Certified Pediatric Nurse (CPN)

What should be the nurse's first action when examining a 6-month-old infant sitting on the mother's lap?

1. Assessment of the fontanel

2. Palpation of the pulses

3. Auscultation of the chest

4. Palpation of the abdomen

The correct answer is: Auscultation of the chest

When examining a 6-month-old infant, the priority is to ensure the infant is calm and reassured, as this facilitates a smoother examination process. Auscultation of the chest is the first action that is appropriate in this scenario because it allows the nurse to assess respiratory function and cardiac status while the infant is in a comfortable position on the mother's lap. This minimizes stress for the infant and provides an opportunity to listen to lung sounds and heart rate, which are crucial components of the overall assessment. In this age group, performing auscultation early in the examination is beneficial because infants can become fussy or upset during assessments, potentially obscuring valuable findings. By starting with auscultation, the nurse can gather important baseline data without causing unnecessary discomfort to the child. Other assessments, such as palpation of pulses, evaluation of the fontanel, or palpation of the abdomen, are also important but can be done after auscultation, as the infant remains calm due to the support of the mother during the initial exam.