Burns’ Pediatric Primary Care (8th Ed.) — Complete Chapter-
by-Chapter Test Bank: Verified Answers & Detailed Rationales
(New Edition)
Chapter 1: Pediatric Primary Care
Chapter 1 – Primary Care versus Primary Prevention
Key Concept: Distinguishing primary care activities from
primary prevention.
Stem: A 2-week-old infant presents for a well-newborn visit.
The nurse prepares to (1) administer the first hepatitis B
vaccine, (2) screen for metabolic disorders, (3) teach parents
about supine sleep and smoke-free home, and (4) perform a
complete physical exam. Which action best exemplifies primary
prevention?
A. Ordering newborn metabolic screening tests
B. Administering the first dose of hepatitis B vaccine
C. Teaching parents about supine sleep and avoiding tobacco
smoke
D. Performing and explaining the newborn physical examination
findings
Correct answer: C
,Rationale (correct): Primary prevention aims to prevent disease
or injury before it occurs; counseling about safe sleep and
smoke-free environments reduces risk factors for SIDS and
respiratory illness through behavior change and environment
modification (Burns, Ch. 1 — Primary Care vs Primary
Prevention). Evolve+1
Distractors:
A. Newborn metabolic screening is early detection (secondary
prevention), not primary prevention.
B. Immunization is primary prevention, but the vignette’s
emphasis on behavioral/environmental prevention makes (C)
the best exemplar.
D. Exam and review are assessment activities that support
prevention but are not themselves primary prevention.
Teaching Point: Primary prevention prevents illness before it
starts (education, immunization, safety).
2)
Chapter & Subtopic: Chapter 1 — Primary Care Versus Primary
Prevention — Key Concept: Anticipatory guidance in well-child
visits.
Stem: During a 15-month well visit, the parent asks about
toddler sleep safety and injury prevention at home. Which
response best reflects effective anticipatory guidance by the
pediatric nurse?
A. “Only tell your child not to climb on furniture; they will
,learn.”
B. “Remove small objects, secure furniture, and use a toddler
bed with rails; let’s show specific steps.”
C. “If they fall once, they’ll stop — it’s part of learning.”
D. “Avoid discussing safety now; focus on immunizations.”
Correct answer: B
Rationale (correct): Anticipatory guidance is proactive, specific,
and developmentally tailored — the nurse should give concrete,
actionable steps (securing furniture, removing hazards,
appropriate sleep environment) at each developmental stage
(Burns, Ch.1 — Primary Care vs Primary Prevention). Evolve
Distractors:
A. Vague admonitions are ineffective; parents need concrete
strategies.
C. Minimizing risk fails to protect the child from predictable
hazards.
D. Safety counseling is a core component of the well visit and
should not be deferred.
Teaching Point: Anticipatory guidance must be specific,
developmentally appropriate, and actionable.
3)
Chapter & Subtopic: Chapter 1 — Unique Issues in Pediatrics —
Key Concept: Anatomical/physiologic differences affecting
medication dosing.
, Stem: A 4-year-old child requires an analgesic. Which nursing
consideration most directly reflects pediatric uniqueness for
medication administration?
A. Use adult tablet doses if the child looks big for age.
B. Convert dose based on weight (mg/kg) and check age-
appropriate formulation.
C. Double the dose if pain persists without consulting
prescriber.
D. Administer the same dose every 8 hours regardless of
weight.
Correct answer: B
Rationale (correct): Pediatric dosing often requires mg/kg
calculations and age-appropriate formulations because
pharmacokinetics and organ maturity differ by age and weight
(Burns, Ch.1 — Unique Issues in Pediatrics).
Distractors:
A. Visual estimation is unreliable and unsafe for dosing.
C. Doubling doses without prescriber input risks toxicity.
D. Fixed adult schedules may be inappropriate; timing should
align with safe pediatric dosing and prescribing.
Teaching Point: Always calculate pediatric medication doses
using weight (mg/kg) and appropriate formulations.
