Deck 20: Assessing the Child and Adolescent

Question 1

You are assessing a 4-year-old child who has ear pain. According to the American Academy of Pediatrics, this stage of pediatric development is called:

A) Baby.
B) Toddler.
C) Preschool.
D) Grade school.

Answer 1

Preschool.

Question 2

According to Tanner's staging of sexual maturity, female staging is based on:

A) Hair growth and breast bud development.
B) Height, weight, and body mass index.
C) Age of girl and pubic hair development.
D) Breast size/shape and the distribution of pubic hair.

Answer 2

Breast size/shape and the distribution of pubic hair.

Question 3

When should infants at risk for lead poisoning be tested?

A) 1 to 3 months
B) 3 to 6 months
C) 6 to 9 months
D) 9 to 12 months

Answer 3

9 to 12 months

Question 4

A comprehensive health history will require many questions. At what age can children actively participate in the review of systems?

A) Age 3
B) Age 4
C) Age 5
D) Age 6

Question 5

Children may not always be able to express their chief complaint. Which of the following is a priority assessment during the health history?

A) Standing posture
B) Nonverbal body language
C) Vital signs
D) Parent's report

Question 6

During the health history, the nurse reviews information about factors that may affect the physical and cognitive development of the child. Which question or statement by the nurse would be most appropriate?

A) "Describe your pregnancy and delivery."
B) "Has your child had any major illnesses or injuries?"
C) "What brought you in today?"
D) "Tell me about your child's immunizations."

Question 7

During an initial comprehensive health history, the mother reveals that her child has not had any immunizations. She states, "My religion is against giving my child immunizations." What is your best response?

A) "Shame on you! You are hurting your child."
B) "This is against the law. You could go to jail."
C) "What is your religion? I will let your health-care provider know."
D) "I am going to have to report this immediately to the Department of Public Health."

Question 8

You are performing a psychosocial history on a teenager. He states that he is very active in sports and rides his bicycle 5 miles daily. What should the nurse ask next?

A) "What type of sports do you play?"
B) "Are you able to maintain good grades in school?"
C) "What type of protective equipment do you wear?"
D) "Do you wear a cup when you play football?"

Question 9

You are doing a psychosocial history on a 12-year-old girl. She reports that she has many friends that she "hangs out" with daily after school. You assess whether she smokes because you know that children usually try their first cigarette around age:

A) 9.
B) 10.
C) 11.
D) 12.

Question 10

When assessing a toddler's abdomen, excessive high-pitched tympanic sounds could indicate:

A) An underlying mass.
B) A paralytic ileus.
C) An early bowel obstruction.
D) Peritoneal inflammation.

Question 11

A mother reports that she is concerned that her 9-year-old daughter is overweight and has poor eating habits. What is the recommended and easiest method to assess daily intake?

A) Teach the 9-year-old girl how to write down everything she eats over a period of 3 days.
B) Ask the mother for a verbal report of the foods her daughter ate yesterday.
C) Document a food diary that includes a 24-hour period including all snacks.
D) Document a food diary that includes 2 weekdays and 1 weekend day.

Question 12

A mother is upset because her 6-year-old son continues to wet the bed every night. You know that this condition is called:

A) Urinary incontinence.
B) Stress incontinence.
C) Nocturnal enuresis.
D) Diurnal enuresis.

Question 13

The FLACC Scale is used to assess pain in children ages 2 months to 7 years. What criteria are evaluated on this scale?

A) Face, lips, activity, color, cooperation
B) Flail, listen, action, cry, color
C) Face, legs, activity, cry, consolability
D) Flail, legs, adjustment, color, cooperation

Question 14

The Review of Systems (ROS) is an essential component of the health history in the evaluation of a child. The ROS uses information from:

A) The physical examination.
B) A conversation with the parent and child about the body systems.
C) A review of all medical records and past examinations.
D) A review of the chief complaint.

Question 15

A 13-year-old female is undergoing a pre-school health assessment. Questions regarding smoking, drinking alcohol, and current sexual activity are best approached by the nurse:

A) In a private conversation with the patient.
B) In a private area with one parent present.
C) During the initial interview with both parents present.
D) With the parent, as these topics should not be addressed with this age patient.

Question 16

When auscultating an apical pulse of a child, the diaphragm of the stethoscope should be placed over the apex of the heart. The apex is located at:

A) The 2nd intercostal space at the midclavicular line.
B) The 4th or 5th intercostal space at the left midclavicular line.
C) The 3rd intercostal space at the left sternal border.
D) The 2nd intercostal space at the right sternal border.

Question 17

When using an otoscope to assess the ear of a child under 3 years, the examiner should:

A) Tip the head slightly toward the examiner.
B) Pull the pinna down and forward slightly.
C) Pull the pinna down and back.
D) With the pinna in its usual position, hold it back against the head.

Question 18

Learning disability is a term used for a wide variety of specific learning differences. Children with learning disabilities:

A) Often have problems with motivation.
B) Should be tested in middle school to implement an educational plan.
C) Frequently have problems with lower intelligence levels.
D) Are at risk for adjustment difficulties.

Question 19

When you are assessing a child's capillary refill, a normal finding would be:

A) Greater than 4 seconds.
B) Greater than 5 seconds.
C) Less than 4 second.
D) 2 to 3 seconds.

