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
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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Related Questions
Correct Answer is B
Explanation
a.Imaginary playmates are more common in the preschool years, typically around ages 3 to 5, rather than during the toddler stage.
b.Toddlers are in Erikson's stage of autonomy versus shame and doubt. During this stage, they strive for independence and autonomy, often exhibiting negative behaviors such as saying "no" frequently as they assert their independence. Theyare often in the stage of asserting their independence, leading to behaviors like tantrums, stubbornness, and defiance.
c.Sexual curiosity is more commonly seen in preschool and school-age children, not typically in toddlers.
d.This stage applies to preschool-aged children (approximately 3 to 6 years old), where they begin to assert power and control over their environment through directing play and other social interactions.
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.
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