The nurse is assessing a newborn's musculoskeletal status. How should the nurse assess for clubfoot?
1. Stimulate the sole of the foot
2. Adduct the foot and listen for a click
3. Extend the foot and observe for pain
4. Move the foot to midline and determine resistance
4
Explanation:
1. Stimulating the sole of the foot will elicit the plantar grasp reflex, and is not an appropriate assessment for clubfoot.
2. Adducting the foot and listening for a click is not an assessment that is done.
3. Extending the foot and observing for pain will not determine or rule out clubfoot.
4. Clubfoot is suspected when the foot will not turn to a midline position or align readily.
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