DAVIS ADVANTAGE FOR PEDIATRIC NURSING COMPREHENSIVE EXAM SCRIPT COMPLETE
QUESTIONS VERIFIED SOLUTIONS
Question:
The nurse is caring for a patient who underwent abdominal surgery 24 hours ago and has a
nasogastric tube to intermittent suction. How should the nurse proceed when performing an
abdominal assessment on this patient? 1) Avoid palpating the patient's abdomen. 2) Turn off the
suction before auscultating bowel sounds. 3) Listen for bowel sounds for 2 minutes in each
quadrant. 4) Percuss the abdomen before auscultating bowel sounds.
Answer:
Turn off the suction before auscultating bowel sounds.
Question:
Abdominal palpation should be avoided in a child who has which disorder? 1) Appendicitis 2)
Wilms' tumor 3) Crohn's disease 4) Small bowel obstruction.
Answer:
Wilms' tumor Rationale: Caution: Do not palpate the abdomen if the client has a Wilms' tumor, a
large diffuse pulsation, or a history of organ transplantation.
Question:
The parent of an 18-month-old child is concerned because the child's legs are bowed. Which
response by the nurse is appropriate? 1) "Your child will most likely require physical therapy." 2)
"You should consider having your child seen by an orthopedic surgeon." 3) "This is a normal
finding in children for 1 year after they begin walking." 4) "Your child is walking fine, so you don't
need to worry.".
Answer:
"This is a normal finding in children for 1 year after they begin walking."
,Question:
The nurse asks the patient to spread the fingers and then bring them together again. What is the
nurse testing when asking the patient to bring the fingers together? 1) Abduction 2) Adduction 3)
Flexion 4) Extension.
Answer:
Adduction
Question:
An adult admitted to the hospital after a stroke does not respond to verbal stimuli. What should the
nurse do next to try to provoke a response? 1) Apply pressure to the mandible at the jaw. 2) Rub the
patient's sternum. 3) Squeeze the trapezius muscle. 4) Gently shake the patient's shoulder.
Answer:
Gently shake the patient's shoulder.
Question:
Which assessment question helps assess immediate memory? 1) "How did you get to the hospital
today?" 2) "Can you repeat the numbers 2, 7, 9 for me?" 3) "Do you recall the three items I
mentioned earlier?" 4) "What was your birth date including the year?".
Answer:
"Can you repeat the numbers 2, 7, 9 for me?" Rationale: The nurse can assess immediate memory by
asking the patient to repeat a series of three numbers and gradually increasing the length of the
series until the patient cannot repeat the series correctly.
Question:
Assuming that all are accurate, which documentation about a patient's level of consciousness is
best? 1) Patient is lethargic and slept when undisturbed. 2) Patient responds to tactile stimulation;
falls back to sleep immediately after tactile and verbal stimulation are stopped. 3) Patient slept
throughout the day, missing his meals and bath. 4) Patient appears to be tired as he slept throughout
the day except when bathed.
Answer:
,Patient responds to tactile stimulation; falls back to sleep immediately after tactile and verbal
stimulation are stopped.
Question:
Based on developmental stage, how should the nurse modify the comprehensive physical
examination of an older adult? 1) Work rapidly to finish as quickly as possible. 2) Sequence the
exam to limit position changes. 3) Demonstrate equipment before using it. 4) Omit portions of the
exam that may be tiring.
Answer:
Sequence the exam to limit position changes. Rationale: Assess the client's support system and
ability to perform activities of daily living. Observe your client's energy level during the physical
examination and provide rest periods if needed. Limit position changes. If the client tires easily,
arrange the exam sequence to limit position changes. Difficulty assuming positions. Be aware that
stiff muscles and arthritic joints may make it impossible for the client to assume certain positions.
Adapt your techniques when examining older adults with impaired vision or hearing. Obtain
feedback to be sure the patient is seeing and hearing you adequately. The acronym SPICES will help
you to remember common problems of the elderly that require nursing intervention (Fulmer, 1991,
2007) and to focus your assessment as you perform a comprehensive physical examination: S-Sleep
disorders P-Problems with eating or feeding I-Incontinence C-Confusion E-Evidence of falls S-Skin
breakdown
Question:
The nurse applies resistance to the top of the client's foot and asks him to pull his toes toward his
knee. The nurse observes active motion against some, but not against full, resistance. How should
the nurse document this finding? 1) 5: Normal 2) 4: Slight weakness 3) 3: Weakness 4) 2: Poor
ROM.
