Burns Pediatric Final Exam Study Guide
2. The primary care pediatric nurse practitioner ANS: C
understands that, to achieve the greatest world-wide Rotavirus is the most common cause of diarrhea globally and Strep pneumonia
reduction in child mortality from pneumonia and diarrhea, is the leading cause of
which intervention is most effective? pneumonia, and together these are the leading infectious causes of childhood
a. Antibiotics morbidity and mortality
b. Optimal nutrition globally. Both are vaccine-preventable diseases. Antibiotics to treat pneumonia,
c. Vaccinations optimal nutrition, and
d. Water purification clean water all help to reduce morbidity and mortality, but vaccination prevents
the diseases from
occurring.
5. The primary care pediatric nurse practitioner is ANS: A
evaluating health literacy in the mother of a new The "newest vital sign," or health literacy, can be determined quickly by asking
preschool-age child. How will the nurse practitioner the parent how many
assess this? children's books are in the home. Greater than 10 books in the home is an
a. Ask the child how many books he has at home. independent positive predictor
b. Ask the mother about her highest grade in school. of adequate parent health literacy. The other questions may determine a specific
c. Ask the mother to determine the correct dose of a drug level of literacy in
from a label. general but are not as efficient.
d. Ask the mother to read a health information handout
aloud.
12. The primary care pediatric nurse practitioner is ANS: A
performing a well child assessment on an adolescent The CRAFFT tool is a six-question tool used to screen for adolescent substance
and is concerned about possible alcohol and tobacco abuse. The HEEADSSS
use. Which assessment tool will the nurse is used as a psychosocial screening tool. The PHQ-2 is a rapid screen for
practitioner use? depression. The RAAPS is used
a. CRAFFT to assess risk behaviors that contribute to most morbidity, mortality, and social
b. HEEADSSS problems in teens.
c. PHQ-2
d. RAAPS
9. The primary care pediatric nurse practitioner ANS: A
prescribes a twice daily inhaled corticosteroid for a 12- In a client-centered relationship, there is reciprocal communication and
year-old child. At a well child visit, the child reports not understanding. The PNP should
using the medication on a regular basis. be able to understand the client's perspective and unique situation. The first step
Which response by the pediatric nurse practitioner is to evaluate possible
demonstrates an understanding of client-centered reasons for nonadherence and not to make referrals or re-educate until potential
care? barriers have been
a. Asking the child to describe usual daily routines and identified and negotiation with the client has occurred.
schedules
b. Referring the family to a social worker to help with
medication compliance
c. Reviewing the asthma action plan with the parent and
the child
d. Teaching the child how the medication will help to
control asthma symptoms
8. The primary care pediatric nurse practitioner performs ANS: D
a physical examination on a 9-month-old infant The American Academy of Pediatric Dentistry recommends a first dental
and notes two central incisors on the lower gums. The examination at the time of
parent states that the infant nurses, takes solid eruption of the first tooth and no later than 12 months old. Parents should be
foods three times daily, and occasionally takes water counseled to clean the
from a cup. What will the pediatric nurse infant's teeth but with water only. Weaning from breastfeeding is not indicated,
practitioner counsel the parent to promote optimum although mothers should
dental health? not let the infant nurse while sleeping to prevent milk from bathing the teeth.
a. To begin brushing the infant's teeth with toothpaste Fluoride supplements
b. To consider weaning the infant from breastfeeding should not be discontinued.
c. To discontinue giving fluoride supplements
d. To make an appointment for an initial dental
examination
2. The parent of a newborn infant asks the primary care ANS: C
pediatric nurse practitioner when to intervene to General learning and acquisition of skills for later reading and writing begin at
help the infant's future intellectual growth. What will the birth, not in kindergarten
nurse practitioner tell the parent? or first grade, and these skills grow with everyday loving interactions between
a. Cognitive learning begins during the toddler years. infants and caregivers.
b. Intellectual growth begin when speech develops. Cognitive learning changes during toddler years but begins at birth. Intellectual
c. Language and literacy skills begin at birth. growth is not tied to
d. Preschool is an optimal time to begin general learning. speech alone.
