MCQs per Chapter
Pediatric Primary Care Test Bank & NCLEX-HESI
Review | Burns' 8th Edition
Reference: Ch. 1, Section: Pediatric Primary Care
Question: A 6-month-old infant arrives for a scheduled well
visit. The caregiver asks why primary care visits are necessary
when immunizations are given elsewhere. As the PNP, which
explanation best captures the role of pediatric primary care?
A. Primary care only provides immunizations and acute visits.
B. Primary care coordinates preventive care, development
surveillance, and family support over time.
C. Primary care is mainly for referrals to specialists when
needed.
D. Primary care is optional unless the child is ill.
Correct Answer: B
Rationale — Correct: Burns emphasizes that pediatric primary
care is longitudinal and comprehensive — it coordinates
preventive services, monitors growth and development, and
supports families. This captures the scope beyond episodic
immunizations.
Rationale — A: Incorrect — limiting primary care to
immunizations ignores its preventive and developmental roles.
Rationale — C: Incorrect — referrals are part of care, but
primary care’s role is broader than simply referring.
,Rationale — D: Incorrect — primary care is essential for
prevention and early detection, not optional.
Teaching Point: Primary care delivers continuous, preventive,
developmental, and family-centered care.
Citation: Burns et al., 2023, Ch. 1, Section: Pediatric Primary
Care
2
Reference: Ch. 1, Section: Primary Care Versus Primary
Prevention
Question: A toddler comes for a 15-month visit and the
caregiver asks about lead testing. Which action best exemplifies
primary prevention?
A. Ordering a venous lead level after elevated capillary screen.
B. Advising removal of peeling lead-paint in the home and
testing water sources.
C. Documenting failure-to-thrive and scheduling developmental
follow-up.
D. Referring to hematology for chelation therapy.
Correct Answer: B
Rationale — Correct: Primary prevention removes exposure
sources before poisoning occurs; Burns highlights
environmental modification (removing lead paint, testing water)
as primary prevention.
Rationale — A: Incorrect — ordering a venous level is
,diagnostic/screening (secondary prevention), not primary
prevention.
Rationale — C: Incorrect — documentation and follow-up
address an existing problem (secondary/tertiary actions).
Rationale — D: Incorrect — chelation is tertiary management
for established toxicity.
Teaching Point: Primary prevention eliminates hazards before
exposure or disease occurs.
Citation: Burns et al., 2023, Ch. 1, Section: Primary Care Versus
Primary Prevention
3
Reference: Ch. 1, Section: Pediatric Primary Care Providers
Question: A rural clinic seeks to expand pediatric services.
Which team composition best aligns with Burns’ recommended
model for accessible pediatric primary care?
A. Pediatrician only, as generalists cannot provide specialty
pediatric care.
B. Interprofessional team including PNP/APRN, pediatrician
consultant, RN care coordinator, and behavioral health provider.
C. Nurse only, with phone consultation to specialists as needed.
D. Receptionist and physician with no care coordination staff.
Correct Answer: B
Rationale — Correct: Burns supports an interprofessional,
team-based medical home model — PNP/APRN with access to
, pediatric consultants, nursing coordination, and integrated
behavioral health improves access and outcomes.
Rationale — A: Incorrect — while pediatricians are important,
team models increase access in underserved areas.
Rationale — C: Incorrect — a nurse with remote consult may be
insufficient for comprehensive primary care.
Rationale — D: Incorrect — lack of care coordination
undermines continuity and family-centered care.
Teaching Point: Team-based primary care (medical home)
improves access and coordination.
Citation: Burns et al., 2023, Ch. 1, Section: Pediatric Primary
Care Providers
4
Reference: Ch. 1, Section: Unique Issues in Pediatrics
Question: During a well visit, a 4-year-old’s height has fallen
from the 75th to the 25th percentile over 6 months. What is the
PNP’s best next step?
A. Reassure the family that percentiles fluctuate and continue
routine care.
B. Obtain a detailed growth history, review nutrition, and
consider further evaluation for organic causes.
C. Start iron supplementation empirically.
D. Refer immediately to psychiatry for possible eating disorder.
Correct Answer: B