Deck 34: Pediatric Assessment

Question 1

The nurse is taking a health history from the family of a 3-year-old child. The statement or question by the nurse that would be most likely to establish rapport and elicit an accurate response from the family is:

A)"Hello, I would like to talk with you and get some information on you and your child."
B)"Does any member of your family have a history of asthma, heart disease, or diabetes?"
C)"Tell me about the concerns that brought you to the clinic today."
D)"You will need to fill out these forms; make sure that the information is as complete as possible."

Answer 1

"Tell me about the concerns that brought you to the clinic today."

Question 2

The nurse is completing a physical examination of a four-year-old child. The best position in which to place the child for assessment of the genitalia would be:

A)Supine, with legs at a 50-degree angle.
B)Right side-lying.
C)In prone position, with knees drawn up under the body.
D)Frog-leg position.

Answer 2

Frog-leg position.

Question 3

While assessing newborns, the nurse should differentiate normal findings from findings which require further evaluation and intervention. Which would be normal newborn findings?

A)Swelling over the occiput that crosses suture lines
B)Tiny white papules located primarily on the nose and chin
C)Tiny red macules and pustules that come and go, primarily on the trunk and extremities
D)When the Moro reflex is elicited, the right arm extends and returns to the body.The left arm remains resting against the chest.
E)Greenish discoloration of skin over the entire body that is not removed by the initial bath

Answer 3

Swelling over the occiput that crosses suture lines
Tiny white papules located primarily on the nose and chin
Tiny red macules and pustules that come and go, primarily on the trunk and extremities

Question 4

A nurse caring for a 9-year-old notices some swelling in the child's ankles. The nurse presses against the ankle bone for 5 seconds, then releases the pressure, noticing a markedly slow disappearance of the indentation. Due to these physical findings, the nurse would suspect a problem with the:

A)Renal system.
B)Musculoskeletal system.
C)Respiratory system.
D)Integumentary system.

Question 5

A nurse working in the newborn nursery notes that an infant is having frequent episodes of apnea lasting 10 to15 seconds without any changes in color or decreases in heart rate. Which intervention would be the most appropriate?

A)Continue to observe the infant and call the physician if the apnea lasts longer than 20 seconds.
B)Suction the infant's mouth and nares.
C)Call the physician immediately.
D)Turn the infant on its right side.

Question 6

The nurse is questioning a 10-year-old child to assess the level of cognitive development. The question by the nurse that would best determine cognitive development would be:

A)"What grade are you in?"
B)"What is your least favorite class?"
C)"What books have you read lately?"
D)"What classes are you taking, and what are your grades in them?"

Question 7

The nurse is taking a health history from the family of a three-year-old child. Which statement or question by the nurse would be most likely to establish rapport and elicit an accurate response from the family?

A)"Tell me about the concerns that brought you to the clinic today."
B)"Does any member of your family have a history of asthma, heart disease, or diabetes?"
C)"Hello, I would like to talk with you and get some information about you and your child."
D)"You will need to fill out these forms; make sure that the information is as complete as possible."

Question 8

While assessing a seven-year-old girl, the nurse notices a regular-irregular heartbeat. The nurse listens carefully and notes that the heart rate increases on inspiration and decreases on expiration. What is the most appropriate action for the nurse to take next?

A)Record the finding as normal.
B)Notify the physician.
C)Schedule an EKG.
D)Ask the mother if a murmur has been detected before.

Question 9

The nurse is assessing a new admission to the newborn nursery. Which physical findings suggest the infant was preterm?

A)The ear pinna quickly returns to original position after being bent manually.
B)The infant's resting position is tightly flexed.
C)Labia widely separated with clitoris prominent.
D)Breast area barely perceptible with flat areola, no bud.
E)Sole creases do not extend the length of the foot.

Question 10

The nurse wants to do a quick evaluation of a one-month-old infant's hearing. Which assessment will provide the best information?

A)Examining the ear canal with an otoscope
B)Using a vibrating tuning fork placed against the child's skull
C)Using tympanometry
D)Using a noisemaker in the infant's presence to evaluate the child's response

Question 11

While assessing the blood pressure of an eight-year-old child, the nurse notes the following: Systolic sound is heard at 98, but the sound continues until it reaches 0. There is a distinct sound softening at 48. How should the nurse record this finding?

A)98/48
B)98/48/0
C)98/0
D)48/0

Question 12

To accurately access blood pressure on a child, the nurse would select a cuff:

A)By the cuff label-infant, child, adult.
B)That covers 2/3 of the upper arm with a bladder that wraps around at least 80% of the circumference of the arm.
C)Based on availability as the size of the cuff will not influence the blood pressure.
D)That extends up to 50 % of the upper arm and the bladder covers 1/4 of the circumference of the arm.

Question 13

While assessing a 10-month-old African-American infant, the nurse notices that the sclerae have a yellowish tint. Which organ system would the nurse suspect as having an ongoing disease process?

A)Hepatic
B)Cardiac
C)Genitourinary
D)Respiratory

Question 14

During the newborn examination, the nurse assesses the infant for signs of developmental dysplasia of the hip. Which finding would strongly suggest this disorder?

A)Asymmetric thigh and gluteal folds
B)Positive Babinski's reflex
C)A negative Moro reflex
D)Flat soles with prominent fat pads