, Burns Pediatric Final Exam Study Guide
3. During an assessment of a 4-week-old infant, the ANS: A
primary care pediatric nurse practitioner learns that a Infants who are encouraged to breastfeed every 2 to 3 hours may have one
breastfed infant nurses every 2 hours during the day but longer stretch of 4 hours at
is able to sleep for a 4-hour period during the night. This infant is gaining between 0.5 and 1 gram per day, which is
night. The infant has gained 20 grams per day in the appropriate. It is not necessary to
interval since last seen in the clinic. What will the alter the pattern of nursing or to supplement with formula.
nurse practitioner recommend?
a. Continuing to nurse the infant using the current pattern
b. Nursing the infant for longer periods every 4 hours
c. Supplementing with formula at the last nighttime
feeding
d. Waking the infant every 2 hours to nurse during the
night
1. 5. The parent of a 24-month-old child asks the primary ANS: C
care pediatric nurse To assess the parent's understanding of toilet readiness, the nurse practitioner
practitioner when toilet training should begin. How will will ask the
the pediatric nurse practitioner parents about the child's daily habits and routines to see if the child has
respond? predictable patterns
a. a. "Begin by reading to your child about toileting." that can be the basis for toilet training. While providing storybooks about toileting
b. b. "Most children are capable by age 2 years." can help
c. c. "Tell me about your child's daily habits." children learn, the first step is to assess toilet readiness. Even though many
d. d. "We should assess your child's motor skills." children are
capable at this age, evaluating personal readiness is key to beginning toilet
training.
Assessment of motor skills may be a second step.
1. 8. During a well child assessment of an 18-month-old ANS: D
child, the primary care Syntax, or the structure of words in sentences or phrases, is developed in stages
pediatric nurse practitioner observes the child point to a between the
picture of a dog and say, "Want ages of 8 months and 3.5 years. Telegraphic speech begins at about 18 months
puppy!" The nurse practitioner recognizes this as an of age when
example of children speak in phrases with many words omitted, so that the sentence sounds
a. a. holophrastic speech. like a
b. b. receptive speech. telegram. Holophrastic speech is the use of a single word to express a complete
c. c. semantic speech. idea.
d. d. telegraphic speech. Receptive speech refers to the ability to understand a word without necessarily
being able to
use the word. Semantics is the understanding that words have specific
meanings.
1. 10. The mother of a 3-year-old child takes the child to ANS: C
a play group once a week. Parallel play is common among toddlers who, although they may be fascinated
She expresses concern that the child plays with toys but by other
does not interact with the other children, generally do not engage with peers in an interactive manner. This does
toddlers. What will the primary care pediatric nurse not mean that
practitioner counsel the mother? the child is shy or has a language delay, although in preschool years, the
a. a. The child probably is very shy but will outgrow this development of
tendency with repeated symbolic language increases interactive play. Children need both structured and
exposure to other children. free play, but
b. b. The toddler may have a language delay that structured play will not increase interaction during this normally parallel period.
interferes with socialization with
other children.
c. c. Toddlers may be interested in other children but
usually do not engage in
interactive play.
d. d. Toddlers need more structured play to encourage
interaction and socialization
with others.
3. A school-age child has begun refusing all cooked ANS: B
vegetables. What will the primary care pediatric Children have food jags that are generally self-limited. The parent's responsibility
nurse practitioner recommend to the parent? is to provide three
a. Allow the child to make food choices since this is nutritious meals and two nutritious snacks each day so that all available choices
usually a phase are acceptable. Allowing
b. Ensure that the child has three nutritious meals and food choices may result in an overabundance of non-nutritious foods selected. It
two nutritious snacks each day is not necessary to
c. Prepare vegetables separately for the child to prepare separate dishes for a child who is going through a temporary phase.
encourage adequate intake Teaching the child about
d. Teach the child how important it is to eat healthy fruits nutrition is important but will not likely have much impact during this phase.
