North American Registry of Midwives (NARM) Practice Exam

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What specific symptom is associated with a diaphragmatic hernia in a newborn?

Concave appearance of the abdomen
Increased right-sided breath sounds
Fever
Loss of appetite

The correct answer is: Concave appearance of the abdomen

The specific symptom associated with a diaphragmatic hernia in a newborn is the concave appearance of the abdomen. This occurs because abdominal contents may move up into the thoracic cavity due to the hernia, leading to a displacement of abdominal organs and affecting the normal contour of the abdomen. As a result, the abdomen can appear sunken or concave rather than distended. This characteristic sign is essential for identifying a diaphragmatic hernia in a clinical setting. The other symptoms listed, while they may appear in various clinical scenarios, are not specific indicators of a diaphragmatic hernia. For example, increased breath sounds can occur for various reasons, fever typically suggests an infection, and loss of appetite can be due to a multitude of factors unrelated to this particular condition. Instead, the distinctively concave appearance of the abdomen is a hallmark sign that prompts further evaluation for a possible diaphragmatic hernia.