HA: Assessing children and adolescents

When the nurse palpates the abdomen of a preschool boy, he begins to giggle and draw his legs up onto his abdomen. Which of the following would be most appropriate for the nurse to do?

Palpate with the child's hand under the nurse's hand.

After inspecting an adolescent male's genitalia, the nurse documents the findings as Tanner stage 3. Which of the following findings would be most likely?

Penis elongated; pubic hair sparse over pubis, coarse and curly

The nurse has assessed the head circumference (HC) of an 18-month-old during a regular checkup. The nurse should compare the percentile of the child's HC to which of the following?

The child's height and weight percentiles

During palpation of a young child's abdomen, the nurse assesses the liver. Which of the following would the nurse expect to find?

The liver is located 2 cm below the right costal margin.

A preadolescent girl comes to the clinic for a sports physical exam. The nurse notes beginning breast development and documents which of the following?

Thelarche

The nurse is teaching a group of parents of children of various ages how to best measure a child's temperature. The nurse instructs the parents that rectal temperature measurement is indicated in which situation?

When no other route is feasible

Which technique should the nurse use to perform scoliosis screening in a school-age child?

Have the child bend forward at the waist.

The nurse's inspection of a young child's anus reveals the presence of hemorrhoids. How should the nurse best interpret this assessment finding?

Hemorrhoids are unusual in children and warrant further assessment.

The nurse inspects a 10-day-old infant's umbilicus and notes that it is reddened with the presence of slight discharge. What nursing diagnosis is suggested by these data?

Infection

The nurse assesses the respiratory rate of a 5-year-old boy. Which finding would indicate to the nurse that his rate is within the age-appropriate range for this child?

24 bpm

The nurse is participating in a vision-screening program for children age 3 to 10 years. The nurse would expect a child to have 20/20 vision at what age?

6 - 7

A mother voices concern about the amount of time her school-age child sleeps? When responding to the mother, the nurse understand that this age group sleeps an average of how many hours each night?

8 to 9.5

The school nurse is assessing a 15-year-old client. The nurse should understand that this child's current priorities will most likely reflect what development task?

Developing personal identity

A nurse is conducting a workshop with a group of adults who are enrolled in a parenting class. Which of the following would the nurse emphasize as important in helping the school-age child achieve the psychosocial task of industry and avoid inferiority?

Acknowledge accomplishments

When describing cultural differences related to tooth eruption, the nurse explains that permanent teeth typically appear earlier in which group?

African American

A 4-year-old boy is brought to the emergency department by his parents, who state that he has been crying and saying his "tummy hurts." Which method would be most appropriate for the nurse to initially assess the problem?

Ask the child to point with one finger where it hurts.

The nurse's assessment of a child's hair reveals that it is clean and neatly trimmed but exceptionally dry and brittle. What is the nurse's best response to this finding?

Assess the child for signs and symptoms of impaired nutrition.

A school nurse plans to test hearing acuity in students who range between kindergarten and sixth grade. Which of the following would be most appropriate method?

Audiometry

When assessing adolescent girls, the nurse should know that which of the following usually appears first?

Breast buds

The nurse has identified a need to discuss sexuality with a 15-year-old client. How should the nurse best plan this aspect of the health interview?

Discuss the matter when a parent is not present.

A nurse is providing an in-service presentation to a group of new pediatric nurses and reviewing differences in assessment of children and adults. When describing the heart sound typically auscultated in children in comparison to an adult, which characteristic would the nurse describe?

Children typically have higher pitch breath sounds

During the health history, a nurse asks a mother to describe the play activities of her school-age son. The mother reports activities that are typical for this age group. The nurse would document this as which type of play?

Competitive

The nurse is assessing a 6-year-old child. While auscultating the child's apical heart rate, the nurse notes that the child's heart rate increases during inspiration. What is the nurse's most appropriate action?

Document this as an expected assessment finding.

The pediatric nurse is obtaining the nursing history of a 4-year-old girl who is accompanied by her mother. What question should the nurse pose to the child's mother?

Does your daughter often ask ''why''?

The nurse is experiencing challenges in eliciting information during the health interview of a 4-year-old boy. How can the nurse best foster communication with the child?

Engage the child in play

The nurse is meeting the parents of an ill child for the first time and is preparing to perform the health interview. In addition to gathering health data, what additional goal should the nurse prioritize during this interaction?

Foster trust with the child's parents

A nurse is having difficulty getting a 14-year-old child to "open up" during the health interview. What strategy is most likely to enhance the nurse's communication with this child?

Give the child some control over the course and content of the interview

Which finding would require further evaluation or referral when auscultating heart sounds on an 8-year-old client during a routine physical exam?

Pulse rate 120 beats per minute

A nurse has completed an assessment of a school-age child. The nurse has identified several soft signs of potential neurologic impairment. How should the nurse best interpret these findings?

Recognize that the findings may or may not indicate the presence of a neurologic problem

During a well-child visit, a parent asks the nurse the best way to manage negativism in her toddler. Which suggestions by the nurse would be most appropriate?

Reduce the opportunities for a "no" answer.