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 ["A","C","D"]
Explanation
Choice A rationale
Keeping the diaper loose in the front helps avoid pressure on the circumcision site, promoting healing and reducing discomfort for the infant.
Choice B rationale
A yellow crust or exudate forming on the circumcision site is a normal part of the healing process and should not be a cause for alarm. It is not an indication to call the doctor immediately unless other signs of infection or complications are present.
Choice C rationale
Notifying the healthcare provider in the case of significant bleeding is crucial. Excessive bleeding can indicate a complication that requires prompt medical attention to ensure the infant's safety and proper healing.
Choice D rationale
Applying petroleum jelly with each diaper change helps to protect the circumcision site from sticking to the diaper, promoting healing and reducing discomfort.
Correct Answer is ["A","B","C","D"]
Explanation
Choice A rationale
Inspection is always the first step in an abdominal assessment. It involves visually examining the abdomen for any abnormalities such as distention, masses, or scars.
Choice B rationale
Auscultation follows inspection and involves listening to bowel sounds with a stethoscope. This helps to assess the presence and frequency of peristalsis.
Choice C rationale
Deep palpation is performed after superficial palpation to identify any deep-seated abnormalities or pain. It helps in assessing the size, shape, consistency, and mobility of abdominal organs.
Choice D rationale
Superficial palpation is performed before deep palpation to detect any tenderness, muscle resistance, or superficial masses. It is done gently to avoid causing discomfort to the child.