• BURNS'
PEDIATRIC 09/13/2026
PRIMARY Exam
BURNS' PEDIATRIC PRIMARY CARE 8TH
EDITION TEST BANK Questions and Answers|
2026/2027 Latest Update | Complete Chapter
Questions & Answers with Rationales | Verified
Questions & Answers | Graded A+
1. The primary care pediatric nurse practitioner is treating an infant with lacrimal duct obstruction who
has developed bacterial conjunctivitis. After 2 weeks of treatment with topical antibiotics along with
massage and frequent cleansing of secretions, the infant's symptoms have not improved. Which action
is correct?
a. Perform massage more frequently.
b. Prescribe an oral antibiotic.
c. Recommend hot compresses.
P 1
, • BURNS'
PEDIATRIC 09/13/2026
PRIMARY Exam
d. Refer to an ophthalmologist. –
Correct Answer :ANS: D
Infants treated for a secondary bacterial conjunctivitis with lacrimal duct obstruction who do not improve
after 1 to 2 weeks of topical antibiotic therapy must be referred to an ophthalmologist for possible
lacrimal duct probe. Performing the massage more often or applying hot compresses will not help clear
the infections. Oral antibiotics are not indicated.
2. The primary care pediatric nurse practitioner performs a well child examination on a 9-month-old
infant who has a history of prematurity at 28 weeks' gestation. The infant was treated for retinopathy
of prematurity (ROP) and all symptoms have resolved. When will the infant need an ophthalmologic
exam?
a. At 12 months of age
b. At 24 months of age
c. At 48 months of age
d. At 60 months of age –
Correct Answer :ANS: A
Children who have a history of ROP requiring treatment, even if ROP has completely resolved, will need
yearly ophthalmologic follow-up. Less frequent follow-up is required for children with ROP who did not
require treatment.
3. A school-age child is hit in the face with a baseball bat and reports pain in one eye. The primary care
P 2
, • BURNS'
PEDIATRIC 09/13/2026
PRIMARY Exam
pediatric nurse practitioner is able to see a dark red fluid level between the cornea and iris on gross
examination, but the child resists any exam with a light. Which action is correct?
a. Administer an oral analgesic medication.
b. Apply a Fox shield and reevaluate the eye in 24 hours.
c. Instill anesthetic eyedrops into the affected eye.
d. Refer the child immediately to an ophthalmologist.
- Correct Answer :ANS: D
This child has a traumatic injury with hyphema to the eye, and an ophthalmologist must examine the eye
to rule out orbital hematoma or retinal detachment. Any further attempt to examine the child may result in
further injury. A Fox shield is used once more serious injury is excluded.
4. During a well-baby assessment on a 1-week-old infant who had a normal exam when discharged from
the newborn nursery 2 days prior, the primary care pediatric nurse practitioner notes moderate eyelid
swelling, bulbar conjunctival injections, and moderate amounts of thick, purulent discharge. What is
the likely diagnosis?
a. Chemical-induced conjunctivitis
b. Chlamydia trachomatis conjunctivitis
c. Herpes simplex virus (HSV) conjunctivitis
d. Neisseria gonorrhea conjunctivitis –
Correct Answer :ANS: B
C. trachomatis conjunctivitis usually begins between 5 to 14 days of life and causes moderate eyelid
swelling, palpebral or bulbar conjunctivitis, and moderate, thick, purulent discharge. Chemical-induced
P 3
, • BURNS'
PEDIATRIC 09/13/2026
PRIMARY Exam
conjunctivitis manifests as nonpurulent discharge. HSV is characterized by serosanguinous discharge. N.
gonorrhea causes acute conjunctival inflammation and excessive purulent discharge.
5. The primary care pediatric nurse practitioner applies fluorescein stain to a child's eye. When
examining the eye with a cobalt blue filter light, the entire cornea appears cloudy. What does this
indicate?
a. The cornea has not been damaged.
b. There is too little stain on the cornea.
c. There is damage to the cornea.
d. There is too much stain on the cornea. - Correct Answer :ANS: D
When fluorescein stain is applied and the entire cornea appears cloudy, it means that there is too much of
the stain. Damaged areas of the cornea should appear greenish after staining with fluorescein dye.
6. During a well child assessment of an African-American infant, the primary care pediatric nurse
practitioner notes a dark red-brown light reflex in the left eye and a slightly brighter, red-orange light
reflex in the right eye. The nurse practitioner will
a. dilate the pupils and reassess the red reflex.
b. order auto-refractor screening of the eyes.
c. recheck the red reflex in 1 month.
d. refer the infant to an ophthalmologist. - Correct Answer :ANS: D
Any asymmetry, dark or white spots, opacities, or leukokoria should be referred immediately to a
pediatric ophthalmologist. The PNP does not dilate pupils or order auto-refractor exams; these are done
by an ophthalmologist. Because retinoblastoma is a concern, any unusual finding should be immediately
referred.
