Positive Kernig's sign is observed in?

Appeared in: Daman & Diu Staff Nurse - 2018

Explanation

Kernig's sign is a classic clinical finding that indicates irritation of the meninges.
Meningitis is the inflammation of the meninges, the protective membranes surrounding the brain and spinal cord, which directly causes this irritation.
The sign is elicited by flexing the patient's hip and knee to 90 degrees and then attempting to straighten the leg; pain or resistance in the hamstring muscles constitutes a positive sign.
This painful response occurs because the maneuver stretches the inflamed meninges and spinal nerve roots.

Option A: Cholecystitis is inflammation of the gallbladder. It does not cause meningeal irritation.
Option B: Nephritis is inflammation of the kidneys. Its symptoms are related to the renal system, such as flank pain and changes in urination.
Option D: Appendicitis is inflammation of the appendix. It causes peritoneal irritation in the abdomen, not meningeal irritation.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Identification of meningeal irritation signs as background academic context rather than a clinical decision trigger.
Prompt recognition of meningeal signs like Kernig's is a critical nursing skill, as it can lead to early diagnosis and treatment of meningitis, a potential medical emergency.
For any patient with suspected bacterial meningitis, the nurse's first priority is to implement droplet precautions to prevent transmission to others.
Nurses must continuously monitor for signs of increased intracranial pressure (e.g., changes in consciousness, pupillary changes, Cushing's triad) in patients with meningitis.

How to Approach the Question

First, identify the key clinical sign mentioned in the question stem: "Positive Kernig's sign".
This is a factual recall question that requires you to connect a specific physical assessment finding to its underlying pathology.
Access your knowledge of pathophysiology and physical assessment. Recall that Kernig's sign is a test for meningeal irritation.
Review the four options provided and determine which condition involves inflammation of the meninges.
Meningitis is, by definition, inflammation of the meninges, making it the most logical answer.
To confirm, mentally rule out the other options by recalling their characteristic signs (e.g., Cholecystitis -> Murphy's sign; Appendicitis -> McBurney's point tenderness).

Concept Tested & Keywords

QDAT_9fuZgZXUHth-vFXoJ

E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 1568-1570

E6 Medicine Harrison 22e Part 1 p. 1161-1163

E6 Medicine Harrison 22e Part 2 p. 499-501

Practise the full Daman & Diu Staff Nurse - 2018

Attempt every question from this paper in a timed mock, then review the full solution for each one.