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","B","C","E"]
Explanation
Choice A rationale
Serving food in small, halved, or quartered pieces can help prevent choking, which is a significant concern for infants and young children who are still developing their chewing and swallowing skills.
Choice B rationale
Ensuring the mattress fits snugly against the sides of the crib prevents the infant from getting trapped between the mattress and the crib sides, reducing the risk of suffocation or injury.
Choice C rationale
Child-proof locks on cabinet doors prevent infants from accessing hazardous substances or dangerous objects that could cause harm. This is a crucial aspect of home safety for young children.
Choice D rationale
Setting the water heater at 65°C (149°F) is not recommended because it is too hot and can cause burns. The water heater should be set at a maximum of 48°C (118°F) to prevent scalding injuries.
Choice E rationale
Never leaving a child unattended during bath time is essential to prevent drowning, which can occur quickly and silently. Close supervision is necessary to ensure the child’s safety in the water. .
Correct Answer is A
Explanation
Choice A rationale
It is common for children who are hospitalized to regress temporarily in their behavior, including toilet training. Stress, unfamiliar environments, and illness can contribute to this regression. Assuring the parents that the child’s skills will return when they feel better helps alleviate their concerns.
Choice B rationale
Asking why it bothers the parent that their child has wet the bed may come across as insensitive or confrontational. It does not provide support or reassurance to the parent.
Choice C rationale
Telling the parent not to worry about the child wetting the bed because the child did not seem upset dismisses the parent’s feelings and does not address the underlying issue of the child’s regression.
Choice D rationale
Sharing personal experiences and saying it doesn’t bother the nurse may seem empathetic but does not provide the professional reassurance and support the parents need. It shifts the focus to the nurse rather than addressing the parents' concerns.