4)
by-Chapter Test Bank: Verified Answers & Detailed Rationales
(New Edition)
Chapter 1: Pediatric Primary Care
Chapter 1 – Primary Care versus Primary Prevention
Key Concept: Distinguishing primary care activities from
primary prevention.
Stem: A 2-week-old infant presents for a well-newborn visit.
The nurse prepares to (1) administer the first hepatitis B
vaccine, (2) screen for metabolic disorders, (3) teach parents
about supine sleep and smoke-free home, and (4) perform a
complete physical exam. Which action best exemplifies primary
prevention?
A. Ordering newborn metabolic screening tests
B. Administering the first dose of hepatitis B vaccine
C. Teaching parents about supine sleep and avoiding tobacco
smoke
D. Performing and explaining the newborn physical examination
findings
Correct answer: C
,Rationale (correct): Primary prevention aims to prevent disease
or injury before it occurs; counseling about safe sleep and
smoke-free environments reduces risk factors for SIDS and
respiratory illness through behavior change and environment
modification (Burns, Ch. 1 — Primary Care vs Primary
Prevention). Evolve+1
Distractors:
A. Newborn metabolic screening is early detection (secondary
prevention), not primary prevention.
B. Immunization is primary prevention, but the vignette’s
emphasis on behavioral/environmental prevention makes (C)
the best exemplar.
D. Exam and review are assessment activities that support
prevention but are not themselves primary prevention.
Teaching Point: Primary prevention prevents illness before it
starts (education, immunization, safety).
2)
Chapter & Subtopic: Chapter 1 — Primary Care Versus Primary
Prevention — Key Concept: Anticipatory guidance in well-child
visits.
Stem: During a 15-month well visit, the parent asks about
toddler sleep safety and injury prevention at home. Which
response best reflects effective anticipatory guidance by the
pediatric nurse?
A. “Only tell your child not to climb on furniture; they will
,learn.”
B. “Remove small objects, secure furniture, and use a toddler
bed with rails; let’s show specific steps.”
C. “If they fall once, they’ll stop — it’s part of learning.”
D. “Avoid discussing safety now; focus on immunizations.”
Correct answer: B
Rationale (correct): Anticipatory guidance is proactive, specific,
and developmentally tailored — the nurse should give concrete,
actionable steps (securing furniture, removing hazards,
appropriate sleep environment) at each developmental stage
(Burns, Ch.1 — Primary Care vs Primary Prevention). Evolve
Distractors:
A. Vague admonitions are ineffective; parents need concrete
strategies.
C. Minimizing risk fails to protect the child from predictable
hazards.
D. Safety counseling is a core component of the well visit and
should not be deferred.
Teaching Point: Anticipatory guidance must be specific,
developmentally appropriate, and actionable.
3)
Chapter & Subtopic: Chapter 1 — Unique Issues in Pediatrics —
Key Concept: Anatomical/physiologic differences affecting
medication dosing.
, Stem: A 4-year-old child requires an analgesic. Which nursing
consideration most directly reflects pediatric uniqueness for
medication administration?
A. Use adult tablet doses if the child looks big for age.
B. Convert dose based on weight (mg/kg) and check age-
appropriate formulation.
C. Double the dose if pain persists without consulting
prescriber.
D. Administer the same dose every 8 hours regardless of
weight.
Correct answer: B
Rationale (correct): Pediatric dosing often requires mg/kg
calculations and age-appropriate formulations because
pharmacokinetics and organ maturity differ by age and weight
(Burns, Ch.1 — Unique Issues in Pediatrics).
Distractors:
A. Visual estimation is unreliable and unsafe for dosing.
C. Doubling doses without prescriber input risks toxicity.
D. Fixed adult schedules may be inappropriate; timing should
align with safe pediatric dosing and prescribing.
Teaching Point: Always calculate pediatric medication doses
using weight (mg/kg) and appropriate formulations.
4)
