,Chapter 1 — Pediatric Primary Care; Scope & Alignment
(Primary care vs primary prevention)
Stem: A 2-month-old infant presents for a well-child visit. The
NP emphasizes immunizations, safe sleep education, and
scheduling the next well visit. Which action best exemplifies
primary prevention in pediatric primary care?
A. Referring the infant to early intervention for poor tone
B. Administering routinely scheduled vaccines at the visit
C. Prescribing iron for microcytic anemia found on screening
D. Initiating inhaled corticosteroid for recurrent wheeze
Correct answer: B
Rationale (correct): Administering routine vaccines prevents
disease before it occurs — a core example of primary
prevention in pediatric primary care (Burns, Ch. 1 — Pediatric
Primary Care: Prevention and Health Supervision). (Google
Books)
Distractor explanations:
A. Referral for early intervention is secondary/tertiary action for
an identified deficit, not primary prevention.
C. Prescribing iron treats identified deficiency — secondary
prevention/management.
D. Starting an inhaled steroid is treatment for an existing
problem (disease management), not primary prevention.
Teaching Point: Vaccination is fundamental primary prevention
in pediatric primary care.
,2
Chapter & Subtopic: Chapter 1 — Pediatric Primary Care; Rules
& Structure (Scope of practice & interprofessional collaboration)
Stem: A family nurse practitioner in an outpatient pediatric
clinic receives a toddler with moderate dehydration after
gastroenteritis. Which action most appropriately reflects the
NP’s role within scope and collaborative primary care?
A. Admit the child directly for inpatient care without consulting
a physician
B. Start oral rehydration therapy, arrange same-day referral to
pediatric hospitalist if not improving
C. Prescribe broad-spectrum IV antibiotics immediately in clinic
D. Discharge with oral antiemetics only and follow up in 2 weeks
Correct answer: B
Rationale (correct): Initiating evidence-based outpatient
therapy (oral rehydration), monitoring, and arranging timely
referral when needed demonstrates appropriate scope, triage,
and collaboration per Burns’ guidance on primary care structure
and referral thresholds. (Burns, Ch. 1 — Scope & Referral).
(Google Books)
Distractor explanations:
A. Direct admission without appropriate triage or
communication may exceed usual outpatient NP workflows.
C. IV antibiotics are not indicated for uncomplicated viral
, gastroenteritis and require appropriate setting.
D. Discharging with only antiemetics and delayed follow-up risks
deterioration in a dehydrated toddler.
Teaching Point: Primary care includes treatment, reassessment,
and timely referral when escalation is needed.
3
Chapter & Subtopic: Chapter 2 — Global and National
Influences on Child Health Status; Health status surveillance
Stem: A pediatric NP teaching students cites a recent national
stat: “About 2% of U.S. children are in fair or poor health.”
Which source is best for routinely updated national child health
statistics?
A. A single-center hospital registry
B. Local clinic electronic health record counts
C. CDC/NCHS child health FastStats and national surveys
D. Manufacturer vaccine safety reports
Correct answer: C
Rationale (correct): The CDC’s National Center for Health
Statistics and related FastStats provide regularly updated,
population-level child health indicators used for surveillance
and planning (Burns, Ch. 2 — Health Status of Children: Global
and National Perspectives). (Google Books, CDC)
Distractor explanations:
A. Single-center registries lack national representativeness.
(Primary care vs primary prevention)
Stem: A 2-month-old infant presents for a well-child visit. The
NP emphasizes immunizations, safe sleep education, and
scheduling the next well visit. Which action best exemplifies
primary prevention in pediatric primary care?
A. Referring the infant to early intervention for poor tone
B. Administering routinely scheduled vaccines at the visit
C. Prescribing iron for microcytic anemia found on screening
D. Initiating inhaled corticosteroid for recurrent wheeze
Correct answer: B
Rationale (correct): Administering routine vaccines prevents
disease before it occurs — a core example of primary
prevention in pediatric primary care (Burns, Ch. 1 — Pediatric
Primary Care: Prevention and Health Supervision). (Google
Books)
Distractor explanations:
A. Referral for early intervention is secondary/tertiary action for
an identified deficit, not primary prevention.
C. Prescribing iron treats identified deficiency — secondary
prevention/management.
D. Starting an inhaled steroid is treatment for an existing
problem (disease management), not primary prevention.
Teaching Point: Vaccination is fundamental primary prevention
in pediatric primary care.
,2
Chapter & Subtopic: Chapter 1 — Pediatric Primary Care; Rules
& Structure (Scope of practice & interprofessional collaboration)
Stem: A family nurse practitioner in an outpatient pediatric
clinic receives a toddler with moderate dehydration after
gastroenteritis. Which action most appropriately reflects the
NP’s role within scope and collaborative primary care?
A. Admit the child directly for inpatient care without consulting
a physician
B. Start oral rehydration therapy, arrange same-day referral to
pediatric hospitalist if not improving
C. Prescribe broad-spectrum IV antibiotics immediately in clinic
D. Discharge with oral antiemetics only and follow up in 2 weeks
Correct answer: B
Rationale (correct): Initiating evidence-based outpatient
therapy (oral rehydration), monitoring, and arranging timely
referral when needed demonstrates appropriate scope, triage,
and collaboration per Burns’ guidance on primary care structure
and referral thresholds. (Burns, Ch. 1 — Scope & Referral).
(Google Books)
Distractor explanations:
A. Direct admission without appropriate triage or
communication may exceed usual outpatient NP workflows.
C. IV antibiotics are not indicated for uncomplicated viral
, gastroenteritis and require appropriate setting.
D. Discharging with only antiemetics and delayed follow-up risks
deterioration in a dehydrated toddler.
Teaching Point: Primary care includes treatment, reassessment,
and timely referral when escalation is needed.
3
Chapter & Subtopic: Chapter 2 — Global and National
Influences on Child Health Status; Health status surveillance
Stem: A pediatric NP teaching students cites a recent national
stat: “About 2% of U.S. children are in fair or poor health.”
Which source is best for routinely updated national child health
statistics?
A. A single-center hospital registry
B. Local clinic electronic health record counts
C. CDC/NCHS child health FastStats and national surveys
D. Manufacturer vaccine safety reports
Correct answer: C
Rationale (correct): The CDC’s National Center for Health
Statistics and related FastStats provide regularly updated,
population-level child health indicators used for surveillance
and planning (Burns, Ch. 2 — Health Status of Children: Global
and National Perspectives). (Google Books, CDC)
Distractor explanations:
A. Single-center registries lack national representativeness.