and vegetables
, Burns Pediatric Final Exam Study Guide
4. The parent of a 6-year-old child expresses concern ANS: C
that the child may have ADHD. Which screening The Conner's Parent and Teacher Rating Scale is used to assess ADHD
tool will the primary care pediatric nurse practitioner use symptoms in children aged 6 to
to evaluate this possibility? 18 years. The BESS-2 is used to evaluate social emotional and mental health in
a. Behavioral and Emotional Screening System for children. The BASC-2 is
Children (BESS-2) used to further assess children who have positive findings on the BESS-2. The
b. Behavioral Assessment for Children - 2nd ed. (BASC- PSC is used to assess
2) cognitive, emotional, and behavioral problems in children.
c. Conner's 3 Parent and Teacher Rating Scale
d. Pediatric Symptom Checklist (PSC)
4. The primary care pediatric nurse practitioner is ANS: B
performing a well child assessment on a 13-year-old Thelarche, or the development of breast budding, generally precedes menarche
female whose mother asks when her daughter's periods by 2.5 years, so this
may start. Which information will the nurse should be determined when attempting to predict this milestone. The age of the
practitioner use to help estimate the onset of periods? mother at menarche is not
a. The age of the mother's menarche a reliable indicator. Adrenarche is related to adrenal and not gonadal
b. The patient's age at thelarche development and is less valid than
c. When adrenarche occurred other secondary sex characteristics in assessing sexual maturation. Rapid linear
d. Whether linear growth has stopped growth usually begins
after thelarche and peaks about a year later but is not used to predict menarche.
9. The primary care pediatric nurse practitioner is ANS: B
working with a 12-year-old female who has poor When adherence is a concern, the PNP should work with the family or the child
diabetes control. The child tells the nurse practitioner to develop intervention
that the parent forgets to remind her to check strategies appropriate to the skills, needs, and desires of the parents and
her blood sugars. Which action is correct? children. A 12-year-old child is
a. Assess the parent's knowledge about diabetes old enough to take responsibility for checking blood glucose, so the PNP can
management. work with her. The other
b. Help the child develop a strategy to remember without options may be used if the situation does not improve.
parental prompts.
c. Refer to a social worker to help the family overcome
obstacles to care.
d. Remind the child's parent about the importance of
good diabetes control.
12. The primary care pediatric nurse practitioner is ANS: C
counseling a school-age child about asthma In the health belief model, clients need to believe that taking some action will
management strategies. The child states that it is "too reduce the risk of
much trouble" to remember to use an inhaled symptoms and that the benefits of the action will outweigh the costs or effort.
corticosteroid medication twice daily and reports feeling Demonstrating pre- and
fine, in spite of exhibiting expiratory post-treatment spirometry measures can help the child see that symptoms are
wheezes. Which action uses the health belief and self- reversible. Asking the child
efficacy model to teach this child about asthma to make one change may be part of the transtheoretical model, in which small
management? behavior changes may
a. Asking the child to try to use the inhaler at least once precede commitment to the actual plan. Discussing athletics may be useful when
daily using the health
b. Discussing whether the child wants to participate in promotion model to encourage the client to participate in behaviors that will
athletics promote healthy activities,
c. Obtaining pre- and post-treatment spirometry testing such as sports. Providing written information is not part of any of the health
d. Providing written information about inhaled behavior models.
corticosteroids
1. 2. The mother of a 2-month-old infant tells the primary ANS: D
care pediatric nurse Infants have growth spurts about every 3 to 4 weeks that increase their breast
practitioner that she is afraid her breast milk is "drying milk needs. Until
up" because her baby never seems the mother's milk supply catches up, the infant will act hungry and want to nurse
satisfied and wants to nurse all the time. Which action is more
correct? frequently. The PNP should evaluate for this growth spurt and then instruct the
a. a. Recommend pumping her breasts after feedings. mother to feed
b. b. Refer the mother to a lactation consultant. her baby more often to increase her milk supply. Since the infant is hungry, the
c. c. Suggest supplementation with formula. infant should
d. d. Weigh the infant to assess for a growth spurt. nurse. It is not necessary to refer for a lactation consultation or to supplement
with formula.
