PEDIATRIC HEALTH ASSESSMENT USE THIS ONE!
UPDATED ACTUAL QUESTIONS WITH CORRECT
ANSWERS
Question 1.
Comprehensive vs Focused Exam** (Bates)
ANSWER
patients you are seeing for the first time in the office - comprehensive assessment
- includes all elements of health history and complete physical examination.
flexible focused or problem-oriented assessment for patients you know well who are returning
for routine office care or for patients with specific "urgent care" concerns like sore throat or
knee pain.
adjust the scope of history and physical to the situation at hand, keeping in mind: the
magnitude and severity of the patient's problems; the need for thoroughness; the clinical
setting—inpatient or outpatient, primary or subspecialty care; and the time available
Question 2.
Comprehensive Assessment** (Bates)
ANSWER
Is appropriate for new patients in the office or hospital
Provides fundamental and personalized knowledge about the patient
Strengthens the clinician-patient relationship
Helps identify or rule out physical causes related to patient concerns
Provides baselines for future assessments
Creates platform for health promotion through education and counseling
Develops proficiency in the essential skills of physical examination
,Question 3.
Focused Assessment** (Bates)
ANSWER
Is appropriate for established patients, especially during routine or urgent care visits
Addresses focused concerns or symptoms
Assesses symptoms restricted to a specific body system
Applies examination methods relevant to assessing the concern or problem as precisely and
carefully as possible
patient with sore throat - decide who may have infectious mononucleosis and warrants careful
palpation of the liver and spleen and who has a common cold and does not need this
examination
,Question 4.
General guidelines for infant visit
ANSWER
distraction and play to examine infant - infants pay attention to one thing at a time, easy to
distract infant from examination. use a moving object, a flashing light, a game of peek-a-boo,
tickling, or any sort of noise
Approach the infant gradually, using a toy or object for distraction.
Perform much of the examination with the infant in the parent's lap. - tired, hungry, or ill, ask
the parent to hold the baby against the parent's chest.
Speak softly to the infant or mimic the infant's sounds to attract attention.
If the infant is cranky, make sure he or she is well fed before proceeding.
Ask a parent about the infant's strengths to elicit useful developmental and parenting
information.
Don't expect to do a head-to-toe exam in a specific order. Take what the infant gives you and
save the mouth and ear exam for last.
Make sure appropriate toys, a blanket, or other familiar objects are nearby.
Many neurologic conditions can be diagnosed during this general part of the exam. hypotonia,
conditions associated with irritability or signs of cerebral palsy
Close observation of an awake infant sitting on the parent's lap can reveal hypotonia or
hypertonia, conditions with abnormal skin color, jaundice or cyanosis, jitteriness, or respiratory
problems.
Observe parent-infant interactions. Watch the parent's affect when talking about the infant.
Note the parent's manner of holding, moving, dressing, comforting infant.
Observation of the infant's communication with the parent can reveal developmental delay,
language delay, hearing deficits, or inadequate parental attachment. may identify maladaptive
nurturing patterns - maternal depression or inadequate social support.
Infants do not object to removing their clothing. To keep yourself and your surroundings dry,
leave the diaper in place; remove it only to examine the genitals, rectum, and hips
, Question 5.
Health History - Younger Children (bates)
ANSWER
parents are usually watching and taking part in the interaction, observe the parent-child
interaction
Note - child displays age-appropriate behaviors.
observe child's interactions with parents and unstructured play - reveal abnormalities in
physical, cognitive, and social development.
Normal toddlers are occasionally terrified or angry at the examiner. they are completely
uncooperative. Most eventually warm up to you.
If this behavior continues or is not developmentally appropriate, there may be an underlying
behavioral or developmental abnormality.
Older, school-aged children have more self-control and prior experience with clinicians and are
generally cooperative with the examination.
Abnormalities Detected While Observing Play
Behavioral*
Poor parent-child interactions
Sibling rivalry
Inappropriate parental discipline
"Difficult temperament"
Developmental
Gross motor delay
Fine motor delay
Language delay (expressive, receptive)
Delay in social or emotional tasks
Social or Environmental
Parental stress, depression
Risk for abuse or neglect
Neurologic
Weakness
Abnormal posture
Spasticity
Clumsiness
Attentional problems, hyperactivity
Autistic features
Musculoskeletal abnormalities
*Note: The child's behavior during the visit may not represent typical behavior, but your
observations may serve as a springboard for discussion with parents.
