Burns Pediatric Final Exam Study
Guide
1. The primary care pediatric nurse practitioner understands that a major child health outcome
associated
with worldwide climate change is :
a. cost of living.
b. education.
c. nutrition.
d. pollution.
ANS: C
There is growing evidence that climate change is having a dramatic effect on food crops that leads to
food distribution issues and food insecurity among families.
2. The primary care pediatric nurse practitioner understands that, to achieve the greatest world-wide
reduction in child mortality from pneumonia and diarrhea, which intervention is most effective?
a. Antibiotics
b. Optimal nutrition
c. Vaccinations
d. Water purification
ANS: C
Rotavirus is the most common cause of diarrhea globally and Strep pneumonia is the leading cause of
pneumonia, and together these are the leading infectious causes of childhood morbidity and mortality
globally. Both are vaccine-preventable diseases. Antibiotics to treat pneumonia, optimal nutrition, and
clean water all help to reduce morbidity and mortality, but vaccination prevents the diseases from
,occurring.
3. When providing well child care for an infant in the first year of life, the primary care pediatric nurse
practitioner is adhering to the most recent American Academy of Pediatrics Recommendations for
Preventive Pediatric Health Care guidelines by :
a. focusing less on development and more on illness prevention and nutrition.
b. following guidelines established by the Bright Futures publication.
c. scheduling well-baby visits to coincide with key developmental milestones.
d. seeing the infant at ages 2, 4, 6, and 12 months when immunizations are due.
ANS: C
In the most recent AAP Recommendations for Preventive Pediatric Health Care, there is a greater
emphasis on behavioral and developmental issues and a recommendation that well child care be based
on
child and family development rather than the periodicity of immunization schedules. This will require a
revision of the current recommendations in Bright Futures.
4. Which is true about the health status of children in the United States?
a. Globalism has relatively little impact on child health measures in the U.S.
b. Obesity rates among 2- to 5-year-olds have shown a recent significant decrease.
c. The rate of household poverty is lower than in other economically developed nations.
d. Young children who attend preschool or day care have higher food insecurity.
ANS: B
Obesity rates are a major concern for child health in the U.S. but recently have stabilized in the rate of
increase and have declined among 2- to 5-year-olds between 2004 and 2013. Globalism has an
increasing
effect on child health in the U.S. The rate of household poverty in the U.S. is higher than in other
,economically developed nations. Young children who attend preschool or day care have lower food
insecurity.
5. Which region globally has the highest infant mortality rate?
a. Indonesia
b. Southern Asia
c. Sub-Saharan Africa
d. Syria
ANS: C
Although Sub-Saharan Africa and Southern Asia together account for 81% of the infant mortality rate
globally, Sub-Saharan Africa has the highest infant mortality rate in the world.
1. The parent of a toddler is concerned that the child may have autism. The primary care pediatric nurse
practitioner completes a Modified Checklist for Autism in Toddlers (M-CHAT) tool, which indicates
several areas of concern. What will the nurse practitioner do?
a. Administer a Childhood Autism Rating Scale (CARS) in the clinic.
b. Consult a specialist to determine appropriate early intervention strategies.
c. Refer the child to a behavioral specialist for further evaluation.
d. Tell the parent that this result indicates that the child has autism.
ANS: C
The M-CHAT is a screening tool and is useful for detecting behaviors that may indicate autism. This
instrument has been found to have acceptable sensitivity, specificity, and significant positive predictive
value. If these behaviors are detected, the PNP should refer the child to a specialist for further
assessment,
using more diagnostic tools. The CARS may be used but requires specialty training and proper
credentials. Until the diagnosis is determined, strategies for intervention are not discussed. The M-CHAT
is a screening tool and is not diagnostic.
, 2. The mother of a newborn tells the primary care pediatric nurse practitioner that she is worried that
her
child will develop allergies and asthma. Which tool will the nurse practitioner use to evaluate this
risk?
a. Three-generation pedigree
b. Review of systems
c. Genogram
d. Ecomap
ANS: A
The three-generation pedigree is used to map out risks for genetic diseases in families, as well as
conditions with modifiable risk factors. The review of systems is used to evaluate the history of the
child's body systems. The genogram is an approach to developing a family database to provide a graphic
representation of family structure, roles, and problems of recurring significance in a family. The ecomap
is used to identify relationships in the family and community that are supportive or harmful.
3. The primary care pediatric nurse practitioner is performing a well child check-up on a 20-month-old
child. The child was 4 weeks premature and, according to a parent-completed developmental
questionnaire, has achieved milestones for a 15-month-old infant. Which action is correct?
a. Perform an in-depth developmental assessment screen at this visit to evaluate this child.
b. Reassure the parent that the child will catch up to normal development by age 2 years.
c. Re-evaluate this child's development and milestone achievements at the 2-year visit.
d. Refer the child to a specialty clinic for evaluation and treatment of developmental delay.
ANS: A
This child should be at a 19-month adjusted age for prematurity so, according to the parent screen, is 4
months behind. The PNP should perform a more in-depth screen to evaluate this delay. Waiting to see if
Guide
1. The primary care pediatric nurse practitioner understands that a major child health outcome
associated
with worldwide climate change is :
a. cost of living.
b. education.
c. nutrition.
d. pollution.
ANS: C
There is growing evidence that climate change is having a dramatic effect on food crops that leads to
food distribution issues and food insecurity among families.
2. The primary care pediatric nurse practitioner understands that, to achieve the greatest world-wide
reduction in child mortality from pneumonia and diarrhea, which intervention is most effective?
a. Antibiotics
b. Optimal nutrition
c. Vaccinations
d. Water purification
ANS: C
Rotavirus is the most common cause of diarrhea globally and Strep pneumonia is the leading cause of
pneumonia, and together these are the leading infectious causes of childhood morbidity and mortality
globally. Both are vaccine-preventable diseases. Antibiotics to treat pneumonia, optimal nutrition, and
clean water all help to reduce morbidity and mortality, but vaccination prevents the diseases from
,occurring.
3. When providing well child care for an infant in the first year of life, the primary care pediatric nurse
practitioner is adhering to the most recent American Academy of Pediatrics Recommendations for
Preventive Pediatric Health Care guidelines by :
a. focusing less on development and more on illness prevention and nutrition.
b. following guidelines established by the Bright Futures publication.
c. scheduling well-baby visits to coincide with key developmental milestones.
d. seeing the infant at ages 2, 4, 6, and 12 months when immunizations are due.
ANS: C
In the most recent AAP Recommendations for Preventive Pediatric Health Care, there is a greater
emphasis on behavioral and developmental issues and a recommendation that well child care be based
on
child and family development rather than the periodicity of immunization schedules. This will require a
revision of the current recommendations in Bright Futures.
4. Which is true about the health status of children in the United States?
a. Globalism has relatively little impact on child health measures in the U.S.
b. Obesity rates among 2- to 5-year-olds have shown a recent significant decrease.
c. The rate of household poverty is lower than in other economically developed nations.
d. Young children who attend preschool or day care have higher food insecurity.
ANS: B
Obesity rates are a major concern for child health in the U.S. but recently have stabilized in the rate of
increase and have declined among 2- to 5-year-olds between 2004 and 2013. Globalism has an
increasing
effect on child health in the U.S. The rate of household poverty in the U.S. is higher than in other
,economically developed nations. Young children who attend preschool or day care have lower food
insecurity.
5. Which region globally has the highest infant mortality rate?
a. Indonesia
b. Southern Asia
c. Sub-Saharan Africa
d. Syria
ANS: C
Although Sub-Saharan Africa and Southern Asia together account for 81% of the infant mortality rate
globally, Sub-Saharan Africa has the highest infant mortality rate in the world.
1. The parent of a toddler is concerned that the child may have autism. The primary care pediatric nurse
practitioner completes a Modified Checklist for Autism in Toddlers (M-CHAT) tool, which indicates
several areas of concern. What will the nurse practitioner do?
a. Administer a Childhood Autism Rating Scale (CARS) in the clinic.
b. Consult a specialist to determine appropriate early intervention strategies.
c. Refer the child to a behavioral specialist for further evaluation.
d. Tell the parent that this result indicates that the child has autism.
ANS: C
The M-CHAT is a screening tool and is useful for detecting behaviors that may indicate autism. This
instrument has been found to have acceptable sensitivity, specificity, and significant positive predictive
value. If these behaviors are detected, the PNP should refer the child to a specialist for further
assessment,
using more diagnostic tools. The CARS may be used but requires specialty training and proper
credentials. Until the diagnosis is determined, strategies for intervention are not discussed. The M-CHAT
is a screening tool and is not diagnostic.
, 2. The mother of a newborn tells the primary care pediatric nurse practitioner that she is worried that
her
child will develop allergies and asthma. Which tool will the nurse practitioner use to evaluate this
risk?
a. Three-generation pedigree
b. Review of systems
c. Genogram
d. Ecomap
ANS: A
The three-generation pedigree is used to map out risks for genetic diseases in families, as well as
conditions with modifiable risk factors. The review of systems is used to evaluate the history of the
child's body systems. The genogram is an approach to developing a family database to provide a graphic
representation of family structure, roles, and problems of recurring significance in a family. The ecomap
is used to identify relationships in the family and community that are supportive or harmful.
3. The primary care pediatric nurse practitioner is performing a well child check-up on a 20-month-old
child. The child was 4 weeks premature and, according to a parent-completed developmental
questionnaire, has achieved milestones for a 15-month-old infant. Which action is correct?
a. Perform an in-depth developmental assessment screen at this visit to evaluate this child.
b. Reassure the parent that the child will catch up to normal development by age 2 years.
c. Re-evaluate this child's development and milestone achievements at the 2-year visit.
d. Refer the child to a specialty clinic for evaluation and treatment of developmental delay.
ANS: A
This child should be at a 19-month adjusted age for prematurity so, according to the parent screen, is 4
months behind. The PNP should perform a more in-depth screen to evaluate this delay. Waiting to see if
