Home › MCQs › Nursing › Question #9268
Back to Questions
Nursing QUESTION #9268
Question 1
A nurse is assessing a child for signs of meningitis. She flexes the child's neck and observes involuntary flexion of the knees and hips. She also notes that with the hip and knee flexed at 90°, the knee cannot be fully extended. These signs are named:
  • Brudzinski's sign positive; Kernig's sign positive✔️
  • Kernig's sign positive; Brudzinski's sign positive
  • Romberg's sign; Babinski's sign
  • Cushing's triad; Battle's sign
Correct Answer Explanation

Meningeal Irritation Signs:

SignTestPositive Finding
Brudzinski's SignPassive neck flexion (supine patient)Involuntary flexion of hips and knees
Kernig's SignHip and knee flexed to 90°; attempt to extend kneeResistance/pain — cannot fully extend (positive if <135°)
Nuchal rigidityPassive neck flexionResistance; chin cannot touch chest

The question describes Brudzinski's sign first (neck flexion → knee/hip flex), then Kernig's sign (hip-knee 90° → cannot extend knee).

Meningitis management (bacterial):

  • IV Ceftriaxone \(100\,\text{mg/kg/day}\) in 2 divided doses
  • Dexamethasone \(0.15\,\text{mg/kg}\) IV every 6 hrs × 4 days (reduces inflammation, hearing loss)
  • Isolate patient for first 24 hrs of antibiotics

CSF findings in bacterial meningitis: Turbid, \(\uparrow\) WBC (neutrophils), \(\downarrow\) glucose, \(\uparrow\) protein, positive culture/Gram stain.