The nurse tells a joke to a 12-year-old to distract him from a painful procedure. What pain management technique is the nurse using?

A. Palpate the breasts: Palpation is performed after inspection to assess for lumps, tenderness, or abnormalities. Starting with palpation may miss subtle visual changes and could cause discomfort before completing the visual assessment.

B. Palpate the axillary area: The axillary area is palpated after breast palpation to check for lymph node enlargement or tenderness. This step helps identify possible spread of infection or malignancy but is not the first part of the exam.

C. Compress the nipple for a discharge: Nipple compression is performed later in the examination to check for abnormal discharge. Doing it first could obscure or alter inspection findings by stimulating tissue changes.

D. Inspect the breasts: Inspection is always the first step. The nurse observes breast size, symmetry, contour, skin texture, color, and the condition of the nipples. This provides baseline information and guides where to focus palpation during the physical exam.

A. Heart: The heart can be assessed while the newborn is calm or asleep to obtain an accurate heart rate and rhythm. Auscultating early avoids startling the infant, allowing for a more reliable assessment.

B. Abdomen: The abdomen should be examined while the newborn is relaxed, as palpation can disturb or wake the baby. Performing this assessment early ensures accurate findings without excessive movement or crying.

C. Lungs: The lungs can be auscultated while the newborn is sleeping to hear clear, unobstructed breath sounds. A quiet, sleeping state minimizes crying, which can interfere with accurate assessment.

D. Throat: The throat examination should be performed last because it involves handling the mouth and airway, which typically awakens or irritates the newborn. This can lead to crying and distress, making it harder to assess other systems afterward.