What is the cardinal sign of meningitis?

RRB Nsg. Superintendent 21 July 2019 (shift 1st)

Medical & Surgical Nursing

Easy

Appeared in: RRB Nsg. Superintendent 21 July 2019 (shift 1st)

Explanation

Kernig's sign is a classic physical finding indicating meningeal irritation, which is a core feature of meningitis.
The test is performed by flexing the patient's hip and knee, then attempting to straighten the leg. Pain and resistance during this maneuver suggest inflammation of the meninges.
Along with Brudzinski's sign and nuchal rigidity, Kernig's sign is a key component of the neurological assessment for suspected meningitis.

Option A: Trousseau's sign is not related to meningitis. It indicates neuromuscular irritability caused by hypocalcemia (low blood calcium).
Option C: Ortolani sign is a specific orthopedic test for developmental dysplasia of the hip (DDH) in infants and is completely unrelated to meningitis.
Option D: Like Trousseau's sign, Chvostek's sign is an indicator of hypocalcemia, not meningitis. It tests for facial nerve irritability.

Visual 1: Diagram - Illustration showing the correct procedure to elicit Kernig's sign on a patient.
Visual 2: Diagram - Illustration of a positive Brudzinski's sign, another key sign of meningitis, for comparison.
Visual 3: Infographic - A chart comparing the clinical signs of meningitis (Kernig's, Brudzinski's) with signs of hypocalcemia (Trousseau's, Chvostek's).

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Clinical signs of meningeal irritation as background academic context rather than a clinical decision trigger.
Recognizing signs of meningeal irritation like Kernig's sign is a critical nursing skill. Prompt identification can lead to earlier diagnosis and treatment of meningitis, which is a medical emergency.
A thorough neurological assessment, including testing for Kernig's and Brudzinski's signs, is essential for any patient presenting with fever, headache, and altered mental status.
What if the patient was an infant under 1 year old? In this population, classic signs like Kernig's and nuchal rigidity are often absent. A nurse should instead be highly alert for a bulging fontanelle, high-pitched cry, irritability, and poor feeding as primary indicators of meningitis.

How to Approach the Question

First, identify the key condition in the question stem, which is 'meningitis'.
Next, recall the specific clinical signs associated with meningeal irritation caused by meningitis.
Evaluate each option provided. Ask yourself, 'Is this sign used to test for meningitis?'
Kernig's sign is a well-known test for meningeal irritation.
Eliminate the other options by recalling what they test for: Trousseau's and Chvostek's for hypocalcemia, and Ortolani for infant hip dysplasia.
Select the option that directly relates to the condition mentioned in the question.

Concept Tested & Keywords

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