1. 5. The primary care pediatric nurse practitioner sees a ANS: D
3-day-old nursing infant Infants with galactosemia cannot consume galactose, which is in both cow's milk
whose newborn metabolic screen is positive for and breast
galactosemia. The nurse practitioner refers milk. Since there is a potential for a life-threatening response, the mother should
the newborn to a specialist for immediate evaluation and be instructed to
will tell the mother stop nursing immediately.
a. a. to continue to breastfeed her infant.
b. b. to give the infant a cow's milk formula.
c. c. to supplement breast milk with formula.
d. d. to stop breastfeeding immediately.
2. The primary care pediatric nurse practitioner ANS: C
understands that, to achieve the greatest world-wide Rotavirus is the most common cause of diarrhea globally and Strep pneumonia
reduction in child mortality from pneumonia and diarrhea, is the leading cause of
which intervention is most effective? pneumonia, and together these are the leading infectious causes of childhood
a. Antibiotics morbidity and mortality
b. Optimal nutrition globally. Both are vaccine-preventable diseases. Antibiotics to treat pneumonia,
c. Vaccinations optimal nutrition, and
d. Water purification clean water all help to reduce morbidity and mortality, but vaccination prevents
the diseases from
occurring.
5. The primary care pediatric nurse practitioner is ANS: A
evaluating health literacy in the mother of a new The "newest vital sign," or health literacy, can be determined quickly by asking
preschool-age child. How will the nurse practitioner the parent how many
assess this? children's books are in the home. Greater than 10 books in the home is an
a. Ask the child how many books he has at home. independent positive predictor
b. Ask the mother about her highest grade in school. of adequate parent health literacy. The other questions may determine a specific
c. Ask the mother to determine the correct dose of a drug level of literacy in
from a label. general but are not as efficient.
d. Ask the mother to read a health information handout
aloud.
12. The primary care pediatric nurse practitioner is ANS: A
performing a well child assessment on an adolescent The CRAFFT tool is a six-question tool used to screen for adolescent substance
and is concerned about possible alcohol and tobacco abuse. The HEEADSSS
use. Which assessment tool will the nurse is used as a psychosocial screening tool. The PHQ-2 is a rapid screen for
practitioner use? depression. The RAAPS is used
a. CRAFFT to assess risk behaviors that contribute to most morbidity, mortality, and social
b. HEEADSSS problems in teens.
c. PHQ-2
d. RAAPS
9. The primary care pediatric nurse practitioner ANS: A
prescribes a twice daily inhaled corticosteroid for a 12- In a client-centered relationship, there is reciprocal communication and
year-old child. At a well child visit, the child reports not understanding. The PNP should
using the medication on a regular basis. be able to understand the client's perspective and unique situation. The first step
Which response by the pediatric nurse practitioner is to evaluate possible
demonstrates an understanding of client-centered reasons for nonadherence and not to make referrals or re-educate until potential
care? barriers have been
a. Asking the child to describe usual daily routines and identified and negotiation with the client has occurred.
schedules
b. Referring the family to a social worker to help with
medication compliance
c. Reviewing the asthma action plan with the parent and
the child
d. Teaching the child how the medication will help to
control asthma symptoms
8. The primary care pediatric nurse practitioner performs ANS: D
a physical examination on a 9-month-old infant The American Academy of Pediatric Dentistry recommends a first dental
and notes two central incisors on the lower gums. The examination at the time of
parent states that the infant nurses, takes solid eruption of the first tooth and no later than 12 months old. Parents should be
foods three times daily, and occasionally takes water counseled to clean the
from a cup. What will the pediatric nurse infant's teeth but with water only. Weaning from breastfeeding is not indicated,
practitioner counsel the parent to promote optimum although mothers should
dental health? not let the infant nurse while sleeping to prevent milk from bathing the teeth.