7. The primary care pediatric nurse practitioner performs a Hirschberg test to evaluate
P 4
PEDIATRIC 09/13/2026
PRIMARY Exam
BURNS' PEDIATRIC PRIMARY CARE 8TH
EDITION TEST BANK Questions and Answers|
2026/2027 Latest Update | Complete Chapter
Questions & Answers with Rationales | Verified
Questions & Answers | Graded A+
1. The primary care pediatric nurse practitioner is treating an infant with lacrimal duct obstruction who
has developed bacterial conjunctivitis. After 2 weeks of treatment with topical antibiotics along with
massage and frequent cleansing of secretions, the infant's symptoms have not improved. Which action
is correct?
a. Perform massage more frequently.
b. Prescribe an oral antibiotic.
c. Recommend hot compresses.
P 1
, • BURNS'
PEDIATRIC 09/13/2026
PRIMARY Exam
d. Refer to an ophthalmologist. –
Correct Answer :ANS: D
Infants treated for a secondary bacterial conjunctivitis with lacrimal duct obstruction who do not improve
after 1 to 2 weeks of topical antibiotic therapy must be referred to an ophthalmologist for possible
lacrimal duct probe. Performing the massage more often or applying hot compresses will not help clear
the infections. Oral antibiotics are not indicated.
2. The primary care pediatric nurse practitioner performs a well child examination on a 9-month-old
infant who has a history of prematurity at 28 weeks' gestation. The infant was treated for retinopathy
of prematurity (ROP) and all symptoms have resolved. When will the infant need an ophthalmologic
exam?
a. At 12 months of age
b. At 24 months of age
c. At 48 months of age
d. At 60 months of age –
Correct Answer :ANS: A
Children who have a history of ROP requiring treatment, even if ROP has completely resolved, will need
yearly ophthalmologic follow-up. Less frequent follow-up is required for children with ROP who did not
require treatment.
3. A school-age child is hit in the face with a baseball bat and reports pain in one eye. The primary care
P 2
, • BURNS'
PEDIATRIC 09/13/2026
PRIMARY Exam
pediatric nurse practitioner is able to see a dark red fluid level between the cornea and iris on gross
examination, but the child resists any exam with a light. Which action is correct?
a. Administer an oral analgesic medication.
b. Apply a Fox shield and reevaluate the eye in 24 hours.
c. Instill anesthetic eyedrops into the affected eye.
d. Refer the child immediately to an ophthalmologist.
- Correct Answer :ANS: D
This child has a traumatic injury with hyphema to the eye, and an ophthalmologist must examine the eye
to rule out orbital hematoma or retinal detachment. Any further attempt to examine the child may result in
further injury. A Fox shield is used once more serious injury is excluded.
4. During a well-baby assessment on a 1-week-old infant who had a normal exam when discharged from
the newborn nursery 2 days prior, the primary care pediatric nurse practitioner notes moderate eyelid
swelling, bulbar conjunctival injections, and moderate amounts of thick, purulent discharge. What is
the likely diagnosis?
a. Chemical-induced conjunctivitis
b. Chlamydia trachomatis conjunctivitis
c. Herpes simplex virus (HSV) conjunctivitis
d. Neisseria gonorrhea conjunctivitis –
Correct Answer :ANS: B
C. trachomatis conjunctivitis usually begins between 5 to 14 days of life and causes moderate eyelid
swelling, palpebral or bulbar conjunctivitis, and moderate, thick, purulent discharge. Chemical-induced
P 3
, • BURNS'
PEDIATRIC 09/13/2026
PRIMARY Exam
conjunctivitis manifests as nonpurulent discharge. HSV is characterized by serosanguinous discharge. N.
gonorrhea causes acute conjunctival inflammation and excessive purulent discharge.
5. The primary care pediatric nurse practitioner applies fluorescein stain to a child's eye. When
examining the eye with a cobalt blue filter light, the entire cornea appears cloudy. What does this
indicate?
a. The cornea has not been damaged.
b. There is too little stain on the cornea.
c. There is damage to the cornea.
d. There is too much stain on the cornea. - Correct Answer :ANS: D
When fluorescein stain is applied and the entire cornea appears cloudy, it means that there is too much of
the stain. Damaged areas of the cornea should appear greenish after staining with fluorescein dye.
6. During a well child assessment of an African-American infant, the primary care pediatric nurse
practitioner notes a dark red-brown light reflex in the left eye and a slightly brighter, red-orange light
reflex in the right eye. The nurse practitioner will
a. dilate the pupils and reassess the red reflex.
b. order auto-refractor screening of the eyes.
c. recheck the red reflex in 1 month.
d. refer the infant to an ophthalmologist. - Correct Answer :ANS: D
Any asymmetry, dark or white spots, opacities, or leukokoria should be referred immediately to a
pediatric ophthalmologist. The PNP does not dilate pupils or order auto-refractor exams; these are done
by an ophthalmologist. Because retinoblastoma is a concern, any unusual finding should be immediately
referred.
7. The primary care pediatric nurse practitioner performs a Hirschberg test to evaluate
P 4
