NURS 5130 Exam 3 V1 | NURS 5130
Comprehensive Assessment – Pediatric
Assessment Lab | Actual Q&A with
Rationale (NURS5130 Exam 3) | The
University of Texas at Arlington
1. When assessing the tympanic membrane of a 20-month-old child, which technique should
the advanced practice nurse utilize?
A. Pull the pinna up and back towards the occiput.
B. Pull the pinna straight back and slightly upward.
C. Insert the speculum deeply to stabilize the canal.
D. Pull the pinna down and back to straighten the canal.
Answer: D
Rationale: For infants and children under the age of 3, the ear canal is curved upward.
Pulling the pinna down and back is essential to visualize the tympanic membrane
effectively. This anatomical consideration is a core component of pediatric assessment
training at UT Arlington.
2. Which of the following findings is considered normal when assessing the anterior
fontanelle of a 6-month-old infant?
A. A bulging fontanelle while the infant is resting.
,B. A slight pulsation and a flat appearance when the infant is quiet.
C. A depressed or sunken fontanelle when the infant is upright.
D. Complete closure of the fontanelle sutures.
Answer: B
Rationale: The anterior fontanelle should be flat and may exhibit slight pulsations
reflecting the peripheral pulse. It typically closes between 12 and 18 months of age, making
its presence at 6 months normal. Bulging or sunken fontanelles are clinical indicators of
increased intracranial pressure or dehydration, respectively.
3. An advanced practice nurse is evaluating a 4-year-old child’s vision. Which tool is most
appropriate for this developmental stage?
A. The standard Snellen letter chart.
B. The Rosenbaum pocket vision screener.
C. Observation of tracking a colorful toy.
D. The Allen picture cards or the Tumbling E chart.
Answer: D
Rationale: Preschool-age children may not yet know their alphabet, making the Allen
picture cards or Tumbling E chart more reliable. These tools assess visual acuity by
requiring the child to identify familiar shapes or directionality. Using developmentally
appropriate tools ensures accurate screening for amblyopia during pediatric visits.
, 4. At what age should the nurse practitioner expect the posterior fontanelle to be closed?
A. 1 to 2 months of age.
B. 6 months of age.
C. 12 months of age.
D. At birth.
Answer: A
Rationale: The posterior fontanelle is much smaller than the anterior fontanelle and closes
much earlier. It usually closes by the end of the second month of life. Delayed closure may
necessitate further investigation into metabolic or skeletal disorders.
5. Which physical assessment finding in a newborn is a clinical sign of potential
developmental dysplasia of the hip (DDH)?
A. Symmetrical gluteal folds when prone.
B. An audible ‘cluck’ or ‘thud’ during the Ortolani maneuver.
C. Negative Barlow and Ortolani maneuvers.
D. Equality in leg length and knee height.
Answer: B
Rationale: The Ortolani maneuver is used to reduce a dislocated hip; a positive sign is a
‘cluck’ as the femoral head moves back into the acetabulum. Asymmetry of the gluteal folds
Comprehensive Assessment – Pediatric
Assessment Lab | Actual Q&A with
Rationale (NURS5130 Exam 3) | The
University of Texas at Arlington
1. When assessing the tympanic membrane of a 20-month-old child, which technique should
the advanced practice nurse utilize?
A. Pull the pinna up and back towards the occiput.
B. Pull the pinna straight back and slightly upward.
C. Insert the speculum deeply to stabilize the canal.
D. Pull the pinna down and back to straighten the canal.
Answer: D
Rationale: For infants and children under the age of 3, the ear canal is curved upward.
Pulling the pinna down and back is essential to visualize the tympanic membrane
effectively. This anatomical consideration is a core component of pediatric assessment
training at UT Arlington.
2. Which of the following findings is considered normal when assessing the anterior
fontanelle of a 6-month-old infant?
A. A bulging fontanelle while the infant is resting.
,B. A slight pulsation and a flat appearance when the infant is quiet.
C. A depressed or sunken fontanelle when the infant is upright.
D. Complete closure of the fontanelle sutures.
Answer: B
Rationale: The anterior fontanelle should be flat and may exhibit slight pulsations
reflecting the peripheral pulse. It typically closes between 12 and 18 months of age, making
its presence at 6 months normal. Bulging or sunken fontanelles are clinical indicators of
increased intracranial pressure or dehydration, respectively.
3. An advanced practice nurse is evaluating a 4-year-old child’s vision. Which tool is most
appropriate for this developmental stage?
A. The standard Snellen letter chart.
B. The Rosenbaum pocket vision screener.
C. Observation of tracking a colorful toy.
D. The Allen picture cards or the Tumbling E chart.
Answer: D
Rationale: Preschool-age children may not yet know their alphabet, making the Allen
picture cards or Tumbling E chart more reliable. These tools assess visual acuity by
requiring the child to identify familiar shapes or directionality. Using developmentally
appropriate tools ensures accurate screening for amblyopia during pediatric visits.
, 4. At what age should the nurse practitioner expect the posterior fontanelle to be closed?
A. 1 to 2 months of age.
B. 6 months of age.
C. 12 months of age.
D. At birth.
Answer: A
Rationale: The posterior fontanelle is much smaller than the anterior fontanelle and closes
much earlier. It usually closes by the end of the second month of life. Delayed closure may
necessitate further investigation into metabolic or skeletal disorders.
5. Which physical assessment finding in a newborn is a clinical sign of potential
developmental dysplasia of the hip (DDH)?
A. Symmetrical gluteal folds when prone.
B. An audible ‘cluck’ or ‘thud’ during the Ortolani maneuver.
C. Negative Barlow and Ortolani maneuvers.
D. Equality in leg length and knee height.
Answer: B
Rationale: The Ortolani maneuver is used to reduce a dislocated hip; a positive sign is a
‘cluck’ as the femoral head moves back into the acetabulum. Asymmetry of the gluteal folds