Answer:
4: Slight weakness Rationale: 5 - Active motion against full resistance = Normal 4 - Active motion
against some resistance = Slight weakness 3 - Active motion against gravity = Weakness 2 - Passive
range of motion =Poor range of motion 1 - Slight flicker of contraction = Severe weakness 0 - No
muscular contraction = Paralysis
Question:
, The nurse obtains vital signs for a 56-year-old patient who underwent surgery yesterday. Which
finding(s) require(s) further assessment? Select all that apply. 1) Blood pressure 110/64 mm Hg 2)
Pulse rate 118 beats/minute 3) Respiratory rate 35 breaths/minute 4) Oral temperature 98.6°F (37°C)
5) Pulse oximetry reading 94% on room air.
Answer:
Pulse rate 118 beats/minute Respiratory rate 35
Question:
Which disorder(s) might limit a patient's visual field? Select all that apply. 1) Diabetes 2) Advanced
glaucoma 3) Peripheral vascular disease 4) Cataracts 5) Macular degeneration.
Answer:
Diabetes Advanced glaucoma Cataracts Macular degeneration
Question:
A client asks why the nurse needs so much time to complete a physical assessment. What should the
nurse explain as the purposes for this type of assessment? Select all that apply. 1) Obtain baseline
data 2) Identify nursing diagnoses 3) Screen for health problems 4) Evaluate teaching provided 5)
Monitor previously identified problems.
Answer:
Obtain baseline data Identify nursing diagnoses Screen for health problems Monitor previously
identified problems
Question:
The nurse prepares to complete a focused physical assessment on a client with a chronic health
problem. What should the nurse explain to the client as being the purpose of this assessment? Select
all that apply. 1) Adds data to the database 2) Examines all body systems 3) Focuses on one body
system 4) Focuses on a particular body part 5) Includes a health history interview.
Answer:
Adds data to the database Focuses on a particular body part
QUESTIONS VERIFIED SOLUTIONS
Question:
The nurse is caring for a patient who underwent abdominal surgery 24 hours ago and has a
nasogastric tube to intermittent suction. How should the nurse proceed when performing an
abdominal assessment on this patient? 1) Avoid palpating the patient's abdomen. 2) Turn off the
suction before auscultating bowel sounds. 3) Listen for bowel sounds for 2 minutes in each
quadrant. 4) Percuss the abdomen before auscultating bowel sounds.
Answer:
Turn off the suction before auscultating bowel sounds.
Question:
Abdominal palpation should be avoided in a child who has which disorder? 1) Appendicitis 2)
Wilms' tumor 3) Crohn's disease 4) Small bowel obstruction.
Answer:
Wilms' tumor Rationale: Caution: Do not palpate the abdomen if the client has a Wilms' tumor, a
large diffuse pulsation, or a history of organ transplantation.
Question:
The parent of an 18-month-old child is concerned because the child's legs are bowed. Which
response by the nurse is appropriate? 1) "Your child will most likely require physical therapy." 2)
"You should consider having your child seen by an orthopedic surgeon." 3) "This is a normal
finding in children for 1 year after they begin walking." 4) "Your child is walking fine, so you don't
need to worry.".
Answer:
"This is a normal finding in children for 1 year after they begin walking."
,Question:
The nurse asks the patient to spread the fingers and then bring them together again. What is the
nurse testing when asking the patient to bring the fingers together? 1) Abduction 2) Adduction 3)
Flexion 4) Extension.
Answer:
Adduction
Question:
An adult admitted to the hospital after a stroke does not respond to verbal stimuli. What should the
nurse do next to try to provoke a response? 1) Apply pressure to the mandible at the jaw. 2) Rub the
patient's sternum. 3) Squeeze the trapezius muscle. 4) Gently shake the patient's shoulder.
Answer:
Gently shake the patient's shoulder.
