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
The deltoid muscle is not recommended for newborns due to its small size and underdevelopment.
Choice B rationale
The vastus lateralis muscle is well-developed in newborns and has a large enough surface area to safely accommodate injections.
Choice C rationale
The gluteus maximus muscle is not suitable for newborn injections due to the risk of nerve damage.
Choice D rationale
The rectus femoris muscle is less commonly used due to the potential for more pain and discomfort.
Correct Answer is B
Explanation
Choice A rationale
Hanging crib toys are not suitable for a 12-month-old toddler as they are more appropriate for younger infants. Toddlers need toys that can stimulate their fine and gross motor skills, and hanging crib toys do not fulfill this need.
Choice B rationale
Large building blocks are ideal for a 12-month-old toddler as they help in developing fine motor skills, hand-eye coordination, and creativity. These blocks also encourage problem-solving and spatial awareness, which are crucial developmental milestones at this age.
Choice C rationale
Crayons and a coloring book are not the best choice for a toddler under contact precautions as they can be difficult to disinfect and might pose a risk of infection. Additionally, at 12 months, toddlers are still developing their pincer grasp and may not have the coordination for coloring.
Choice D rationale
Modeling clay is not suitable for a 12-month-old due to the potential choking hazard. Toddlers at this age tend to put objects in their mouths, and modeling clay can be difficult to keep clean under contact precautions.