• 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. A child is in the clinic after swallowing a metal bead. A radiograph of the GI tract shows a 6 mm
cylindrical object in the child's stomach. The child is able to swallow without difficulty and is not
experiencing pain. What is the correct course of treatment?
a. Administer ipecac to induce vomiting.
b. Have the parents watch for the object in the child's stool.
P 1
, • BURNS'
PEDIATRIC 09/13/2026
PRIMARY Exam
c. Insert a nasogastric tube to flush out the object.
d. Refer the child for endoscopic removal of the object. –
Correct Answer :ANS: B
A small foreign body that is not corrosive or sharp and that has reached the stomach is most likely to
continue to pass through the GI tract and no intervention is necessary. Inducing vomiting increases the
risk of aspiration of the FB. NG tube removal and endoscopy are not indicated unless the object has the
potential to damage the GI tract; most objects that are not sharp or corrosive that have reached the
abdomen will pass through without causing damage.
2. A toddler who was born prematurely refuses most solid foods and has poor weight gain. A barium
swallow study reveals a normal esophagus. What will the primary care pediatric nurse practitioner
consider next to manage this child's nutritional needs?
a. Consultation with a dietician
b. Fiberoptic endoscopy evaluation
c. Magnetic resonance imaging
d. Videofluoroscopy swallowing study
- Correct Answer :ANS: D
A videofluoroscopy swallowing study will evaluate other structural defects that may interfere with
swallowing and is relatively non-invasive. A dietician consult may be a part of the overall plan, but the
toddler first needs a thorough evaluation of potential problems. Fiberoptic endoscopy is invasive. MRI
may be performed if videofluoroscopy is inconclusive, but this is an expensive test.
3. A school-age child has a 3-month history of dull, aching epigastric pain that worsens with eating and
P 2
, • BURNS'
PEDIATRIC 09/13/2026
PRIMARY Exam
awakens the child from sleep. A complete blood count shows a hemoglobin of 8 mg/dL. What is the
next step in management?
a. Administration of H2RA or PPI medications
b. Empiric therapy for H. pylori (HP)
c. Ordering an upper GI series
d. Referral for esophagogastroduodenoscopy (EGD) –
Correct Answer :ANS: D
EGD is the procedure of choice in children for detecting PUD because it allows direct visualization of
mucosa, localization of the source of bleeding, and collection of tissue specimens. Empiric therapy for HP
is not recommended due to increased antibiotic resistance. An upper GI series may have false negative
findings. Once peptic ulcer disease is diagnosed, H2RA or PPI medications are first-line drugs.
4. A 2-year-old child has an acute diarrheal illness. The child is afebrile and, with oral rehydration
measures, has remained well hydrated. The parent asks what can be done to help shorten the course of
this illness. What will the primary care pediatric nurse practitioner recommend?
a. Clear liquids only
b. Lactobacillus
c. Loperamide
d. Peppermint oil - Correct Answer :ANS: B
Lactobacillus, given early in a viral diarrheal illness, can decrease the duration of diarrhea by about 25
hours and is safe to use in children. Parents should begin refeeding early to stimulate enterocyte growth
and help facilitate mucosal repair. Loperamide may be given to children over the age of 3 years.
Peppermint oil may help reduce cramping, but its efficacy is not certain.
P 3
, • BURNS'
PEDIATRIC 09/13/2026
PRIMARY Exam
5. A school-age child has recurrent diarrhea with foul-smelling stools, excessive flatus, abdominal
distension, and failure-to-thrive. A 2-week lactose-free trial failed to reduce symptoms. What is the
next step in diagnosing this condition?
a. Lactose hydrogen breath test
b. Serologic testing for celiac disease
c. Stool for ova and parasites
d. Sweat chloride test for cystic fibrosis - Correct Answer :ANS: B
This child has symptoms consistent with celiac disease, especially FTT and foul-smelling stools. Since
the lactose-free trial did not reduce symptoms, the likelihood of lactose intolerance is less and thus testing
is not likely to be helpful. The symptoms are recurrent, so giardiasis is less likely. CF is still possible, but
most children with CF are diagnosed as infants and have accompanying respiratory symptoms of some
type.
6. A 12-month-old infant exhibits poor weight gain after previously normal growth patterns. There is no
history of vomiting, diarrhea, or irregular bowel movements, and the physical exam is normal. What
is the next step in evaluating these findings?
a. Complete blood count and electrolytes
b. Feeding and stooling history and 3-day diet history
c. Stool cultures for ova and parasites
d. Swallow study with videofluoroscopy - Correct Answer :ANS: B
Vomiting, diarrhea, and bowel irregularities are more predictive of organic causes of FTT, which are not
present in this infant. A careful history and physical examination and limited laboratory evaluation are the
first steps unless there is reason to think that an organic cause is present. The fact that the infant was
previously gaining weight appropriately makes a swallowing disorder less likely.
