NUR 6210 Exam 1
Study Guide 2025/2026
William Paterson University
Administrator
,NUR 6210
NUR 6210 Exam 1 Study Guide
Look at child, ABCs, Safety, Family present in room – survey the room – who is who?; caregivers mental state (alert, oriented, sleeping,
sober); child’s mood
-before entering room: know your “norms”; remember your growth and development when approaching patient; ideal time to do exam:
sleeping and not aware; assess a lot by just observing; make exam fun – blow out your penlight
-approaching pediatric patient – newborns/<6 months old = easiest to examine, no resistance; use pacifier, hold patient; warm hands,
stethoscope; order of assessment varies depending on patient
-infants >6 months = keep with parent due to separation anxiety; toys for distraction; start at feet but may need to vary assessment due to
mood
- toddlers = demonstrate instrument use on parent; parents hold patient if possible; don’t ask patient if you can do something: “NO” will
be the answer; speak with confidence, explain each step
-preschooler: allow them to touch/play with equipment; listen to stuff animals first; give positive feedback; use distraction to talk
-school-age children: if older school age, ask if ok if parents are present; head to toe assessment; offer as many choices as possible;
demonstrate how to use equipment and let them use it; teach about how body works
-adolescent: cover body parts not being examined; offer privacy when changing – if safe!!; ask if ok with parents present during
perineal/genital exam/care
Vital signs:
1. Respirations – observe/feel abdomen <6 years
2. Pulse – auscultate apical pulse 1 full minute
3. Blood pressure – appropriate cuff size; use same extremity (if possible) every time
4. Temperature – oral: 1 minute, axillary: 3 minutes; < 7 years old axillary method preferred
5. Height – rule of thumb: Average newborn length is 19.5-20 inches; birth length increases 50% by end of 1st year
6. Weight – rule of thumb: Average newborn weight: 7-7.5 lbs; doubles by 6 months; triples by 1 year of age
7. Head circumference – done until age 2; wraps around head at supraorbital prominence, above ears, and around occipital prominence
-anterior fontanel – closes approximately 8 -18 months; posterior fontanel closes approximately 1-2 months; assess through at
least 2 years of age
HEENT Assessment – head circumference, face symmetry, hair distribution, light reflex –pupils, eye size/spacing/color/drainage/discharge,
nasal passage patent, ear placement, mouth (lips, teeth, gums, tongue, odor), trachea midline, lymph nodes,
1. Respiratory assessment – observe/touch abdomen to obtain RR if <6 years old for 1 full minute; look for color, capillary refill,
chest expansion/retractions, nasal flaring; check ease and depth: affected by emotion**; Respirations are irregular in
infant/toddler – newborn: 30-50/minute; apnea in newborn (no breathing 20 seconds) is ABNORMAL
2. Cardiovascular assessment – full minute (note activity); heart rate fluctuates with crying, eating, etc; check for tachycardia when
sleeping; assess as much as quietly as possible before awakes; newborn 100-160/bpm; infants-2 years old 80-130/bpm; listen
with bell and diaphragm; warm stethoscope!; listen recumbent & then sitting up
3. Abdomen assessment – assess shape, assess abdominal movement – infants-6 years old breathe with diaphragm;
auscultation with diaphragm x 4 quadrants; percussion (supine) – dullness over organs, tympany over stomach/intestines,
resonance; palpation
4. Genital/perineal assessment – PRIVACY; often deferred; explain what you’re going to do; assess: swelling, bruising, testicles –
descended?, discharge, tanner stage
5. Musculoskeletal assessment – assess upper/lower extremities for leg length discrepancies, skin fold asymmetry; ROM –
active/passive; muscle strength – meeting developmental milestones good indication of muscle strength/tone
6. Nervous system – behavior: calm, anxious, lack of interest; does it correlate with developmental milestones; communication:
appropriate for age/developmental stage; balance; sensory function – numbness, tingling, altered sensation
7. Skin Assessment – temperature, moisture, turgor, mottling, Mongolian spot, café au lait spot, moles/birth marks, acne, eczema,