Question 20

The congenital displacement of the urethral opening of the penis to below the glans penis is called:

A) Hypospadias.
B) Cryptorchidism.
C) Epispadias.
D) Phimosis.

Question 21

You are assessing a 15-year-old boy and are discussing testicular self-examination. He states, "I do not know anything about that examination and I would never do that!" Which of the following remarks by the nurse is most appropriate?

A) "Adolescent boys over the age of 14 should start performing testicular self-examinations."
B) "You should know what your normal testicles feel like to check for abnormal lumps."
C) "You should have been told about doing a testicular examination in your health education class."
D) "Do you know where your testicles are?"

Question 22

A 5-year-old boy is being assessed for right leg pain. What pain scale will you use?

A) Face, Legs, Activity, Cry, Consolability (FLACC) Scale
B) Comfort B Scale
C) OUCHER! Scale
D) Visual Analog Scale

Question 23

At what age is head circumference measurement stopped?

A) Age 1
B) Age 2
C) Age 3
D) Age 4

Question 24

You are assessing the mouth of a 5-year-old child. You know that baby teeth are expected to fall out by:

A) Age 3.
B) Age 4.
C) Age 5.
D) Age 6.

Question 25

You are performing a pediatric assessment on a 13-year-old boy. Select your equipment. Select all that apply.

A) Sterile gloves
B) Stand-up scale
C) Length board
D) Paper measuring tape
E) Adult stethoscope
F) Rectal thermometer

Question 26

During a review of systems of the skin, which of the following questions are appropriate to ask a teenager? Select all that apply.

A) Do you have any piercings or tattoos?
B) Do you pick or try to pop your acne pimples?
C) Do you color your hair?
D) Do you have any problems with oily skin or skin blemishes?
E) Do you go to the tanning salon?
F) Do you bite your nails?

Question 27

You are assessing the posture and gait of a 14-month-old toddler. What are the normal assessment findings? Select all that apply.

A) Wide base of support
B) May be knock-kneed
C) Often pigeon-toed
D) May be bowlegged

Question 28

A 16-year-old girl reports that she has a severe allergy to peanuts. You educate the patient that children who are allergic to peanuts may also be allergic to which of the following? Select all that apply.

A) Milk products
B) Chocolate chip cookies
C) Pistachios
D) Cashews
E) Walnuts

Question 29

When examining an inner ear in a child, the structures that should be identified include which of the following? Select all that apply.

A) The tympanic membrane
B) Portions of the mandible (dense, whitish streak)
C) The umbo
D) The cone of light

Question 30

You are assessing a 6-year-old child who is showing signs of respiratory distress. What would be the abnormal findings that you may assess? Select all that apply.

A) Intercostal retractions
B) Nasal flaring
C) Grunting
D) Skin pallor
E) Change in level of consciousness

Question 31

When testing for human immunodeficiency virus (HIV) in the adolescent, it is important to maintain the three C's. What are the three C's? Select all that apply.

A) Crisis management
B) Informed consent
C) Connectivity
D) Counseling
E) Confidentiality

Question 32

Identify the true statements about pediatric cardiac assessment. Select all that apply.

A) Normal heart sounds are best heard with the bell of the stethoscope at all landmarks.
B) For children age 7 and older, the mitral area is located at or near the 3rd left intercostal space
C) Normally, pulsations are felt at the five landmarks on the chest wall next to the sternal border.
D) Erb's point is at the left sternal border in the 5th intercostal space at the apex of the heart.
E) For children up to age 7, the mitral area is located at or near the 4th intercostal space.

Question 33

Special considerations that are helpful to know when examining a child include which of the following? Select all that apply.

A) During gait assessment a child should wear shoes to help with stability.
B) Have the child place his or her hand over the examiner's hand when palpating the abdomen.
C) Playing a game of "Simon Says" can help to evaluate range of motion.
D) Newborns present with a rounded or C-shaped curve to the spine.

Question 34

A child's normal development includes which of the following? Select all that apply.

A) Occurs in a caudal to cephalic fashion
B) Proceeds in an orderly, sequential pathway
C) Begins with acquisition of fine motor skills followed by gross motor skills
D) Becomes increasingly integrated and organized

Question 35

A 14-year-old boy was playing football and suffered a concussion. Symptoms of a concussion include which of the following? Select all that apply.

A) Agitation
B) Headache
C) Nausea
D) Photophobia
E) Memory loss
F) Anosmia

Question 36

You are performing a physical assessment on a 3-year-old toddler. Correctly order the techniques of the physical examination (A-E). (Enter the number of each step in the proper sequence. Do not use punctuation or spaces. Example: ABCD.)

A) Assess the mouth and tongue using a tongue blade.
B) Take a tympanic temperature.
C) Assess the respiratory rate.
D) Auscultate lung sounds.
E) Perform a general survey.

Question 37

A stiff neck or limited range of motion with muscle spasm that causes contracture of the musculature of the neck is called ____________________.

Question 38

Swelling of the lips and tongue in response to an allergic reaction in a child is called ____________________.

Question 39

Pediatric breath sounds that are heard over the periphery of the lung fields with inspiration longer and louder than expiration are called ____________________ breath sounds.

Question 40

____________________ smoking puts children at high risk for respiratory infections, wheezing, and asthma.

Question 41

You are assessing a toddler who has just learned how to walk. Look at the picture and identify the type of legs that are normally seen in this age group. It is called _________ ___________.