Burns’ Pediatric Primary Care 8th Edition Comprehensive Practice Exam 2026

Burns’ Pediatric Primary Care 8th Edition Comprehensive Practice Exam 2026 1. A community health nurse is planning a program to reduce infant mortality in a region with limited resources. Which intervention would have the most significant global impact on reducing childhood deaths from infectious diseases? A. Distributing insecticide-treated bed nets. B. Providing nutritional supplements to pregnant women. C. Implementing a widespread vaccination program. D. Building new healthcare facilities in rural areas. Correct Answer: C. Vaccinations Rationale: While all options are important, vaccinations are the most cost-effective and impactful intervention for preventing infectious diseases like pneumonia and diarrhea, which are leading causes of childhood mortality globally. 2. A pediatric nurse practitioner is reviewing global health data. Which region is consistently identified as having the highest infant mortality rate? A. Latin America B. Eastern Europe C. Sub-Saharan Africa D. Southeast Asia Correct Answer: C. Sub-Saharan Africa Rationale: Sub-Saharan Africa has the highest infant mortality rate globally due to a combination of factors including poverty, limited access to healthcare, and high rates of infectious disease. 3. A nurse is advocating for policy changes to improve child health in the United States. Which statement accurately reflects a current health trend among American children? A. The rate of childhood obesity has increased significantly in the last decade. B. Household poverty rates in the U.S. are lower than in most European countries. C. Vaccination rates for measles, mumps, and rubella are at an all-time low. D. The percentage of children living in food-insecure households has declined. Correct Answer: D. The percentage of children living in food-insecure households has declined. Rationale: Recent data indicate a slight but notable decline in food insecurity among U.S. households with children, though it remains a significant concern. 4. A primary care pediatric nurse practitioner is planning well-child visits for the first year of life. According to the most recent AAP recommendations, what is the primary basis for scheduling these visits? A. To align with the timing of routine immunizations. B. To coincide with key developmental milestones. C. To focus primarily on illness prevention and nutrition. D. To follow the schedule established by the Bright Futures publication. Correct Answer: B. To coincide with key developmental milestones. Rationale: The AAP’s Recommendations for Preventive Pediatric Health Care schedule visits to align with critical developmental milestones to ensure timely screening and anticipatory guidance. 5. A 7-year-old child is referred to a mental health specialist due to a history of enuresis, cruelty to animals, and fire-setting. This combination of behaviors is best described as: A. Oppositional defiant disorder. B. The MacDonald Triad. C. Reactive attachment disorder. D. Conduct disorder. Correct Answer: B. The MacDonald Triad. Rationale: The MacDonald Triad is a set of three behavioral characteristics—enuresis, cruelty to animals, and fire-setting—that have been historically linked to later aggressive or violent behavior. 6. The mother of a child with autism spectrum disorder is concerned about her child’s rigidity and difficulty with transitions. Which intervention is most appropriate to address these executive functioning challenges? A. Allowing the child to choose between two acceptable options. B. Providing a visual schedule of the daily routine. C. Encouraging the child to ask for help when overwhelmed. D. Reminding the child to use calm words when frustrated. Correct Answer: B. Providing a visual schedule of the daily routine. Rationale: Visual aids and schedules help children with executive functioning issues by making routines predictable and reducing anxiety related to transitions. 7. A 15-year-old adolescent is being discharged after a psychiatric hospitalization for borderline personality disorder. Which discharge instruction is most important for the nurse to include in the plan of care? A. “Monitor your child’s use of social media and video games.” B. “Ensure your child has a consistent primary caregiver.” C. “Seek medical attention if your child reports feeling good.” D. “Help your child build and maintain a strong support system.” Correct Answer: D. “Help your child build and maintain a strong support system.” Rationale: For adolescents with borderline personality disorder, a strong network of family and friends is crucial for emotional regulation and reducing feelings of isolation. 8. A child has been diagnosed with reactive attachment disorder following a history of severe neglect. The nurse practitioner should anticipate that the child’s behavior may include: A. Seeking comfort from strangers. B. Avoiding eye contact and resisting comfort. C. Being overly affectionate with caregivers. D. Displaying high levels of empathy. Correct Answer: B. Avoiding eye contact and resisting comfort. Rationale: Reactive attachment disorder is characterized by a lack of attachment behaviors, such as seeking and responding to comfort. These children may avoid eye contact and resist comforting efforts. 9. A crisis nurse is speaking with an 18-year-old male who called a crisis line. The nurse recognizes the need to avoid “entropy” in the conversation. What does this mean in the context of crisis intervention? A. The nurse should encourage the caller to discuss everyday activities. B. The nurse should prepare for the caller to express intense emotions. C. The nurse should work to reduce the caller’s disorganization and chaos. D. The nurse should avoid showing empathy to maintain a professional distance. Correct Answer: C. The nurse should work to reduce the caller’s disorganization and chaos. Rationale: In crisis intervention, entropy refers to the state of chaos and disorganization a person feels during a crisis. The nurse’s goal is to help the caller reduce this state. 10. A mental health nurse is educating a mother on how to help her child who has difficulty with executive function. Which strategy is most appropriate to improve the child’s morning routine? A. Giving the child a choice of breakfast items. B. Placing a checklist with pictures on the bathroom mirror. C. Reminding the child to be polite to siblings. D. Allowing the child to watch television while getting ready. Correct Answer: B. Placing a checklist with pictures on the bathroom mirror. Rationale: Visual checklists are a highly effective strategy for children with executive function difficulties to help them remember multi-step tasks like a morning routine. 11. A nurse practitioner is providing anticipatory guidance to the parents of a toddler. Which statement is true regarding injury prevention and environmental safety? A. Poison control center numbers should be posted near all phones. B. Children’s developmental milestones are a good predictor of injury risk. C. Safety precautions should be relaxed as the child grows older. D. Most childhood injuries occur outside the home. Correct Answer: A. Poison control center numbers should be posted near all phones. Rationale: Rapid access to poison control is critical in case of an accidental ingestion. This is a standard and essential piece of anticipatory guidance. 12. An 8-year-old girl is brought to the clinic with a history of frequent tantrums, difficulty maintaining friendships, and a lack of empathy. She was adopted at age 5 after a history of neglect. Which diagnosis is most likely? A. Attention-deficit/hyperactivity disorder. B. Reactive attachment disorder. C. Oppositional defiant disorder. D. Generalized anxiety disorder. Correct Answer: B. Reactive attachment disorder. Rationale: The child’s history of neglect, coupled with social difficulties, lack of empathy, and manipulative behavior, is characteristic of reactive attachment disorder. 13. A 12-year-old is diagnosed with a conduct disorder. In addition to psychotherapy, the nurse practitioner should address which of the following as a priority? A. School-based interventions to support learning. B. Sleep hygiene and nutritional counseling. C. Substance use assessment and prevention. D. Pain management strategies. Correct Answer: C. Substance use assessment and prevention. Rationale: Conduct disorder is a significant risk factor for substance use disorders, making assessment and prevention a critical component of the overall plan of care. 14. A nurse is providing education to a group of parents about bullying. What is the most accurate statement regarding the long-term effects of bullying? A. Most children who are bullied will have no lasting effects. B. Bullies typically outgrow their behavior by adulthood. C. Victims of bullying are at increased risk for depression and anxiety. D. Bystanders who witness bullying are not affected by it. Correct Answer: C. Victims of bullying are at increased risk for depression and anxiety. Rationale: Research consistently shows that victims of bullying are at significantly higher risk for developing mental health issues such as depression, anxiety, and suicidal ideation.