A nurse is assessing a toddler at a well-child visit. At what point in the physical examination should the nurse examine the child's tympanic membrane?

At the beginning

Before examining the head and neck

At the end

Before auscultating the chest

Answer and Explanation

The Correct Answer is C

A. It’s usually best to build trust and rapport first with non-invasive assessments. Starting with a potentially uncomfortable procedure like looking in the ears may cause distress and make the rest of the exam more difficult.

B. Examining the tympanic membrane before the head and neck might still be too early in the assessment and could cause the child to become uncooperative for subsequent steps. If the child becomes upset, it could complicate the rest of the physical exam, making it harder to complete.

C. Performing the ear examination at the end allows the nurse to build trust and rapport throughout the visit. The child is less likely to become distressed too early in the exam, which helps maintain cooperation for as long as possible. If the child does become upset, it is at the end of the visit, and the more critical assessments have already been completed.

D. If the ear exam causes distress, it may make the child uncooperative for important assessments like auscultating the heart and lungs.

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Correct Answer is A

Explanation

The nurse should include information that growth spurts in height occur toward the end of mid puberty. Gynecomastia is not a common change in boys during puberty, but it might occur in some cases. Changes in the voice and pubic hair growth signal the beginning of puberty. If scrotal changes have not occurred by the age of 14 years, puberty might be considered delayed.

A. 24 B. 12 C. 18 D. 30

Correct Answer is D

Explanation

Walking Well: The ability to walk well typically develops around12 to 15 months. Since the child walks well, we can consider her closer to this age range.

Stating first name: By 24-30 months, most children can identify themselves by name.

Repeating Phrases (“All done” and “Go bye-bye”): Repeating phrases is common around15 to 18 months. The child’s language development aligns with this stage.

24 Deciduous Teeth: By the age of2 to 3 years, children typically have all 20 deciduous (baby) teeth. Since this child has 24 deciduous teeth, she is likely closer to the2-year-oldmark.

Closed Anterior Fontanel: The anterior fontanel (soft spot on the baby’s head) usually closes by18 months. The fact that it is closed indicates that the child is beyond this age.

Child is most likely 30 months old.

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A nurse is assessing a toddler at a well-child visit. At what point in the physical examination should the nurse examine the child's tympanic membrane?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

Correct Answer is D

Explanation

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