diaper rash, burns/bruises, thrush, stork bites, port wine stains
Infant reflexes – all should be present at birth
1. Moro/startle – any startling event causes arms to go straight out and hands wide open; disappears at 2 months
2. Palmer grasp – disappears at 5-6 months
3. Plantar reflex/babinski – lateral aspect of foot – big toe dorsiflexes, toes spread, and plantar flexion; disappears 9-12 months
4. Stepping reflex (until 2 months) – when held upright with feet on surface, appears to be taking steps or dancing; disappears 2 months
5. Tonic neck/fencing - when baby is lying down and head turned to one side, corresponding arm extends while other arm bends next to
head – like fencing; disappears 5-7 months
6. Rooting reflex – prompts baby to turn head towards hand that strokes cheek or mouth – helps find nipple for feeding; disappears 4 months
Health Promotion
- routine well visits – newborn (2-3 days after discharge from hospital) then 2, 4, 6, 9, 12, 18, 24 months of age; then yearly from 3 years old
-immunization schedule https://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html
-anticipatory guidance
HEENT Assessment:
1. Head assessment - visualization, head circumference measured at each well visit at each up to 36 months or until fontanelles
closed, fontanelles (anterior and posterior fontanelles easily palpable during first several weeks of life), palpation is performed
with patient in upright position – both are soft, relatively flat, visual pulsation of anterior fontanelle is normal especially in
crying/agitating patient; POUNDING pulsations, or persistent tenseness of fontanelle may indicate intracranial pressure;
EXM
, NUR 6210
SUNKEN or depressed fontanelle is malnutrition/dehydration; normal closure depends upon gestational age of birth - posterior
fontanelle can’t be palpated after 2 months of age; anterior fontanelle closes 8-18, 9-18 or 10-24 months of age; premature infants,
fontanelles WILL CLOSE AT LATER TIME; scalp and hair –look at texture, pattern, abundance/absence of scalp hair can be
suggestive of underlying problem; any HARD OR FIRM MASSES SHOULD BE NOTED
EXM
Study Guide 2025/2026
William Paterson University
Administrator
,NUR 6210
NUR 6210 Exam 1 Study Guide
Look at child, ABCs, Safety, Family present in room – survey the room – who is who?; caregivers mental state (alert, oriented, sleeping,
sober); child’s mood
-before entering room: know your “norms”; remember your growth and development when approaching patient; ideal time to do exam:
sleeping and not aware; assess a lot by just observing; make exam fun – blow out your penlight
-approaching pediatric patient – newborns/<6 months old = easiest to examine, no resistance; use pacifier, hold patient; warm hands,
stethoscope; order of assessment varies depending on patient
-infants >6 months = keep with parent due to separation anxiety; toys for distraction; start at feet but may need to vary assessment due to
mood
- toddlers = demonstrate instrument use on parent; parents hold patient if possible; don’t ask patient if you can do something: “NO” will
be the answer; speak with confidence, explain each step
-preschooler: allow them to touch/play with equipment; listen to stuff animals first; give positive feedback; use distraction to talk
-school-age children: if older school age, ask if ok if parents are present; head to toe assessment; offer as many choices as possible;
demonstrate how to use equipment and let them use it; teach about how body works
-adolescent: cover body parts not being examined; offer privacy when changing – if safe!!; ask if ok with parents present during
perineal/genital exam/care
Vital signs:
1. Respirations – observe/feel abdomen <6 years
2. Pulse – auscultate apical pulse 1 full minute
3. Blood pressure – appropriate cuff size; use same extremity (if possible) every time
4. Temperature – oral: 1 minute, axillary: 3 minutes; < 7 years old axillary method preferred
5. Height – rule of thumb: Average newborn length is 19.5-20 inches; birth length increases 50% by end of 1st year
6. Weight – rule of thumb: Average newborn weight: 7-7.5 lbs; doubles by 6 months; triples by 1 year of age
7. Head circumference – done until age 2; wraps around head at supraorbital prominence, above ears, and around occipital prominence
