Burns’ Pediatric Primary Care (8th Ed.) — Complete Chapter-
by-Chapter Test Bank: Verified Answers & Detailed Rationales
(New Edition)
Question 1:
A 6-month-old infant arrives for a well-child visit. The parent
asks whether the visit is “primary care” or “prevention.” The
nurse practitioner explains that primary prevention is best
described as which of the following?
A. Management of an acute otitis media episode.
B. Screening for developmental delay at 9 months.
C. Administration of routine immunizations according to
schedule.
D. Referral to a cardiologist for a congenital murmur.
Correct Answer: C
Rationale:
C is correct because primary prevention prevents disease or
injury before it occurs (e.g., immunizations). This is aligned with
Bright Futures and primary prevention concepts. AAP
A is incorrect — managing an acute illness is clinical
care/episodic care, not prevention.
B is partially preventive (secondary prevention/early detection),
not primary prevention. Screening aims to detect early disease
or delay.
,D is incorrect — referral is specialty care for a detected problem
(tertiary or specialty care), not primary prevention.
Question 2:
A 15-year-old with stable congenital heart disease is
approaching transfer to adult cardiology. Which action best
demonstrates an evidence-based, developmentally appropriate
step in the transition process?
A. Discharging the patient from pediatric clinic when the patient
turns 18 without further planning.
B. Starting a written transition plan at age 14 that includes self-
management goals and adult provider identification.
C. Having the parent continue to schedule all future
appointments indefinitely.
D. Waiting until a medical crisis forces contact with adult
cardiology.
Correct Answer: B
Rationale:
B is correct — transition should be planned, individualized, and
begin early in adolescence with written goals and identification
of adult providers to ensure continuity (AAP transition
guidance). AAP Publications
A is incorrect — abrupt discharge is unsafe and contrary to
transition recommendations.
C is incorrect — encouraging adolescent independence in
scheduling/self-management is important; indefinite parental
,control impedes transition.
D is incorrect — crisis-driven transition is unreliable and unsafe.
Question 3:
A 4-year-old in primary care screens positive for two adverse
childhood experiences (ACEs): caregiver substance misuse and
household domestic violence. Which statement best reflects
the pediatric primary care provider’s immediate priority?
A. Document the ACEs in the chart and defer discussion until
the next well visit.
B. Provide trauma-informed anticipatory guidance, assess
current safety, and link family to resources.
C. Advise the family that ACEs only affect adults and are not
relevant now.
D. Refer the child for adult psychiatric care.
Correct Answer: B
Rationale:
B is correct — primary care should be trauma-informed, assess
immediate safety, provide supportive anticipatory guidance,
and connect families with community and behavioral health
resources (ACEs have lifelong impacts; primary care is a key
setting for prevention/early intervention). CDC
A is incorrect — deferring is unsafe and misses opportunity for
timely intervention.
C is incorrect — ACEs affect child development and long-term
health; this statement is false.
, D is incorrect — adult psychiatry is inappropriate for a child;
referral should be to pediatric behavioral health or community
child services.
Question 4:
A family brings their 2-year-old for a well visit. The child has a
chronic asthma diagnosis that requires multiple community
supports. The family asks what the “medical home” means.
Which provider action best exemplifies the medical home
model?
A. The clinic sees the child for asthma only when symptoms
worsen.
B. The primary care team coordinates with school,
pulmonology, and social services and provides a written plan.
C. The family is asked to coordinate appointments with all
specialists independently.
D. The primary care provider limits visits to acute care only.
Correct Answer: B
Rationale:
B is correct — medical home emphasizes continuous,
comprehensive, coordinated, family-centered care, especially
for CYSHCN (coordinate with schools, specialists, offer written
plans). AAP
A is incorrect — episodic acute visits do not reflect
comprehensive continuity.
C is incorrect — asking families to manage all coordination
by-Chapter Test Bank: Verified Answers & Detailed Rationales
(New Edition)
Question 1:
A 6-month-old infant arrives for a well-child visit. The parent
asks whether the visit is “primary care” or “prevention.” The
nurse practitioner explains that primary prevention is best
described as which of the following?
A. Management of an acute otitis media episode.
B. Screening for developmental delay at 9 months.
C. Administration of routine immunizations according to
schedule.
D. Referral to a cardiologist for a congenital murmur.
Correct Answer: C
Rationale:
C is correct because primary prevention prevents disease or
injury before it occurs (e.g., immunizations). This is aligned with
Bright Futures and primary prevention concepts. AAP
A is incorrect — managing an acute illness is clinical
care/episodic care, not prevention.
B is partially preventive (secondary prevention/early detection),
not primary prevention. Screening aims to detect early disease
or delay.
,D is incorrect — referral is specialty care for a detected problem
(tertiary or specialty care), not primary prevention.
Question 2:
A 15-year-old with stable congenital heart disease is
approaching transfer to adult cardiology. Which action best
demonstrates an evidence-based, developmentally appropriate
step in the transition process?
A. Discharging the patient from pediatric clinic when the patient
turns 18 without further planning.
B. Starting a written transition plan at age 14 that includes self-
management goals and adult provider identification.
C. Having the parent continue to schedule all future
appointments indefinitely.
D. Waiting until a medical crisis forces contact with adult
cardiology.
Correct Answer: B
Rationale:
B is correct — transition should be planned, individualized, and
begin early in adolescence with written goals and identification
of adult providers to ensure continuity (AAP transition
guidance). AAP Publications
A is incorrect — abrupt discharge is unsafe and contrary to
transition recommendations.
C is incorrect — encouraging adolescent independence in
scheduling/self-management is important; indefinite parental
,control impedes transition.
D is incorrect — crisis-driven transition is unreliable and unsafe.
Question 3:
A 4-year-old in primary care screens positive for two adverse
childhood experiences (ACEs): caregiver substance misuse and
household domestic violence. Which statement best reflects
the pediatric primary care provider’s immediate priority?
A. Document the ACEs in the chart and defer discussion until
the next well visit.
B. Provide trauma-informed anticipatory guidance, assess
current safety, and link family to resources.
C. Advise the family that ACEs only affect adults and are not
relevant now.
D. Refer the child for adult psychiatric care.
Correct Answer: B
Rationale:
B is correct — primary care should be trauma-informed, assess
immediate safety, provide supportive anticipatory guidance,
and connect families with community and behavioral health
resources (ACEs have lifelong impacts; primary care is a key
setting for prevention/early intervention). CDC
A is incorrect — deferring is unsafe and misses opportunity for
timely intervention.
C is incorrect — ACEs affect child development and long-term
health; this statement is false.
, D is incorrect — adult psychiatry is inappropriate for a child;
referral should be to pediatric behavioral health or community
child services.
Question 4:
A family brings their 2-year-old for a well visit. The child has a
chronic asthma diagnosis that requires multiple community
supports. The family asks what the “medical home” means.
Which provider action best exemplifies the medical home
model?
A. The clinic sees the child for asthma only when symptoms
worsen.
B. The primary care team coordinates with school,
pulmonology, and social services and provides a written plan.
C. The family is asked to coordinate appointments with all
specialists independently.
D. The primary care provider limits visits to acute care only.
Correct Answer: B
Rationale:
B is correct — medical home emphasizes continuous,
comprehensive, coordinated, family-centered care, especially
for CYSHCN (coordinate with schools, specialists, offer written
plans). AAP
A is incorrect — episodic acute visits do not reflect
comprehensive continuity.
C is incorrect — asking families to manage all coordination
