McKinney – Test Bank Physical
Assessment of Children Questions
and Actual Answers 2025\2026 Edition.
Physical Assessment of Children
1. The nurse percussing over an empty stomach expects to hear which sound?
a. Tympany
b. Resonance
c. Flatness
d. Dullness - Answer ANS: A
Tympany is a high-pitched, loud-intensity sound heard over air-filled body parts such as the
stomach and bowel. Resonance is a low-pitched, low-intensity sound elicited over hollow organs
such as the lungs. Flatness is a high-pitched, soft-intensity sound elicited by percussing over
solid masses such as bone or muscle. Dullness is a medium-pitched, medium-intensity sound
elicited when percussing over high-density structures such as the liver.
PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 720 | Box 33.1 OBJ: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance
Physical Assessment of Children
2. The nurse is admitting a toddler to the pediatric infectious disease unit. What is the single
most important component of the child's physical examination?
a. Assessment of heart and lungs
b. Measurement of height and weight
c. Documentation of parental concerns
d. Obtaining an accurate history - Answer ANS: D
An accurate history is most helpful in identifying problems and potential problems. Heart and
lung assessment is not as important as an accurate history. A single measurement of height and
weight is not as significant as determining growth over time. The child's growth pattern can be
elicited from the history. Documentation of parental concerns is not as relevant to the physical
examination as an accurate history in this case.
PTS: 1 DIF: Cognitive Level: Comprehension/Understanding
,Physical Assessment of Children
3. In which section of the health history should the nurse record that the parent brought the
infant to the clinic today because of frequent diarrhea?
a. Review of systems
b. Chief complaint
c. Lifestyle and life patterns
d. Health history - Answer ANS: B
The chief complaint is documented using the child's or parent's words for the reason the child
was brought to the health care center. The review of systems includes health functions of body
systems. Lifestyle and life patterns include the child's interaction with the social, psychological,
physical, and cultural environment. Health history includes birth history, growth and
development, common childhood illnesses, immunizations, hospitalizations, injuries, and
allergies.
PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 721 | Box 33.4 OBJ: Nursing Process: Implementation
MSC: Client Needs: Physiologic Integrity
Physical Assessment of Children
4. The nurse assesses a child's oculomotor, trochlear, and abducent nerves by using which
technique?
a. Assessing the six cardinal gazes
b. Identification of common odors
c. Having child bite on a tongue blade
d. Ask child to shrug against resistance - Answer ANS: A
Using the six cardinal gazes the nurse assesses the oculomotor, trochlear, and abducent nerves.
Odors are detected by the olfactory nerve. Biting on tongue blade assesses the trigeminal
nerve. Shrugging against resistance assesses the accessory nerve.
PTS: 1 DIF: Cognitive Level: Application/Applying
REF: p. 745 | Table 33.4 OBJ: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance
Physical Assessment of Children
, b. 6 months
c. 1 year
d. 3 years - Answer ANS: C
Head and chest measurements are almost equal at 1 year of age.
PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 724 OBJ: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance
Physical Assessment of Children
6. An 8-year-old girl asks the nurse how the blood pressure apparatus works. The most
appropriate nursing action is to
a. ask her why she wants to know.
b. determine why she is so anxious.
c. explain in simple terms how it works.
d. tell her she will see how it works as it is used. - Answer ANS: C
School-age children require explanations and reasons for everything. They are interested in the
functional aspect of all procedures, objects, and activities. It is appropriate for the nurse to
explain how equipment works and what will happen to the child. "Why" questions are not
therapeutic, plus this question makes it sound like the nurse thinks the child does not need this
information. The child is not exhibiting anxiety, just requesting clarification of what will be
occurring. The nurse must explain how the blood pressure cuff works so that the child can then
observe during the procedure.
PTS: 1 DIF: Cognitive Level: Application/Applying
REF: p. 719 OBJ: Nursing Process: Implementation
MSC: Client Needs: Psychosocial Integrity
Physical Assessment of Children
7. Which chart should the nurse use to assess the visual acuity of an 8-year-old child?
a. Lea chart
b. Snellen chart
c. HOTV chart
Assessment of Children Questions
and Actual Answers 2025\2026 Edition.
