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Peds Exam 1 Questions
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Peds Exam 1 Questions Peds Exam 1 Questions Peds Exam 1 Questions
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Peds Exam 1 QuestionsThe nurse percussing over an empty stomach expects to hear which sound?
a. Tympany
b. Resonance
c. Flatness
d. Dullness - verified ANS: A
Tympany is a high-pitched, loud-intensity sound heard over air-filled body parts such as the stomach
and bowel. Resonance is a low-pitched, low-intensity sound elicited over hollow organs such as the
lungs. Flatness is a high-pitched, soft-intensity sound elicited by percussing over solid masses such as
bone or muscle. Dullness is a medium-pitched, medium-intensity sound elicited when percussing
over high-density structures such as the liver.
The nurse is admitting a toddler to the pediatric infectious disease unit. What is the single most
important component of the child's physical examination?
a. Assessment of heart and lungs
b. Measurement of height and weight
c. Documentation of parental concerns
d. Obtaining an accurate history - verified ANS: D
An accurate history is most helpful in identifying problems and potential problems. Heart and lung
assessment is not as important as an accurate history. A single measurement of height and weight is
not as significant as determining growth over time. The child's growth pattern can be elicited from
the history. Documentation of parental concerns is not as relevant to the physical examination as an
accurate history in this case.
In which section of the health history should the nurse record that the parent brought the infant to
the clinic today because of frequent diarrhea?
a. Review of systems
b. Chief complaint
c. Lifestyle and life patterns
d. Health history - verified ANS: B
,The chief complaint is documented using the child's or parent's words for the reason the child was
brought to the health care center. The review of systems includes health functions of body systems.
Lifestyle and life patterns include the child's interaction with the social, psychological, physical, and
cultural environment. Health history includes birth history, growth and development, common
childhood illnesses, immunizations, hospitalizations, injuries, and allergies.
The nurse assesses a child's oculomotor, trochlear, and abducent nerves by using which technique?
a. Assessing the six cardinal gazes
b. Identification of common odors
c. Having child bite on a tongue blade
d. Ask child to shrug against resistance - verified ANS: A
Using the six cardinal gazes the nurse assesses the oculomotor, trochlear, and abducent nerves.
Odors are detected by the olfactory nerve. Biting on tongue blade assesses the trigeminal nerve.
Shrugging against resistance assesses the accessory nerve.
The nurse is performing a comprehensive physical examination on a young child in the hospital. At
what age can the nurse expect a child's head and chest circumferences to be almost equal?
a. Birth
b. 6 months
c. 1 year
d. 3 years - verified ANS: C
Head and chest measurements are almost equal at 1 year of age.
An 8-year-old girl asks the nurse how the blood pressure apparatus works. The most appropriate
nursing action is to
a. ask her why she wants to know.
b. determine why she is so anxious.
c. explain in simple terms how it works.
d. tell her she will see how it works as it is used. - verified ANS: C
School-age children require explanations and reasons for everything. They are interested in the
functional aspect of all procedures, objects, and activities. It is appropriate for the nurse to explain
,how equipment works and what will happen to the child. "Why" questions are not therapeutic, plus
this question makes it sound like the nurse thinks the child does not need this information. The child
is not exhibiting anxiety, just requesting clarification of what will be occurring. The nurse must
explain how the blood pressure cuff works so that the child can then observe during the procedure.
Which chart should the nurse use to assess the visual acuity of an 8-year-old child?
a. Lea chart
b. Snellen chart
c. HOTV chart
d. Tumbling E chart - verified ANS: B
The Snellen chart is used to assess the vision of children older than 6 years of age. The Lea chart
tests vision using four different symbols designed for use with preschool children. The HOTV chart
tests vision by using graduated letters and is designed for use with children ages 3 to 6 years. The
tumbling E chart uses the letter E in various directions and is designed for use with children ages 3 to
6 years.
Which action is appropriate when the nurse is assessing breath sounds of an 18-month-old crying
child?
a. Ask the parent to quiet the child so the nurse can listen.
b. Auscultate breath sounds and chart that the child was crying.
c. Let the child play with the stethoscope for distraction.
d. Document that data are not available because of crying. - verified ANS: C
Distracting the child with an interesting activity can assist the child to calm down so an accurate
assessment can be made. Asking a parent to quiet the child may or may not work. Auscultating while
the child is crying typically results in less than optimal data. The assessment needs to be completed
so documenting that data are not available is not appropriate.
The nurse is obtaining vital signs on a 1-year-old child. What is the most appropriate site for
assessing the pulse rate?
a. Apical
b. Radial
c. Carotid
d. Femoral - verified ANS: A
Apical pulse rates are taken in children younger than 2 years. Radial pulse rates may be taken in
children older than 2 years. It is difficult to palpate the carotid pulse in an infant. The femoral pulse is
palpated when comparing peripheral pulses, but it is not used to measure an infant's pulse rate.
, A nurse is reviewing pediatric physical assessment techniques. Which statement about performing a
pediatric physical assessment is correct?
a. Physical examinations proceed systematically from head to toe unless developmental
considerations dictate otherwise.
b. The physical examination should be done with parents in the examining room for children of any
age.
c. Measurement of head circumference is done until the child is 5 years old.
d. The physical examination is done only when the child is cooperative. - verified ANS: A
Physical assessment usually proceeds from head to toe; however, developmental considerations
with infants and toddlers dictate that the least threatening assessments be done first to obtain
accurate data. Having parents in the examining room with adolescents is not appropriate. Head
circumference is routinely measured until 36 months of age. Children will not always be cooperative
during the physical examination. The examiner will need to incorporate communication and play
techniques to facilitate cooperation.
What term should be used in the nurse's documentation to describe auscultation of breath sounds
that are short, popping, and discontinuous on inspiration?
a. Pleural friction rub
b. Sonorous rhonchi
c. Crackles
d. Wheeze - verified ANS: C
Crackles are short, popping, discontinuous sounds heard on inspiration. Sonorous rhonchi are low-
pitched, moaning, musical sounds. A pleural friction rub has a grating, coarse, low-pitched sound.
Wheezes are musical, high-pitched, predominant sounds heard on expiration.
Which strategy is the best approach when initiating the physical examination of a 9-month-old male
infant?
a. Undress the infant and do a head-to-toe examination.
b. Have the parent hold the child on his or her lap.
c. Put the infant on the examination table and begin assessments at the head.
d. Ask the parent to leave because the infant will be upset. - verified ANS: B
Toddlers may be resistant and uncooperative. The nurse allows the child to remain on the parent's
lap to ease anxiety. The head-to-toe approach needs to be modified for the infant. Uncomfortable
procedures, such as the otoscopic examination, should be left until last. There is no reason to ask a
parent to leave when an infant is being examined. Having the parent with the infant will make the
experience less upsetting for the infant.
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