Pediatric Physical Assessment

Question 1

principles of communication

Answer 1

make it developmentally appropriate
get on eye level
approach gently and quietly
be truthful
give them as many choices as possible

Question 2

how to perform a health history

Answer 2

identifying information
chief complaint
present illness
past history
current meds
immunizations
pain history
psychosocial history
family med history
sexual history
ROS

Question 3

age classifications for newborns, infants, toddlers, preschool, school age, adolescents

Answer 3

birth to 1 month
1 month to 12 month
1 year to 3 year
3-5 years
6-11 years
12-18/20 years

Question 4

how to obtain growth measurements

Answer 4

recumbent length for infants up to 36 months + weight and head circumference

Question 5

what is considered outside expected paramaters for height, weight, and head circumference

Answer 5

less than 5th or greater than 95th percentile

Question 6

appropriate approach to examine a young infant

Answer 6

parents lap or on exam table
listen toh eart lungs first
undress, keep them in diaper, covered
distraction*

Question 7

appropriate approach to examine an older infant

Answer 7

able to sit unsupported
stranger anxiety
sit on parents lap
prevent prolong eye contact
address the parents
instrucive procedures last

Question 8

appropriate approach to examine a toddler

Answer 8

sitting or standing
separation anxiety so keep parents in view
talk with parents first
utilize play
instrusive procedures last
let htem handle the equipment
have parent remove clothing
transitional objects
demonostrate assessment on a toy
praise and reward

Question 9

appropriate approach to examine a preschool age

Answer 9

lying, standing, sitting, keep parents close
cooperative modified head to toe
play games
instrusive procedures last
let them handle equipment
self undress
demonstrate
tell a story
educate with exam
leave on underpants

Question 10

appropriate approach to examine a school age or adolescent

Answer 10

sitting
address child first
head to toe assessment
privacy, self undress
teach about bodily functions and health habits
offer choices

Question 11

what to assess for general appearance

Answer 11

faces
posture
position
body movement
hygiene
nutrition
behavior
development

Question 12

skin assessment

Answer 12

color
texture
temperature
moisture
tissue turgor
pigment lesions
accessory structures- hair and nails

Question 13

head and neck

Answer 13

shape
symmetry
head control
head posture
ROM of neck

Question 14

anterior fontanel should be closed around when:

Answer 14

12-18 months

Question 15

the posterior fontanel cranial sutures close by when:

Answer 15

6-8 weeks

Question 16

what is plagiocephaly

Answer 16

flat head

Question 17

what is craniosynotosis

Answer 17

premature closing of sutures, or ICP

Question 18

eyes assessment

Answer 18

size
shape
symmetry
conjunctiva
cornea
pupils
fundoscopic exam
(fundus, red, reflex, blood vessels)
vision testing
(ocular alignment, visual acuity, peripheral vision, color vision)

Question 19

strabismus

Answer 19

eye misalignment
normal up until 3 months of age

Question 20

age 3-8 need objective vision screening how often

Answer 20

yearly

Question 21

what are tests for visual acuitiy for ages 3-5

Answer 21

illiterate E or HOTV

Question 22

what ages use the Snellen chart

Answer 22

6+

Question 23

ear assessment

Answer 23

external structures: position, cerumen
internal structures: landmarks, light reflex

Question 24

nose assessment

Answer 24

external structures: position and placement, nasal flaring
internal structures: mucosa, turbinates, septum
nasal drainage and odor

Question 25

tonsil sizing

Answer 25

1- normal 2- normal 3- viral pharyngitis, strep 4- airway obstructions

Question 26

chest and back assessment

Answer 26

size, shape, symmetry movement nipples breast development scapular symmetry spinal curvature ROM

Question 27

pectus excavatum

Answer 27

sternum is compressed in, concerned about heart or blood vessels common in scoliosis

Question 28

pectus carinatum

Answer 28

pigeon chest sternum protrudes outward can affect pulmonary function

Question 29

respiratory assessment

Answer 29

rapid rate adventitious vs oral sounds chest wall more compliant infant- chest rounded neonates-obligatory nose breath under 6-7 years - abominal breathing flaring/grunting/retractions

Question 30

cardiac assessment

Answer 30

under 7- PMI @ 4th ICS, laterl to MCL over 7- PMI @ 5th ICS, lateral to MCL cap refill <2 sinus arrythmia is normal assess heart upright and supine

Question 31

abominal assessment

Answer 31

inspection, auscultation, palpation contour movement umbilicus hernias bowel sounds palpation

Question 32

tanner scale

Answer 32

puberty changes into adolescence (1-5)

Question 33

male genitalia assessment

Answer 33

male structures: penis glans and shaft, urethral meatus, scrotum and testes hair distrubution tanner stage anus

Question 34

female genitalia assessment

Answer 34

structures: labia majora/minora, clitoris, urethral orifice, vaginal orifice hair distrubiution tanner stage anus

Question 35

musculosketal and extremity exam

Answer 35

hips (infants) bowleggedness (until 2 years) knock knees (2-7 yers) appearance of flatfoot (infants) tibial torsion babinski (normal until 18 months) muscle strenght gait sole and palm creases

Question 36

bowleg

Answer 36

genu varum

Question 37

knock knee

Answer 37

genu valgum

Question 38

neurological assessment

Answer 38

balance and coordination finger to nose test heel to shin romberg test reflexes- triceps, biceps, patellar, achilles cranial nerves