Physical Assessment of Children
1. The nurse percussing over an empty stomach expects to hear which sound?
a. Tympany
b. Resonance
c. Flatness
d. Dullness - Answer ANS: A
Tympany is a high-pitched, loud-intensity sound heard over air-filled body parts such as the
stomach and bowel. Resonance is a low-pitched, low-intensity sound elicited over hollow organs
such as the lungs. Flatness is a high-pitched, soft-intensity sound elicited by percussing over
solid masses such as bone or muscle. Dullness is a medium-pitched, medium-intensity sound
elicited when percussing over high-density structures such as the liver.
PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 720 | Box 33.1 OBJ: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance
Physical Assessment of Children
2. The nurse is admitting a toddler to the pediatric infectious disease unit. What is the single
most important component of the child's physical examination?
a. Assessment of heart and lungs
b. Measurement of height and weight
c. Documentation of parental concerns
d. Obtaining an accurate history - Answer ANS: D
An accurate history is most helpful in identifying problems and potential problems. Heart and
lung assessment is not as important as an accurate history. A single measurement of height and
weight is not as significant as determining growth over time. The child's growth pattern can be
elicited from the history. Documentation of parental concerns is not as relevant to the physical
examination as an accurate history in this case.
PTS: 1 DIF: Cognitive Level: Comprehension/Understanding
,Physical Assessment of Children
3. In which section of the health history should the nurse record that the parent brought the
infant to the clinic today because of frequent diarrhea?
a. Review of systems
b. Chief complaint
c. Lifestyle and life patterns
d. Health history - Answer ANS: B
The chief complaint is documented using the child's or parent's words for the reason the child
was brought to the health care center. The review of systems includes health functions of body
systems. Lifestyle and life patterns include the child's interaction with the social, psychological,
physical, and cultural environment. Health history includes birth history, growth and
development, common childhood illnesses, immunizations, hospitalizations, injuries, and
allergies.
PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 721 | Box 33.4 OBJ: Nursing Process: Implementation
MSC: Client Needs: Physiologic Integrity
Physical Assessment of Children
4. The nurse assesses a child's oculomotor, trochlear, and abducent nerves by using which
technique?
a. Assessing the six cardinal gazes
b. Identification of common odors
c. Having child bite on a tongue blade
d. Ask child to shrug against resistance - Answer ANS: A
Using the six cardinal gazes the nurse assesses the oculomotor, trochlear, and abducent nerves.
Odors are detected by the olfactory nerve. Biting on tongue blade assesses the trigeminal
nerve. Shrugging against resistance assesses the accessory nerve.
PTS: 1 DIF: Cognitive Level: Application/Applying
REF: p. 745 | Table 33.4 OBJ: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance
Physical Assessment of Children
, b. 6 months
c. 1 year
d. 3 years - Answer ANS: C
Head and chest measurements are almost equal at 1 year of age.
PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 724 OBJ: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance
Physical Assessment of Children
6. An 8-year-old girl asks the nurse how the blood pressure apparatus works. The most
appropriate nursing action is to
a. ask her why she wants to know.
b. determine why she is so anxious.
c. explain in simple terms how it works.
d. tell her she will see how it works as it is used. - Answer ANS: C
School-age children require explanations and reasons for everything. They are interested in the
functional aspect of all procedures, objects, and activities. It is appropriate for the nurse to
explain how equipment works and what will happen to the child. "Why" questions are not
therapeutic, plus this question makes it sound like the nurse thinks the child does not need this
information. The child is not exhibiting anxiety, just requesting clarification of what will be
occurring. The nurse must explain how the blood pressure cuff works so that the child can then
observe during the procedure.
PTS: 1 DIF: Cognitive Level: Application/Applying
REF: p. 719 OBJ: Nursing Process: Implementation
MSC: Client Needs: Psychosocial Integrity
Physical Assessment of Children
7. Which chart should the nurse use to assess the visual acuity of an 8-year-old child?
a. Lea chart
b. Snellen chart
c. HOTV chart