-anterior fontanel – closes approximately 8 -18 months; posterior fontanel closes approximately 1-2 months; assess through at
least 2 years of age
HEENT Assessment – head circumference, face symmetry, hair distribution, light reflex –pupils, eye size/spacing/color/drainage/discharge,
nasal passage patent, ear placement, mouth (lips, teeth, gums, tongue, odor), trachea midline, lymph nodes,
1. Respiratory assessment – observe/touch abdomen to obtain RR if <6 years old for 1 full minute; look for color, capillary refill,
chest expansion/retractions, nasal flaring; check ease and depth: affected by emotion**; Respirations are irregular in
infant/toddler – newborn: 30-50/minute; apnea in newborn (no breathing 20 seconds) is ABNORMAL
2. Cardiovascular assessment – full minute (note activity); heart rate fluctuates with crying, eating, etc; check for tachycardia when
sleeping; assess as much as quietly as possible before awakes; newborn 100-160/bpm; infants-2 years old 80-130/bpm; listen
with bell and diaphragm; warm stethoscope!; listen recumbent & then sitting up
3. Abdomen assessment – assess shape, assess abdominal movement – infants-6 years old breathe with diaphragm;
auscultation with diaphragm x 4 quadrants; percussion (supine) – dullness over organs, tympany over stomach/intestines,
resonance; palpation
4. Genital/perineal assessment – PRIVACY; often deferred; explain what you’re going to do; assess: swelling, bruising, testicles –
descended?, discharge, tanner stage
5. Musculoskeletal assessment – assess upper/lower extremities for leg length discrepancies, skin fold asymmetry; ROM –
active/passive; muscle strength – meeting developmental milestones good indication of muscle strength/tone
6. Nervous system – behavior: calm, anxious, lack of interest; does it correlate with developmental milestones; communication:
appropriate for age/developmental stage; balance; sensory function – numbness, tingling, altered sensation
7. Skin Assessment – temperature, moisture, turgor, mottling, Mongolian spot, café au lait spot, moles/birth marks, acne, eczema,
diaper rash, burns/bruises, thrush, stork bites, port wine stains
Infant reflexes – all should be present at birth
1. Moro/startle – any startling event causes arms to go straight out and hands wide open; disappears at 2 months
2. Palmer grasp – disappears at 5-6 months
3. Plantar reflex/babinski – lateral aspect of foot – big toe dorsiflexes, toes spread, and plantar flexion; disappears 9-12 months
4. Stepping reflex (until 2 months) – when held upright with feet on surface, appears to be taking steps or dancing; disappears 2 months
5. Tonic neck/fencing - when baby is lying down and head turned to one side, corresponding arm extends while other arm bends next to
head – like fencing; disappears 5-7 months
6. Rooting reflex – prompts baby to turn head towards hand that strokes cheek or mouth – helps find nipple for feeding; disappears 4 months
Health Promotion
- routine well visits – newborn (2-3 days after discharge from hospital) then 2, 4, 6, 9, 12, 18, 24 months of age; then yearly from 3 years old
-immunization schedule https://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html
-anticipatory guidance
HEENT Assessment:
1. Head assessment - visualization, head circumference measured at each well visit at each up to 36 months or until fontanelles
closed, fontanelles (anterior and posterior fontanelles easily palpable during first several weeks of life), palpation is performed
with patient in upright position – both are soft, relatively flat, visual pulsation of anterior fontanelle is normal especially in
crying/agitating patient; POUNDING pulsations, or persistent tenseness of fontanelle may indicate intracranial pressure;
EXM
, NUR 6210
SUNKEN or depressed fontanelle is malnutrition/dehydration; normal closure depends upon gestational age of birth - posterior
fontanelle can’t be palpated after 2 months of age; anterior fontanelle closes 8-18, 9-18 or 10-24 months of age; premature infants,
fontanelles WILL CLOSE AT LATER TIME; scalp and hair –look at texture, pattern, abundance/absence of scalp hair can be
suggestive of underlying problem; any HARD OR FIRM MASSES SHOULD BE NOTED
EXM
