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Chapter 33 Physical Assessment of Children
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Chapter 33 Physical Assessment of Children
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Chapter 33: Physical Assessment of ChildrenTest Bank
MULTIPLE CHOICE
1. The nurse percussing over an empty stomach expects to hear which sound?
a. Tympany
b. Resonance
c. Flatness
d. Dullness
ANS: A
Feedback
A Tympany is a high-pitched, loud-intensity sound heard over air-filled body parts
such as the stomach and bowel.
B Resonance is a low-pitched, low-intensity sound elicited over hollow organs
such as the lungs.
C Flatness is a high-pitched, soft-intensity sound elicited by percussing over solid
masses such as bone or muscle.
D Dullness is a medium-pitched, medium-intensity sound elicited when percussing
over high-density structures such as the liver.
PTS: 1 DIF: Cognitive Level: Application REF: p. 806 | Box 33-1
OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance
2. You are the nurse admitting a toddler to the pediatric infectious disease unit. What is the
single most important component of the child’s physical examination?
a. Assessment of heart and lungs
b. Measurement of height and weight
c. Documentation of parental concerns
d. Obtaining an accurate history
ANS: D
Feedback
A Heart and lung assessment is not as important as an accurate history.
B A single measurement of height and weight is not as significant as determining
growth over time. The child’s growth pattern can be elicited from the history.
C Documentation of parental concerns is not as relevant to the physical
examination as an accurate history.
D An accurate history is most helpful in identifying problems and potential
problems.
PTS: 1 DIF: Cognitive Level: Application REF: p. 807
OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance
,3. In which section of the health history should the nurse record that the parent brought the
infant to the clinic today because of frequent diarrhea?
a. Review of systems
b. Chief complaint
c. Lifestyle and life patterns
d. Health history
ANS: B
Feedback
A The review of systems includes past health functions of body systems.
B The chief complaint is documented using the child’s or parent’s words for the
reason the child was brought to the health care center.
C Lifestyle and life patterns include the child’s interaction with the social,
psychological, physical, and cultural environment.
D Health history includes birth history, growth and development, common
childhood illnesses, immunizations, hospitalizations, injuries, and allergies.
PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 808 | Box 33-4
OBJ: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance
4. Which choice includes the components of a complete pediatric history?
a. Statistical information, client profile, health history, family history, review of
systems, lifestyle and life patterns
b. Vital signs, chief complaint, and list of previous problems
c. Chief complaint, including body location, quality, quantity, timeframe, and
alleviating and aggravating factors
d. Pertinent developmental and family information
ANS: A
Feedback
A The identified items are included in a complete pediatric history.
B Vital signs, chief complaint, and list of previous problems do not constitute a
complete history.
C A problem-oriented history includes specific information about the chief
complaint.
D Pertinent developmental and family information are part of the complete history.
PTS: 1 DIF: Cognitive Level: Application REF: p. 807 | Box 33-3
OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance
5. The nurse is performing a comprehensive physical examination on a young child in the
hospital. At what age can the nurse expect a child’s head and chest circumferences to be
almost equal?
a. Birth
b. 6 months
c. 1 year
d. 3 years
, ANS: C
Feedback
A Head circumference is larger than chest circumference until approximately 12
months of age.
B Chest circumference is smaller than head circumference until approximately 1
year of age.
C Head and chest measurements are almost equal at 1 year of age.
D By 3 years of age, the chest circumference exceeds the head circumference.
PTS: 1 DIF: Cognitive Level: Application REF: p. 811
OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance
6. An 8-year-old girl asks the nurse how the blood pressure apparatus works. The most
appropriate nursing action is to
a. Ask her why she wants to know.
b. Determine why she is so anxious.
c. Explain in simple terms how it works.
d. Tell her she will see how it works as it is used.
ANS: C
Feedback
A The nurse should respond positively for requests for information about
procedures and health information. By not responding, the nurse may be limiting
communication with the child.
B The child is not exhibiting anxiety, just requesting clarification of what will be
occurring.
C School-age children require explanations and reasons for everything. They are
interested in the functional aspect of all procedures, objects, and activities. It is
appropriate for the nurse to explain how equipment works and what will happen
to the child.
D The nurse must explain how the blood pressure cuff works so that the child can
then observe during the procedure.
PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 805
OBJ: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance
7. Which chart should the nurse use to assess the visual acuity of an 8-year-old child?
a. Lea chart
b. Snellen chart
c. HOTV chart
d. Tumbling E chart
ANS: B
Feedback
A The Lea chart tests vision using four different symbols designed for use with
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