Question:
Which assessment question helps assess immediate memory? 1) "How did you get to the hospital
today?" 2) "Can you repeat the numbers 2, 7, 9 for me?" 3) "Do you recall the three items I
mentioned earlier?" 4) "What was your birth date including the year?".
Answer:
"Can you repeat the numbers 2, 7, 9 for me?" Rationale: The nurse can assess immediate memory by
asking the patient to repeat a series of three numbers and gradually increasing the length of the
series until the patient cannot repeat the series correctly.
Question:
Assuming that all are accurate, which documentation about a patient's level of consciousness is
best? 1) Patient is lethargic and slept when undisturbed. 2) Patient responds to tactile stimulation;
falls back to sleep immediately after tactile and verbal stimulation are stopped. 3) Patient slept
throughout the day, missing his meals and bath. 4) Patient appears to be tired as he slept throughout
the day except when bathed.
Answer:
,Patient responds to tactile stimulation; falls back to sleep immediately after tactile and verbal
stimulation are stopped.
Question:
Based on developmental stage, how should the nurse modify the comprehensive physical
examination of an older adult? 1) Work rapidly to finish as quickly as possible. 2) Sequence the
exam to limit position changes. 3) Demonstrate equipment before using it. 4) Omit portions of the
exam that may be tiring.
Answer:
Sequence the exam to limit position changes. Rationale: Assess the client's support system and
ability to perform activities of daily living. Observe your client's energy level during the physical
examination and provide rest periods if needed. Limit position changes. If the client tires easily,
arrange the exam sequence to limit position changes. Difficulty assuming positions. Be aware that
stiff muscles and arthritic joints may make it impossible for the client to assume certain positions.
Adapt your techniques when examining older adults with impaired vision or hearing. Obtain
feedback to be sure the patient is seeing and hearing you adequately. The acronym SPICES will help
you to remember common problems of the elderly that require nursing intervention (Fulmer, 1991,
2007) and to focus your assessment as you perform a comprehensive physical examination: S-Sleep
disorders P-Problems with eating or feeding I-Incontinence C-Confusion E-Evidence of falls S-Skin
breakdown
Question:
The nurse applies resistance to the top of the client's foot and asks him to pull his toes toward his
knee. The nurse observes active motion against some, but not against full, resistance. How should
the nurse document this finding? 1) 5: Normal 2) 4: Slight weakness 3) 3: Weakness 4) 2: Poor
ROM.
Answer:
4: Slight weakness Rationale: 5 - Active motion against full resistance = Normal 4 - Active motion
against some resistance = Slight weakness 3 - Active motion against gravity = Weakness 2 - Passive
range of motion =Poor range of motion 1 - Slight flicker of contraction = Severe weakness 0 - No
muscular contraction = Paralysis
Question:
, The nurse obtains vital signs for a 56-year-old patient who underwent surgery yesterday. Which
finding(s) require(s) further assessment? Select all that apply. 1) Blood pressure 110/64 mm Hg 2)
Pulse rate 118 beats/minute 3) Respiratory rate 35 breaths/minute 4) Oral temperature 98.6°F (37°C)
5) Pulse oximetry reading 94% on room air.
Answer:
Pulse rate 118 beats/minute Respiratory rate 35
Question:
Which disorder(s) might limit a patient's visual field? Select all that apply. 1) Diabetes 2) Advanced
glaucoma 3) Peripheral vascular disease 4) Cataracts 5) Macular degeneration.
Answer:
Diabetes Advanced glaucoma Cataracts Macular degeneration
Question:
A client asks why the nurse needs so much time to complete a physical assessment. What should the
nurse explain as the purposes for this type of assessment? Select all that apply. 1) Obtain baseline
data 2) Identify nursing diagnoses 3) Screen for health problems 4) Evaluate teaching provided 5)
Monitor previously identified problems.
Answer:
Obtain baseline data Identify nursing diagnoses Screen for health problems Monitor previously
identified problems
Question:
The nurse prepares to complete a focused physical assessment on a client with a chronic health
problem. What should the nurse explain to the client as being the purpose of this assessment? Select
all that apply. 1) Adds data to the database 2) Examines all body systems 3) Focuses on one body
system 4) Focuses on a particular body part 5) Includes a health history interview.
Answer:
Adds data to the database Focuses on a particular body part
