What should the nurse assess last when examining a 5-year-old child?

• A. Heart.
• B. Lungs.
• C. Throat.
• D. Abdomen.

Answer: (C)

In pediatric examinations, the flow is chosen to keep the child calm and cooperative. The most uncomfortable or distressing part is saved for last so it doesn’t disrupt the whole assessment or provoke unnecessary distress early on. Examining the throat can trigger a gag reflex, coughing, or vomiting and can make a child’s cooperation wander quickly. If you start with it, the child may become upset, which can alter breathing, heart rate, and other findings, and it can also make the rest of the exam harder to complete accurately. By assessing the heart, lungs, and abdomen first while the child is still calm, you obtain reliable observations, and you can then perform the throat exam quickly and with the child more prepared. In a 5-year-old, keeping the throat exam for last helps maintain rapport and yields better overall assessment results.