7. The parent of an infant asks about using a probiotic medication. What will the primary care pediatric
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. A child is in the clinic after swallowing a metal bead. A radiograph of the GI tract shows a 6 mm
cylindrical object in the child's stomach. The child is able to swallow without difficulty and is not
experiencing pain. What is the correct course of treatment?
a. Administer ipecac to induce vomiting.
b. Have the parents watch for the object in the child's stool.
P 1
, • BURNS'
PEDIATRIC 09/13/2026
PRIMARY Exam
c. Insert a nasogastric tube to flush out the object.
d. Refer the child for endoscopic removal of the object. –
Correct Answer :ANS: B
A small foreign body that is not corrosive or sharp and that has reached the stomach is most likely to
continue to pass through the GI tract and no intervention is necessary. Inducing vomiting increases the
risk of aspiration of the FB. NG tube removal and endoscopy are not indicated unless the object has the
potential to damage the GI tract; most objects that are not sharp or corrosive that have reached the
abdomen will pass through without causing damage.
2. A toddler who was born prematurely refuses most solid foods and has poor weight gain. A barium
swallow study reveals a normal esophagus. What will the primary care pediatric nurse practitioner
consider next to manage this child's nutritional needs?
a. Consultation with a dietician
b. Fiberoptic endoscopy evaluation
c. Magnetic resonance imaging
d. Videofluoroscopy swallowing study
- Correct Answer :ANS: D
A videofluoroscopy swallowing study will evaluate other structural defects that may interfere with
swallowing and is relatively non-invasive. A dietician consult may be a part of the overall plan, but the
toddler first needs a thorough evaluation of potential problems. Fiberoptic endoscopy is invasive. MRI
may be performed if videofluoroscopy is inconclusive, but this is an expensive test.
3. A school-age child has a 3-month history of dull, aching epigastric pain that worsens with eating and
P 2
, • BURNS'
PEDIATRIC 09/13/2026
PRIMARY Exam
awakens the child from sleep. A complete blood count shows a hemoglobin of 8 mg/dL. What is the
next step in management?
a. Administration of H2RA or PPI medications
b. Empiric therapy for H. pylori (HP)
c. Ordering an upper GI series
d. Referral for esophagogastroduodenoscopy (EGD) –
Correct Answer :ANS: D
EGD is the procedure of choice in children for detecting PUD because it allows direct visualization of
mucosa, localization of the source of bleeding, and collection of tissue specimens. Empiric therapy for HP
is not recommended due to increased antibiotic resistance. An upper GI series may have false negative
findings. Once peptic ulcer disease is diagnosed, H2RA or PPI medications are first-line drugs.
4. A 2-year-old child has an acute diarrheal illness. The child is afebrile and, with oral rehydration
measures, has remained well hydrated. The parent asks what can be done to help shorten the course of
this illness. What will the primary care pediatric nurse practitioner recommend?
a. Clear liquids only
b. Lactobacillus
c. Loperamide
d. Peppermint oil - Correct Answer :ANS: B
Lactobacillus, given early in a viral diarrheal illness, can decrease the duration of diarrhea by about 25
hours and is safe to use in children. Parents should begin refeeding early to stimulate enterocyte growth
and help facilitate mucosal repair. Loperamide may be given to children over the age of 3 years.
Peppermint oil may help reduce cramping, but its efficacy is not certain.
P 3
, • BURNS'
PEDIATRIC 09/13/2026
PRIMARY Exam
5. A school-age child has recurrent diarrhea with foul-smelling stools, excessive flatus, abdominal
distension, and failure-to-thrive. A 2-week lactose-free trial failed to reduce symptoms. What is the
next step in diagnosing this condition?
a. Lactose hydrogen breath test
b. Serologic testing for celiac disease
c. Stool for ova and parasites
d. Sweat chloride test for cystic fibrosis - Correct Answer :ANS: B
This child has symptoms consistent with celiac disease, especially FTT and foul-smelling stools. Since
the lactose-free trial did not reduce symptoms, the likelihood of lactose intolerance is less and thus testing
is not likely to be helpful. The symptoms are recurrent, so giardiasis is less likely. CF is still possible, but
most children with CF are diagnosed as infants and have accompanying respiratory symptoms of some
type.
6. A 12-month-old infant exhibits poor weight gain after previously normal growth patterns. There is no
history of vomiting, diarrhea, or irregular bowel movements, and the physical exam is normal. What
is the next step in evaluating these findings?
a. Complete blood count and electrolytes
b. Feeding and stooling history and 3-day diet history
c. Stool cultures for ova and parasites
d. Swallow study with videofluoroscopy - Correct Answer :ANS: B
Vomiting, diarrhea, and bowel irregularities are more predictive of organic causes of FTT, which are not
present in this infant. A careful history and physical examination and limited laboratory evaluation are the
first steps unless there is reason to think that an organic cause is present. The fact that the infant was
previously gaining weight appropriately makes a swallowing disorder less likely.
7. The parent of an infant asks about using a probiotic medication. What will the primary care pediatric
P 4
