Review Practice Exercise 1

Childhood And Family Assessment > Child Health

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Practice Exercise 1

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Total Questions : 4

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Question 1:

Which statement indicates the best sequence for the nurse to conduct an assessment in a nonemergency situation?

A. Introduce yourself, ask about any problems, take a history, and do the physical examination. B. Perform the physical examination and then ask the family if there are any problems in the child’s life. C. Do the physical examination while at the same time asking about the child’s previous illnesses; then talk about the family’s concerns. D. Get a complete history of the family’s health beliefs and practices, and then assess the child.

Answer and Explanation

Choice A:

Introducing yourself establishes trust. Asking about problems shows concern for immediate issues. Taking a history before the physical exam provides valuable background that can guide the assessment and focus attention on potential problem areas.Rationale for incorrect answers:

Choice B:

Starting with the physical exam before discussing problems may increase anxiety for the child and family and risks missing important background information.

Choice C:

Combining the physical exam with history-taking may be efficient in some urgent situations but is less ideal for a relaxed, thorough nonemergency assessment.

Choice D:

While understanding health beliefs is important, taking an overly detailed family history before addressing immediate concerns or examining the child may delay care and rapport building.

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Question 2:

What approach by the nurse would most likely encourage a child to cooperate with an assessment of physical and developmental health?

A. Explain to the child what’s going to happen when the child asks questions. B. Explain what is going to happen in words the child can understand. C. Force the child to cooperate by having a parent hold him or her down. D. Give the child a sticker before beginning the examination.

Answer and Explanation

Choice A:

Waiting to explain only when the child asks questions is reactive and may leave the child uncertain or fearful. Proactive communication is more effective in reducing anxiety.

Choice B:

Using age-appropriate language helps children feel respected, informed, and less anxious. It allows them to mentally prepare for the assessment and encourages active participation. This aligns with pediatric communication principles that emphasize honesty, clarity, and developmental sensitivity.Rationale for incorrect answers:

Choice C:

Forcing cooperation undermines trust, increases fear, and can cause long-term resistance to medical care. It should be avoided unless absolutely necessary for urgent safety reasons.

Choice D:

Offering a reward before starting may create expectations of discomfort or coercion. While positive reinforcement is useful, it is most effective when given after the procedure as acknowledgment of cooperation.

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Question 3:

A nurse in the pediatric clinic is examining a group of clients. These general approaches can be helpful when performing a physical examination. Select all that apply

A. With toddlers, restraint may be necessary, and requesting a parent’s assistance is appropriate. B. When examining a preschooler, giving a choice of which parts to examine may be helpful in gaining the child’s cooperation. C. With a school-age child, it is always best to have the parents present when examining. D. Giving explanations about body systems can make adolescents nervous due to their egocentricities. E. An infant physical examination is done head to toe, similarly to the adult.

Answer and Explanation

Choice A:

Toddlers often resist examinations due to fear and lack of understanding. Gentle restraint, with parental support, helps keep the child safe while providing comfort. Involving parents reduces the toddler’s distress and strengthens the nurse–family alliance.

Choice B:

Preschoolers like to feel a sense of control. Offering limited choices such as, "Should I look in your ears or your mouth first?", encourages cooperation and helps reduce anxiety without compromising the exam.Rationale for incorrect answers:

Choice C:

School-age children, especially older ones may prefer privacy, particularly for sensitive topics or exams. Asking the child’s preference promotes respect and autonomy.

Choice D:

Adolescents benefit from clear explanations and often want to understand what’s happening with their bodies. While they may be self-conscious, providing honest information builds trust and supports their need for autonomy.

Choice E:

Infant exams are typically foot to head to allow the nurse to assess the least invasive areas first, building trust before disturbing the infant with more uncomfortable procedures like inspecting the ears or mouth.

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Question 4:

A 4½-year-old child is being assessed after sustaining an injury. The child is reluctant to tell the nurse exactly how the injury occurred. Which of the following statements made to the child by the nurse would likely result in the child communicating with the nurse? Select all that apply

A. “Would you please draw me a picture of what happened to you?” B. “Would you please write me a story about what happened to you?” C. “Here is a puppet friend of mine. Could he tell me what happened to you?” D. “What if your friends were hurt in the same way. What would have happened to him?” E. “I can’t help you if I don’t know what happened. Would you please tell me how you got hurt?”

Answer and Explanation

Choice A:

Drawing allows young children to express themselves nonverbally. It's a safe, developmentally appropriate method to explore thoughts and events, especially after distressing experiences.

Choice B:

Most 4½-year-olds have not yet developed sufficient writing skills for storytelling. This request is developmentally inappropriate and may cause frustration or withdrawal.

Choice C:

Puppet play encourages communication through projection. A child may feel more comfortable attributing their experience to the puppet, reducing fear of judgment or retribution.

Choice D:

This technique uses third-person storytelling, allowing the child to describe their experience in a hypothetical, less direct way. It reduces anxiety and encourages narrative without direct confrontation.Rationale for incorrect answers:

Choice E:

This direct request can feel pressuring or guilt-inducing. It may cause the child to shut down, especially if fear or trauma is involved. Preschoolers respond better to indirect, play-based communication.

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Practice Exercise 1

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