,Chapter 1 – Primary Care Versus Primary Prevention:
Definitions
Key Concept: Distinguish primary care from primary prevention
Stem: A 4-year-old comes for her annual well-child visit. Her
nurse explains that primary care includes all of the following
except:
A. Obtaining immunizations according to schedule
B. Teaching car-seat safety to parents
C. Managing acute otitis media when it occurs
D. Screening for developmental delays
Answer: C
Rationale (Correct): Managing acute otitis media is a tertiary
intervention (treatment of disease) rather than primary
care/prevention (Burns Ch 1 § “Primary Care Versus Primary
Prevention”).
Distractor Rationales:
• A: Immunizations are a core primary prevention activity.
• B: Car-seat teaching is anticipatory guidance (primary
prevention).
• D: Developmental screening is a primary care function.
Teaching Point: Primary prevention focuses on disease
prevention, not treatment.
2. Chapter 1 – Primary Care Versus Primary Prevention: Scope
,Key Concept: Levels of prevention
Stem: Which of the following is an example of secondary
prevention in pediatric primary care?
A. Administering DTaP to a 2-month-old
B. Offering lead-screening for 1-year-olds in high-risk areas
C. Prescribing inhaled corticosteroids for chronic asthma
D. Providing nutrition counseling to prevent obesity
Answer: B
Rationale (Correct): Lead screening identifies subclinical
exposure before symptoms—secondary prevention (Burns Ch 1
§ “Levels of Prevention”).
Distractor Rationales:
• A & D: Primary prevention.
• C: Tertiary prevention (disease management).
Teaching Point: Secondary prevention detects early
disease to limit progression.
3. Chapter 1 – Unique Issues in Pediatrics: Growth &
Development
Key Concept: Age-related vital sign norms
Stem: A 6-month-old infant presents for routine check. Which
respiratory rate is within normal range?
A. 20 breaths/min
B. 40 breaths/min
C. 60 breaths/min
, D. 80 breaths/min
Answer: B
Rationale (Correct): Infants 2–12 months normally breathe 25–
50 breaths/min (Burns Ch 1 § “Vital Sign Variations”).
Distractor Rationales:
• A: Too low for age.
• C–D: Tachypnea threshold is >50 – 60 breaths/min.
Teaching Point: Pediatric vitals vary markedly by age.
4. Chapter 1 – Unique Issues in Pediatrics: Communication
Key Concept: Developmentally appropriate communication
Stem: A 3-year-old is hospitalized for dehydration. The nurse
uses which approach to prepare her for IV placement?
A. Explain with medical terminology
B. Tell her “it won’t hurt”
C. Use a simple play demonstration with doll
D. Show a videotape of teenagers having IVs
Answer: C
Rationale (Correct): Doll play is developmentally appropriate
for preschoolers (Burns Ch 1 § “Communication with Children”).
Distractor Rationales:
• A & D: Too complex/irrelevant.
• B: False reassurance undermines trust.
Teaching Point: Use play to explain procedures to young
children.
Definitions
Key Concept: Distinguish primary care from primary prevention
Stem: A 4-year-old comes for her annual well-child visit. Her
nurse explains that primary care includes all of the following
except:
A. Obtaining immunizations according to schedule
B. Teaching car-seat safety to parents
C. Managing acute otitis media when it occurs
D. Screening for developmental delays
Answer: C
Rationale (Correct): Managing acute otitis media is a tertiary
intervention (treatment of disease) rather than primary
care/prevention (Burns Ch 1 § “Primary Care Versus Primary
Prevention”).
Distractor Rationales:
• A: Immunizations are a core primary prevention activity.
• B: Car-seat teaching is anticipatory guidance (primary
prevention).
• D: Developmental screening is a primary care function.
Teaching Point: Primary prevention focuses on disease
prevention, not treatment.
2. Chapter 1 – Primary Care Versus Primary Prevention: Scope
,Key Concept: Levels of prevention
Stem: Which of the following is an example of secondary
prevention in pediatric primary care?
A. Administering DTaP to a 2-month-old
B. Offering lead-screening for 1-year-olds in high-risk areas
C. Prescribing inhaled corticosteroids for chronic asthma
D. Providing nutrition counseling to prevent obesity
Answer: B
Rationale (Correct): Lead screening identifies subclinical
exposure before symptoms—secondary prevention (Burns Ch 1
§ “Levels of Prevention”).
Distractor Rationales:
• A & D: Primary prevention.
• C: Tertiary prevention (disease management).
Teaching Point: Secondary prevention detects early
disease to limit progression.
3. Chapter 1 – Unique Issues in Pediatrics: Growth &
Development
Key Concept: Age-related vital sign norms
Stem: A 6-month-old infant presents for routine check. Which
respiratory rate is within normal range?
A. 20 breaths/min
B. 40 breaths/min
C. 60 breaths/min
, D. 80 breaths/min
Answer: B
Rationale (Correct): Infants 2–12 months normally breathe 25–
50 breaths/min (Burns Ch 1 § “Vital Sign Variations”).
Distractor Rationales:
• A: Too low for age.
• C–D: Tachypnea threshold is >50 – 60 breaths/min.
Teaching Point: Pediatric vitals vary markedly by age.
4. Chapter 1 – Unique Issues in Pediatrics: Communication
Key Concept: Developmentally appropriate communication
Stem: A 3-year-old is hospitalized for dehydration. The nurse
uses which approach to prepare her for IV placement?
A. Explain with medical terminology
B. Tell her “it won’t hurt”
C. Use a simple play demonstration with doll
D. Show a videotape of teenagers having IVs
Answer: C
Rationale (Correct): Doll play is developmentally appropriate
for preschoolers (Burns Ch 1 § “Communication with Children”).
Distractor Rationales:
• A & D: Too complex/irrelevant.
• B: False reassurance undermines trust.
Teaching Point: Use play to explain procedures to young
children.
