by-Chapter Test Bank: Verified Answers & Detailed Rationales
(New Edition)
Chapter 1: Pediatric Primary Care
Chapter 1 – Primary Care versus Primary Prevention
Key Concept: Distinguish primary care roles from primary
prevention.
Stem: A 6-month-old infant presents for a well-child visit. The
nurse identifies which activity as primary prevention rather than
primary care?
A. Assessing developmental milestones and documenting
concerns
B. Administering routine immunizations according to schedule
C. Screening for iron-deficiency anemia with hemoglobin testing
D. Counseling the parents about signs of developmental delay
Correct answer: B
Rationale (correct): Administering immunizations prevents
disease before it occurs and is classic primary prevention
(Burns, Ch.1 — Primary Care vs Primary Prevention). The
,AAP/CDC immunization schedule exemplifies primary
prevention recommendations.
Distractors:
A. Assessment/documentation is primary care activity focusing
on surveillance, not prevention.
C. Screening (hemoglobin) is secondary prevention—early
detection.
D. Counseling about signs of delay is anticipatory
guidance/primary care, not primary prevention.
Teaching point: Immunizations are primary prevention—
prevent disease before onset.
2) Chapter & Subtopic
Chapter 1 – Pediatric Primary Care, Unique Issues in Pediatrics
— Key Concept: Family-centered care and developmental
surveillance.
Stem: During a 2-year well visit, the parent reports concerns
that the child’s language is delayed. The nurse’s best initial
action is to:
A. Refer immediately for a speech-language evaluation without
further assessment
B. Perform standardized developmental screening and obtain a
detailed history from the parent
C. Reassure the parent that language develops at variable times
and schedule routine follow-up in 6 months
,D. Start trial of language-stimulating activities and document
the plan
Correct answer: B
Rationale (correct): Burns emphasizes developmental
surveillance plus standardized screening when concerns arise
(Ch.1 — Unique Issues in Pediatrics: Developmental
Management). AAP recommends validated screening tools at
recommended ages before referral.
Distractors:
A. Immediate referral without screening may miss reversible
factors and bypass appropriate triage.
C. Delaying assessment risks missing early intervention
opportunities.
D. While home stimulation is useful, it does not replace formal
screening and history-taking.
Teaching point: Combine parental concerns with standardized
screening before referral.
3) Chapter & Subtopic
Chapter 1 – Caring for Children with Special Healthcare Needs
— Key Concept: Medical home and care coordination.
Stem: A 10-year-old with complex medical needs sees multiple
specialists and the family reports duplicated labs and
miscommunication. Which nursing action best supports a
medical home model?
, A. Ask parents to keep a notebook of appointments and test
results
B. Provide a single, updated care summary and facilitate
communication among providers
C. Refer the child to a new specialty clinic for consolidated care
D. Encourage parents to bring all specialists together for a joint
visit once a year
Correct answer: B
Rationale (correct): Burns describes the medical home’s role in
care coordination—providing an up-to-date care summary and
facilitating communication reduces fragmentation (Ch.1 —
Caring for Children with Special Healthcare Needs). This aligns
with family-centered care principles.
Distractors:
A. A notebook is helpful but insufficient; clinician-led
summaries improve system coordination.
C. Referral to a new clinic may not be feasible and doesn't
guarantee coordination.
D. Annual joint visits are impractical; ongoing coordination is
preferable.
Teaching point: The medical home ensures continuous care
coordination and accessible summaries.
4) Chapter & Subtopic