,Chapter 1 – Pediatric Primary Care — Section: Primary Care
versus Primary Prevention
Key concept: Difference between primary care services and
primary prevention strategies
Stem: A 4-year-old arrives for a well-child visit. The NP
documents growth, administers age-appropriate vaccines, and
gives anticipatory guidance on safety and nutrition. Which
action best represents primary prevention rather than primary
care?
A. Screening for developmental delay with a validated tool
B. Administering the recommended childhood immunizations
C. Assessing the child’s growth curve and plotting BMI
D. Referring to early intervention for suspected delay
Correct answer: B
Rationales:
• Correct (B): Immunization prevents disease occurrence
(primary prevention). This aligns with Burns’ discussion of
prevention strategies within pediatric primary care
(Chapter 1 — Primary Care/Prevention). (Google Books)
• A (wrong): Developmental screening is secondary
prevention/early detection rather than primary
prevention. It’s part of routine primary care but not
prevention of initial disease. (Google Books)
, • C (wrong): Growth assessment is surveillance and
screening (primary care), not an intervention that
prevents disease onset. (Google Books)
• D (wrong): Referral for delay is tertiary/secondary
intervention, not primary prevention. (Google Books)
Teaching Point: Vaccination is a classic primary prevention —
stop disease before it starts.
2
Chapter 1 – Pediatric Primary Care — Section: Scope &
Alignment
Key concept: Role of primary care provider in care
coordination and scope of practice
Stem: A family requests that a pediatric NP manage the care of
their 12-year-old with newly diagnosed type 1 diabetes in
collaboration with the endocrinology team. Which action by
the NP best demonstrates appropriate scope and alignment of
primary care?
A. Independently starting an insulin pump without
endocrinology input
B. Coordinating diabetes education, insulin plan review, and
timely endocrinology follow-up
C. Telling the family to visit the emergency department for
insulin adjustments
, D. Refusing to manage any diabetes follow-up because it’s a
specialist condition
Correct answer: B
Rationales:
• Correct (B): Primary care coordinates chronic disease
management, patient/family education, and specialist
collaboration — core aims described in Burns (Chapter 1
— Scope & Alignment). (Google Books)
• A (wrong): Initiating advanced device therapy without
specialist collaboration exceeds prudent scope and safe
interprofessional practice. (Google Books)
• C (wrong): ED referral is unnecessary for routine insulin
adjustments; not aligned with ambulatory primary care
coordination. (Google Books)
• D (wrong): Refusal to participate undermines continuity
of care; primary care has responsibility for coordination.
(Google Books)
Teaching Point: Primary care coordinates care and partners
with specialists — not always replaces them.
3
Chapter 1 – Pediatric Primary Care — Section: Unique Issues in
Pediatrics
versus Primary Prevention
Key concept: Difference between primary care services and
primary prevention strategies
Stem: A 4-year-old arrives for a well-child visit. The NP
documents growth, administers age-appropriate vaccines, and
gives anticipatory guidance on safety and nutrition. Which
action best represents primary prevention rather than primary
care?
A. Screening for developmental delay with a validated tool
B. Administering the recommended childhood immunizations
C. Assessing the child’s growth curve and plotting BMI
D. Referring to early intervention for suspected delay
Correct answer: B
Rationales:
• Correct (B): Immunization prevents disease occurrence
(primary prevention). This aligns with Burns’ discussion of
prevention strategies within pediatric primary care
(Chapter 1 — Primary Care/Prevention). (Google Books)
• A (wrong): Developmental screening is secondary
prevention/early detection rather than primary
prevention. It’s part of routine primary care but not
prevention of initial disease. (Google Books)
, • C (wrong): Growth assessment is surveillance and
screening (primary care), not an intervention that
prevents disease onset. (Google Books)
• D (wrong): Referral for delay is tertiary/secondary
intervention, not primary prevention. (Google Books)
Teaching Point: Vaccination is a classic primary prevention —
stop disease before it starts.
2
Chapter 1 – Pediatric Primary Care — Section: Scope &
Alignment
Key concept: Role of primary care provider in care
coordination and scope of practice
Stem: A family requests that a pediatric NP manage the care of
their 12-year-old with newly diagnosed type 1 diabetes in
collaboration with the endocrinology team. Which action by
the NP best demonstrates appropriate scope and alignment of
primary care?
A. Independently starting an insulin pump without
endocrinology input
B. Coordinating diabetes education, insulin plan review, and
timely endocrinology follow-up
C. Telling the family to visit the emergency department for
insulin adjustments
, D. Refusing to manage any diabetes follow-up because it’s a
specialist condition
Correct answer: B
Rationales:
• Correct (B): Primary care coordinates chronic disease
management, patient/family education, and specialist
collaboration — core aims described in Burns (Chapter 1
— Scope & Alignment). (Google Books)
• A (wrong): Initiating advanced device therapy without
specialist collaboration exceeds prudent scope and safe
interprofessional practice. (Google Books)
• C (wrong): ED referral is unnecessary for routine insulin
adjustments; not aligned with ambulatory primary care
coordination. (Google Books)
• D (wrong): Refusal to participate undermines continuity
of care; primary care has responsibility for coordination.
(Google Books)
Teaching Point: Primary care coordinates care and partners
with specialists — not always replaces them.
3
Chapter 1 – Pediatric Primary Care — Section: Unique Issues in
Pediatrics
