During stranger anxiety, how is assessment typically affected?

• A. They are easier to assess
• B. They are more difficult to assess
• C. There is no effect
• D. They are usually calmer

Answer: (B)

Stranger anxiety makes assessment more difficult. When a young child is afraid of unfamiliar people, they become clingy to a caregiver, cry, or resist being touched. This fear can blur their responses and make it hard to get an accurate history or perform a complete physical exam. Their behavior may reflect distress rather than symptoms of illness, and they may not cooperate with exam maneuvers or observations.

To support accurate assessment, involve the caregiver—let them stay present and, if possible, hold the child. Approach slowly and calmly, use a soft voice, and keep the environment as reassuring as possible. Gather information from the caregiver while you conduct a focused exam quickly and respectfully, observing the child’s behavior and comfort level.