A 6-month-old infant has been brought to the well-child clinic for a checkup. She is currently sleeping. What should the nurse do first when beginning the examination?

A) Wake the infant before beginning the examination.
B) Examine the infant's hips before the infant wakes up.
C) Auscultate the lungs and heart while the infant is still sleeping.
D) Begin with the assessment of the eye and continue with the remainder of the examination in a head-to-toe approach.

Question

Ma'ruf Saragih · Accepted Answer

Final Answer : C, Explanation :  When the infant is quiet or sleeping it is an ideal time to assess the cardiac, respiratory, and abdominal systems so the nurse does not need to wake the infant. Examining the infant's hips will likely wake the infant and would want to assess the heart and lungs before the infant wakes up. Assessment of the eye, ear, nose, and throat is an invasive procedure that should be performed at the end of the examination.

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