UPDATED ACTUAL QUESTIONS WITH CORRECT
ANSWERS
Question 1.
Comprehensive vs Focused Exam** (Bates)
ANSWER
patients you are seeing for the first time in the office - comprehensive assessment
- includes all elements of health history and complete physical examination.
flexible focused or problem-oriented assessment for patients you know well who are returning
for routine office care or for patients with specific "urgent care" concerns like sore throat or
knee pain.
adjust the scope of history and physical to the situation at hand, keeping in mind: the
magnitude and severity of the patient's problems; the need for thoroughness; the clinical
setting—inpatient or outpatient, primary or subspecialty care; and the time available
Question 2.
Comprehensive Assessment** (Bates)
ANSWER
Is appropriate for new patients in the office or hospital
Provides fundamental and personalized knowledge about the patient
Strengthens the clinician-patient relationship
Helps identify or rule out physical causes related to patient concerns
Provides baselines for future assessments
Creates platform for health promotion through education and counseling
Develops proficiency in the essential skills of physical examination
,Question 3.
Focused Assessment** (Bates)
ANSWER
Is appropriate for established patients, especially during routine or urgent care visits
Addresses focused concerns or symptoms
Assesses symptoms restricted to a specific body system
Applies examination methods relevant to assessing the concern or problem as precisely and
carefully as possible
patient with sore throat - decide who may have infectious mononucleosis and warrants careful
palpation of the liver and spleen and who has a common cold and does not need this
examination
,Question 4.
General guidelines for infant visit
ANSWER
distraction and play to examine infant - infants pay attention to one thing at a time, easy to
distract infant from examination. use a moving object, a flashing light, a game of peek-a-boo,
tickling, or any sort of noise
Approach the infant gradually, using a toy or object for distraction.
Perform much of the examination with the infant in the parent's lap. - tired, hungry, or ill, ask
the parent to hold the baby against the parent's chest.
Speak softly to the infant or mimic the infant's sounds to attract attention.
If the infant is cranky, make sure he or she is well fed before proceeding.
Ask a parent about the infant's strengths to elicit useful developmental and parenting
information.
Don't expect to do a head-to-toe exam in a specific order. Take what the infant gives you and
save the mouth and ear exam for last.
Make sure appropriate toys, a blanket, or other familiar objects are nearby.
Many neurologic conditions can be diagnosed during this general part of the exam. hypotonia,
conditions associated with irritability or signs of cerebral palsy
Close observation of an awake infant sitting on the parent's lap can reveal hypotonia or
hypertonia, conditions with abnormal skin color, jaundice or cyanosis, jitteriness, or respiratory
problems.
Observe parent-infant interactions. Watch the parent's affect when talking about the infant.
Note the parent's manner of holding, moving, dressing, comforting infant.
Observation of the infant's communication with the parent can reveal developmental delay,
language delay, hearing deficits, or inadequate parental attachment. may identify maladaptive
nurturing patterns - maternal depression or inadequate social support.
Infants do not object to removing their clothing. To keep yourself and your surroundings dry,
leave the diaper in place; remove it only to examine the genitals, rectum, and hips
, Question 5.
Health History - Younger Children (bates)
ANSWER
parents are usually watching and taking part in the interaction, observe the parent-child
interaction
Note - child displays age-appropriate behaviors.
observe child's interactions with parents and unstructured play - reveal abnormalities in
physical, cognitive, and social development.
Normal toddlers are occasionally terrified or angry at the examiner. they are completely
uncooperative. Most eventually warm up to you.
If this behavior continues or is not developmentally appropriate, there may be an underlying
behavioral or developmental abnormality.
Older, school-aged children have more self-control and prior experience with clinicians and are
generally cooperative with the examination.
Abnormalities Detected While Observing Play
Behavioral*
Poor parent-child interactions
Sibling rivalry
Inappropriate parental discipline
"Difficult temperament"
Developmental
Gross motor delay
Fine motor delay
Language delay (expressive, receptive)
Delay in social or emotional tasks
Social or Environmental
Parental stress, depression
Risk for abuse or neglect
Neurologic
Weakness
Abnormal posture
Spasticity
Clumsiness
Attentional problems, hyperactivity
Autistic features
Musculoskeletal abnormalities
*Note: The child's behavior during the visit may not represent typical behavior, but your
observations may serve as a springboard for discussion with parents.
