Burns’ Pediatric Primary Care (8th Ed.) — Complete Chapter-
by-Chapter Test Bank: Verified Answers & Detailed Rationales
(New Edition)
Question 1
Reference: Ch. 24, Section: Acne
Question Stem:
A 16-year-old female presents with moderate inflammatory
acne on her face and chest that has not improved with over-
the-counter benzoyl peroxide. She is otherwise healthy. Which
first-line pharmacologic treatment is most appropriate to
initiate?
Options:
A. Oral doxycycline
B. Topical tretinoin cream
C. Topical clindamycin and benzoyl peroxide combination gel
D. Oral isotretinoin
Correct Answer: C
Rationales:
• Correct: For moderate inflammatory acne that is
unresponsive to OTC therapy, the first-line prescription
treatment is a combination topical antimicrobial and
, topical retinoid. Topical clindamycin-benzoyl peroxide is a
recommended first-line combination agent to target both
comedones and inflammatory lesions.
• Incorrect A: Oral antibiotics like doxycycline are typically
reserved for more severe, widespread inflammatory acne
or when topical regimens have failed, due to concerns
about bacterial resistance.
• Incorrect B: Topical tretinoin is excellent for comedonal
acne but is less effective for inflammatory acne when used
alone; it is best used in combination with an antimicrobial.
• Incorrect D: Oral isotretinoin is indicated for severe,
nodulocystic, or scarring acne that is refractory to other
treatments, and its use requires strict monitoring due to
significant side effects.
Teaching Point: First-line treatment for moderate inflammatory
acne is a combination topical antimicrobial and retinoid.
Question 2
Reference: Ch. 23, Section: Developmental Surveillance and
Screening
Question Stem:
During a 9-month well-child visit, the parents of an infant
express concern that he is not pulling to stand. The pediatric
primary care provider notes the infant has good head control,
,rolls both ways, and sits unsupported. What is the most
appropriate initial action?
Options:
A. Refer immediately to a pediatric orthopedist.
B. Reassure the parents that this is a normal variant and
discharge.
C. Administer a standardized developmental screening tool and
schedule a follow-up visit in one month.
D. Order serum creatine kinase and a complete blood count.
Correct Answer: C
Rationales:
• Correct: While not pulling to stand at 9 months is at the
late end of typical, the presence of other gross motor
milestones (sitting unsupported) is reassuring. The most
appropriate action is enhanced surveillance using a
standardized tool and a short-interval follow-up to assess
progress.
• Incorrect A: Immediate specialist referral is premature
without further assessment of the developmental
trajectory.
• Incorrect B: Simply reassuring and discharging ignores the
parents' valid concern and the documented delay, failing to
provide adequate developmental surveillance.
, • Incorrect D: Ordering laboratory studies is not indicated as
an initial step for an isolated motor delay without other
concerning signs (e.g., weakness, regression).
Teaching Point: Use standardized screening and short-interval
follow-up for isolated, mild motor delays with concerning
parental history.
Question 3
Reference: Ch. 29, Section: Otitis Media
Question Stem:
A 2-year-old, otherwise healthy male presents with 48 hours of
otalgia and fever to 38.5°C (101.3°F). On otoscopic examination,
the tympanic membrane is bulging, erythematous, and has
poor mobility. What is the most appropriate management?
Options:
A. Prescribe amoxicillin 80-90 mg/kg/day for a 10-day course.
B. Initiate a 48-72 hour observation period with symptomatic
management.
C. Prescribe amoxicillin-clavulanate 90 mg/kg/day for a 10-day
course.
D. Refer to otolaryngology for possible tympanostomy tubes.
Correct Answer: A
Rationales:
by-Chapter Test Bank: Verified Answers & Detailed Rationales
(New Edition)
Question 1
Reference: Ch. 24, Section: Acne
Question Stem:
A 16-year-old female presents with moderate inflammatory
acne on her face and chest that has not improved with over-
the-counter benzoyl peroxide. She is otherwise healthy. Which
first-line pharmacologic treatment is most appropriate to
initiate?
Options:
A. Oral doxycycline
B. Topical tretinoin cream
C. Topical clindamycin and benzoyl peroxide combination gel
D. Oral isotretinoin
Correct Answer: C
Rationales:
• Correct: For moderate inflammatory acne that is
unresponsive to OTC therapy, the first-line prescription
treatment is a combination topical antimicrobial and
, topical retinoid. Topical clindamycin-benzoyl peroxide is a
recommended first-line combination agent to target both
comedones and inflammatory lesions.
• Incorrect A: Oral antibiotics like doxycycline are typically
reserved for more severe, widespread inflammatory acne
or when topical regimens have failed, due to concerns
about bacterial resistance.
• Incorrect B: Topical tretinoin is excellent for comedonal
acne but is less effective for inflammatory acne when used
alone; it is best used in combination with an antimicrobial.
• Incorrect D: Oral isotretinoin is indicated for severe,
nodulocystic, or scarring acne that is refractory to other
treatments, and its use requires strict monitoring due to
significant side effects.
Teaching Point: First-line treatment for moderate inflammatory
acne is a combination topical antimicrobial and retinoid.
Question 2
Reference: Ch. 23, Section: Developmental Surveillance and
Screening
Question Stem:
During a 9-month well-child visit, the parents of an infant
express concern that he is not pulling to stand. The pediatric
primary care provider notes the infant has good head control,
,rolls both ways, and sits unsupported. What is the most
appropriate initial action?
Options:
A. Refer immediately to a pediatric orthopedist.
B. Reassure the parents that this is a normal variant and
discharge.
C. Administer a standardized developmental screening tool and
schedule a follow-up visit in one month.
D. Order serum creatine kinase and a complete blood count.
Correct Answer: C
Rationales:
• Correct: While not pulling to stand at 9 months is at the
late end of typical, the presence of other gross motor
milestones (sitting unsupported) is reassuring. The most
appropriate action is enhanced surveillance using a
standardized tool and a short-interval follow-up to assess
progress.
• Incorrect A: Immediate specialist referral is premature
without further assessment of the developmental
trajectory.
• Incorrect B: Simply reassuring and discharging ignores the
parents' valid concern and the documented delay, failing to
provide adequate developmental surveillance.
, • Incorrect D: Ordering laboratory studies is not indicated as
an initial step for an isolated motor delay without other
concerning signs (e.g., weakness, regression).
Teaching Point: Use standardized screening and short-interval
follow-up for isolated, mild motor delays with concerning
parental history.
Question 3
Reference: Ch. 29, Section: Otitis Media
Question Stem:
A 2-year-old, otherwise healthy male presents with 48 hours of
otalgia and fever to 38.5°C (101.3°F). On otoscopic examination,
the tympanic membrane is bulging, erythematous, and has
poor mobility. What is the most appropriate management?
Options:
A. Prescribe amoxicillin 80-90 mg/kg/day for a 10-day course.
B. Initiate a 48-72 hour observation period with symptomatic
management.
C. Prescribe amoxicillin-clavulanate 90 mg/kg/day for a 10-day
course.
D. Refer to otolaryngology for possible tympanostomy tubes.
Correct Answer: A
Rationales:
