, Chapter 01: Health Status of Children: Global and National Perspectives
Garzon Maaks: Burns’ Pediatric Primary Care, 7th Edition
MULTIPLE CHOICE :
1. Which region globally has the highest infant mortality rate?
a. Indonesia
b. Southern Asia
c. Sub-Saharan Africa
d. Syria
ANS: B
Although Sub-Saharan Africa and Southern Asia together account for 77% of the infant mortality rate
globally, Southern Asia has the highest infant mortality rate (39%) in the world followed closely by
Sub-Saharan Africa (38%).
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. Which statement correctly reflects 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 stabilized below Health People 2020
goal of 9.4%.
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 at 8.9%.
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.
4. The primary care pediatric nurse practitioner understands that what major child health outcome is
dramatically associated with worldwide climate change?
a. Housing
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.
5. When providing well child care for an infant in the first year of life, the primary care pediatric nurse
practitioner demonstrates an understanding of current guidelines when taking what action?
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.
Chapter 02: Unique Issues in Pediatrics
Garzon Maaks: Burns’ Pediatric Primary Care, 7th Edition
MULTIPLE CHOICE
1. What is the foundational basis of patient-and-family centered care (PFCC)?
a. The family is to be considered when patient care is being planned
b. The patient has ultimate control over health care decisions
c. A family member acts as the patient’s surrogate decision makes
d. The patient is the focus of the primary care provider’s attention
ANS: B
While all options are correct statements, the foundational basis of PFCC is the patient has ultimate
control over health care decisions.
2. Which assessment question best demonstrates the primary care provider’s understanding of effectively
dealing with the greatest challenge to providing dual patient care?
a. To the parent: “Do you feel comfortable providing in-home care for your child?”
b. To the child: “When would you like your physical therapy sessions to be
scheduled?”
, c. To the parent: “What are your feelings about going to family therapy to help with
this transition?”
d. To the child: “When did you first notice the pain in your knees?”
ANS: B
One of the greatest challenges is how to access, acknowledge, and include the child’s voice, which is
often lost and/or overridden in health care. By directly asking the child their opinion or feelings, the
PCP is providing for the child’s voice to be heard and acknowledged. None of the other options
addresses that need.
3. Which intervention best demonstrates a pediatric nurse primary care pediatric nurse practitioner’s
understanding of effective pain assessment?
a. Providing instructions regarding the Faces pain assessment tool to parents of all
newly admitted children
b. Assisting in the development of a child-centered pain assessment scale
c. Reviewing the documentation regarding the child’s pain assessment 30 minutes
after analgesic medication was administered
d. Explaining to both the child and the parents why pain medication will be delivered
intravenously
ANS: B
In the past, clinicians and researchers have relied on adult-developed and adult-centered tools and
approaches, which have been “adapted” for use with children by adding pictures and/or simpler
language. There is increasing realization that data from adapted, adult-centered models have has not
adequately captured the voices and/or experiences of children. Engaging in the development of an
assessment tool that is child focused is the best demonstration of understanding. All other options rely
on adaptation of adult-centered tools or focus on standard pain management related interventions.
4. Which theorist is responsible for presenting an alternative theory to those established theories that
focus on how the pediatric patient thinks?
a. Piaget
b. Vygotsky
c. Skinner
d. Bandura
ANS: B
Vygotsky and Siegler both provide pediatric primary care with a new understanding or alternative lens
through which to view children and childhood regarding how they think and process information. The
other options represent traditional theorists: Piaget does focus on how children think while Skinner and
Bandura are concerned with how children’s learning and behavior is affected by experiences.
5. What is the strongest predictor of health regarding the pediatric patient?
a. The early identification of existing health problems
b. Health literacy of the parent(s) and/or caregiver(s)
c. Assess to specialized healthcare professionals
d. Past experience with same of similar health issues
ANS: B
Garzon Maaks: Burns’ Pediatric Primary Care, 7th Edition
MULTIPLE CHOICE :
1. Which region globally has the highest infant mortality rate?
a. Indonesia
b. Southern Asia
c. Sub-Saharan Africa
d. Syria
ANS: B
Although Sub-Saharan Africa and Southern Asia together account for 77% of the infant mortality rate
globally, Southern Asia has the highest infant mortality rate (39%) in the world followed closely by
Sub-Saharan Africa (38%).
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. Which statement correctly reflects 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 stabilized below Health People 2020
goal of 9.4%.
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 at 8.9%.
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.
4. The primary care pediatric nurse practitioner understands that what major child health outcome is
dramatically associated with worldwide climate change?
a. Housing
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.
5. When providing well child care for an infant in the first year of life, the primary care pediatric nurse
practitioner demonstrates an understanding of current guidelines when taking what action?
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.
Chapter 02: Unique Issues in Pediatrics
Garzon Maaks: Burns’ Pediatric Primary Care, 7th Edition
MULTIPLE CHOICE
1. What is the foundational basis of patient-and-family centered care (PFCC)?
a. The family is to be considered when patient care is being planned
b. The patient has ultimate control over health care decisions
c. A family member acts as the patient’s surrogate decision makes
d. The patient is the focus of the primary care provider’s attention
ANS: B
While all options are correct statements, the foundational basis of PFCC is the patient has ultimate
control over health care decisions.
2. Which assessment question best demonstrates the primary care provider’s understanding of effectively
dealing with the greatest challenge to providing dual patient care?
a. To the parent: “Do you feel comfortable providing in-home care for your child?”
b. To the child: “When would you like your physical therapy sessions to be
scheduled?”
, c. To the parent: “What are your feelings about going to family therapy to help with
this transition?”
d. To the child: “When did you first notice the pain in your knees?”
ANS: B
One of the greatest challenges is how to access, acknowledge, and include the child’s voice, which is
often lost and/or overridden in health care. By directly asking the child their opinion or feelings, the
PCP is providing for the child’s voice to be heard and acknowledged. None of the other options
addresses that need.
3. Which intervention best demonstrates a pediatric nurse primary care pediatric nurse practitioner’s
understanding of effective pain assessment?
a. Providing instructions regarding the Faces pain assessment tool to parents of all
newly admitted children
b. Assisting in the development of a child-centered pain assessment scale
c. Reviewing the documentation regarding the child’s pain assessment 30 minutes
after analgesic medication was administered
d. Explaining to both the child and the parents why pain medication will be delivered
intravenously
ANS: B
In the past, clinicians and researchers have relied on adult-developed and adult-centered tools and
approaches, which have been “adapted” for use with children by adding pictures and/or simpler
language. There is increasing realization that data from adapted, adult-centered models have has not
adequately captured the voices and/or experiences of children. Engaging in the development of an
assessment tool that is child focused is the best demonstration of understanding. All other options rely
on adaptation of adult-centered tools or focus on standard pain management related interventions.
4. Which theorist is responsible for presenting an alternative theory to those established theories that
focus on how the pediatric patient thinks?
a. Piaget
b. Vygotsky
c. Skinner
d. Bandura
ANS: B
Vygotsky and Siegler both provide pediatric primary care with a new understanding or alternative lens
through which to view children and childhood regarding how they think and process information. The
other options represent traditional theorists: Piaget does focus on how children think while Skinner and
Bandura are concerned with how children’s learning and behavior is affected by experiences.
5. What is the strongest predictor of health regarding the pediatric patient?
a. The early identification of existing health problems
b. Health literacy of the parent(s) and/or caregiver(s)
c. Assess to specialized healthcare professionals
d. Past experience with same of similar health issues
ANS: B
