choice C rationale: Stroking the lateral aspect of the sole of the patient's foot and observing for dorsiflexion of the big toe is a procedure for testing for Babinski's sign, which indicates upper motor neuron lesion or damage.
Choice D rationale: Passively flexing the patient's neck forward and observing for hip and knee flexion is a procedure for testing for Brudzinski's sign, which also indicates meningitis.
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Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale: Although important to assess for potential kidney injury, addressing hypotension due to potential spinal shock takes priority.
Choice B rationale: Important for determining any neurological deficits, but addressing hypotension is the initial priority.
Choice C rationale: Hypotension indicates potential spinal shock or hemorrhagic shock, and fluid resuscitation is the immediate priority to stabilize the client's blood pressure.
Choice D rationale: While important for assessing cardiac status, addressing hypotension takes precedence to stabilize the client's condition.
Correct Answer is C
Explanation
Choice A rationale: A glycated hemoglobin (HbA1c) value of 6.9 indicates that the client has prediabetes, which is a risk factor for developing diabetes.
Choice B rationale: A postprandial blood glucose level of 170 mg/dL is within the normal range.
Choice C rationale: This indicates that the client has diabetes mellitus. According to the American Diabetes Association, a diagnosis of diabetes can be made if one of the
following criteria is met: a fasting plasma glucose level of 126 mg/dL or higher, a postprandial blood glucose level of 200 mg/dL or higher, or an HbA1c value of 6.5% or higher.
Choice D rationale: A fasting plasma glucose level of 90 mg/dL is within the normal range.
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