Answer to Question 1
ANS: D
To aid in the abdominal assessment of a ticklish child, have the child lie with knees bent or use the child's smaller hand under your own to palpate the belly. It is also helpful to engage the child in conversation to provide distraction from what you are doing.
Answer to Question 2
ANS: C
The otoscopic examination is described in detail in Chapter 6 (Ear, Nose, Mouth, and Throat). The otoscopic examination should be saved for last in infants and young children because of the distress it often causes. To examine the inner ear in an infant or young child, pull the pinna down and out. For examination in an older child, pull up and back as you would with an adult. As with adults, the tympanic membrane (TM) should be mobile and intact and should appear thin, smooth, and pearly gray with bright light reflexes. The mobility of the TM should be assessed by pneumatic otoscopy if a diagnosis of acute otitis media is expected. Although crying will cause erythema of the TMs, the light reflexes and mobility should remain intact. Diagnosis of acute otitis media should not be based solely on a reddened TM. Also observe for bubbles or an obvious fluid level line behind the TM, which indicates middle ear effusion.
The Four Quadrants and Nine Regions of the Abdomen.
In The Gross Clinic (1875), by Thomas Eakins, Professor Samuel Gross’s team of surgeons cuts through
A child with Down syndrome.
Child Development: A Topical Approach
Child-resistant Packaging