NURS 5130 Exam 3 V2 | NURS 5130
Comprehensive Assessment – Pediatric
Assessment Lab | Actual Q&A with
Rationale (NURS5130 Exam 3) | The
University of Texas at Arlington
1. When performing a physical examination on a 15-month-old child, which of the following
sequences is most appropriate to ensure cooperation?
A. Head-to-toe sequence as used in adults
B. Perform less invasive assessments first, saving ears and throat for last
C. Auscultate heart and lungs only after the child is crying
D. Assess the throat and ears immediately to get them over with
Answer: B
Rationale: In pediatric physical examinations, the sequence must be adapted based on the
child’s developmental stage to minimize distress. Assessing least invasive areas like the
heart and lungs while the child is quiet provides more accurate data. Leaving intrusive
procedures like the otoscopic exam until the end prevents early breakdown of the clinician-
patient relationship.
2. A 4-month-old infant is brought to the clinic. At what age should the nurse practitioner
expect the posterior fontanelle to be closed?
A. 6 to 8 weeks
,B. 9 to 12 months
C. 12 to 18 months
D. At birth
Answer: A
Rationale: The posterior fontanelle is significantly smaller than the anterior fontanelle and
typically closes by 2 months of age. Delayed closure may indicate underlying conditions
such as hydrocephalus or congenital hypothyroidism. The anterior fontanelle usually
remains palpable until 12 to 18 months of age.
3. When examining the tympanic membrane of a 2-year-old child, in which direction should
the nurse practitioner pull the pinna?
A. Down and back
B. Straight back only
C. Up and back
D. Up and forward
Answer: A
Rationale: The external auditory canal in infants and young children is shorter and curves
upward. To straighten the canal for visualization, the pinna must be pulled downward and
backward. In children older than 3 years and adults, the pinna is pulled upward and
backward as the canal matures.
, 4. To assess for strabismus in a 4-year-old child, which clinical test is most appropriate during
the physical exam?
A. Snellen chart
B. Ophthalmoscopic red reflex
C. Corneal light reflex (Hirschberg test)
D. Visual fields by confrontation
Answer: C
Rationale: The corneal light reflex involves shining a light toward the bridge of the nose
and observing the reflection in both pupils. An asymmetric reflection suggests a
misalignment of the eyes known as strabismus. Early detection is critical in pediatrics to
prevent amblyopia or permanent vision loss.
5. During a well-child visit for a 6-month-old, the mother asks when the infant should be able
to sit without support. What is the standard developmental milestone?
A. 8 months
B. 4 months
C. 12 months
D. 10 months
Answer: A
Comprehensive Assessment – Pediatric
Assessment Lab | Actual Q&A with
Rationale (NURS5130 Exam 3) | The
University of Texas at Arlington
1. When performing a physical examination on a 15-month-old child, which of the following
sequences is most appropriate to ensure cooperation?
A. Head-to-toe sequence as used in adults
B. Perform less invasive assessments first, saving ears and throat for last
C. Auscultate heart and lungs only after the child is crying
D. Assess the throat and ears immediately to get them over with
Answer: B
Rationale: In pediatric physical examinations, the sequence must be adapted based on the
child’s developmental stage to minimize distress. Assessing least invasive areas like the
heart and lungs while the child is quiet provides more accurate data. Leaving intrusive
procedures like the otoscopic exam until the end prevents early breakdown of the clinician-
patient relationship.
2. A 4-month-old infant is brought to the clinic. At what age should the nurse practitioner
expect the posterior fontanelle to be closed?
A. 6 to 8 weeks
,B. 9 to 12 months
C. 12 to 18 months
D. At birth
Answer: A
Rationale: The posterior fontanelle is significantly smaller than the anterior fontanelle and
typically closes by 2 months of age. Delayed closure may indicate underlying conditions
such as hydrocephalus or congenital hypothyroidism. The anterior fontanelle usually
remains palpable until 12 to 18 months of age.
3. When examining the tympanic membrane of a 2-year-old child, in which direction should
the nurse practitioner pull the pinna?
A. Down and back
B. Straight back only
C. Up and back
D. Up and forward
Answer: A
Rationale: The external auditory canal in infants and young children is shorter and curves
upward. To straighten the canal for visualization, the pinna must be pulled downward and
backward. In children older than 3 years and adults, the pinna is pulled upward and
backward as the canal matures.
, 4. To assess for strabismus in a 4-year-old child, which clinical test is most appropriate during
the physical exam?
A. Snellen chart
B. Ophthalmoscopic red reflex
C. Corneal light reflex (Hirschberg test)
D. Visual fields by confrontation
Answer: C
Rationale: The corneal light reflex involves shining a light toward the bridge of the nose
and observing the reflection in both pupils. An asymmetric reflection suggests a
misalignment of the eyes known as strabismus. Early detection is critical in pediatrics to
prevent amblyopia or permanent vision loss.
5. During a well-child visit for a 6-month-old, the mother asks when the infant should be able
to sit without support. What is the standard developmental milestone?
A. 8 months
B. 4 months
C. 12 months
D. 10 months
Answer: A
