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 auscultating the chest and abdomen.
Before examining the head and neck.
At the end.
The Correct Answer is D
Choice A rationale
Examining the tympanic membrane at the beginning may cause distress to the child and make the rest of the exam difficult.
Choice B rationale
Before auscultating the chest and abdomen, the child needs to be calm and cooperative, which might not be the case if their ear is examined first.
Choice C rationale
Examining the tympanic membrane before the head and neck could lead to increased anxiety and uncooperativeness in the child during the rest of the exam.
Choice D rationale
Examining the tympanic membrane at the end allows for a more accurate and complete examination without causing the child to become distressed early in the process.
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Correct Answer is B
Explanation
Choice A rationale
Placing a baby’s crib next to a heater can pose a risk of overheating or burns. Newborns should be kept at a safe distance from heaters to prevent accidents.
Choice B rationale
Removing extra blankets from the crib is recommended to reduce the risk of suffocation and sudden infant death syndrome (SIDS). This choice reflects an understanding of crib safety.
Choice C rationale
Padding the mattress can pose suffocation risks and is not recommended. A firm mattress without any padding is the safest option for newborns.
Choice D rationale
Placing a baby on their stomach to sleep increases the risk of SIDS. The recommended sleeping position for newborns is on their back, as this significantly reduces the risk.
Correct Answer is A
Explanation
Choice A rationale
Preterm newborns have underdeveloped mechanisms for thermoregulation, making it difficult for them to maintain stable body temperatures without external assistance.
Choice B rationale
Preterm newborns do not sweat significantly because their sweat glands are not fully developed; thus, this rationale is incorrect.
Choice C rationale
Preterm newborns actually have a larger body surface area relative to their weight, contributing to their difficulty in maintaining body temperature.
Choice D rationale
Preterm newborns have insufficient brown fat, not an excess, which impairs their ability to generate heat effectively.