a. To begin brushing the infant's teeth with toothpaste Fluoride supplements
b. To consider weaning the infant from breastfeeding should not be discontinued.
c. To discontinue giving fluoride supplements
d. To make an appointment for an initial dental
examination
2. The parent of a newborn infant asks the primary care ANS: C
pediatric nurse practitioner when to intervene to General learning and acquisition of skills for later reading and writing begin at
help the infant's future intellectual growth. What will the birth, not in kindergarten
nurse practitioner tell the parent? or first grade, and these skills grow with everyday loving interactions between
a. Cognitive learning begins during the toddler years. infants and caregivers.
b. Intellectual growth begin when speech develops. Cognitive learning changes during toddler years but begins at birth. Intellectual
c. Language and literacy skills begin at birth. growth is not tied to
d. Preschool is an optimal time to begin general learning. speech alone.
, Burns Pediatric Final Exam Study Guide
3. During an assessment of a 4-week-old infant, the ANS: A
primary care pediatric nurse practitioner learns that a Infants who are encouraged to breastfeed every 2 to 3 hours may have one
breastfed infant nurses every 2 hours during the day but longer stretch of 4 hours at
is able to sleep for a 4-hour period during the night. This infant is gaining between 0.5 and 1 gram per day, which is
night. The infant has gained 20 grams per day in the appropriate. It is not necessary to
interval since last seen in the clinic. What will the alter the pattern of nursing or to supplement with formula.
nurse practitioner recommend?
a. Continuing to nurse the infant using the current pattern
b. Nursing the infant for longer periods every 4 hours
c. Supplementing with formula at the last nighttime
feeding
d. Waking the infant every 2 hours to nurse during the
night
1. 5. The parent of a 24-month-old child asks the primary ANS: C
care pediatric nurse To assess the parent's understanding of toilet readiness, the nurse practitioner
practitioner when toilet training should begin. How will will ask the
the pediatric nurse practitioner parents about the child's daily habits and routines to see if the child has
respond? predictable patterns
a. a. "Begin by reading to your child about toileting." that can be the basis for toilet training. While providing storybooks about toileting
b. b. "Most children are capable by age 2 years." can help
c. c. "Tell me about your child's daily habits." children learn, the first step is to assess toilet readiness. Even though many
d. d. "We should assess your child's motor skills." children are
capable at this age, evaluating personal readiness is key to beginning toilet
training.
Assessment of motor skills may be a second step.
1. 8. During a well child assessment of an 18-month-old ANS: D
child, the primary care Syntax, or the structure of words in sentences or phrases, is developed in stages
pediatric nurse practitioner observes the child point to a between the
picture of a dog and say, "Want ages of 8 months and 3.5 years. Telegraphic speech begins at about 18 months
puppy!" The nurse practitioner recognizes this as an of age when
example of children speak in phrases with many words omitted, so that the sentence sounds
a. a. holophrastic speech. like a
b. b. receptive speech. telegram. Holophrastic speech is the use of a single word to express a complete
c. c. semantic speech. idea.
d. d. telegraphic speech. Receptive speech refers to the ability to understand a word without necessarily
being able to
use the word. Semantics is the understanding that words have specific
meanings.
1. 10. The mother of a 3-year-old child takes the child to ANS: C
a play group once a week. Parallel play is common among toddlers who, although they may be fascinated
She expresses concern that the child plays with toys but by other
does not interact with the other children, generally do not engage with peers in an interactive manner. This does
toddlers. What will the primary care pediatric nurse not mean that
practitioner counsel the mother? the child is shy or has a language delay, although in preschool years, the
a. a. The child probably is very shy but will outgrow this development of
tendency with repeated symbolic language increases interactive play. Children need both structured and
exposure to other children. free play, but
b. b. The toddler may have a language delay that structured play will not increase interaction during this normally parallel period.
interferes with socialization with
other children.
c. c. Toddlers may be interested in other children but
usually do not engage in
interactive play.
d. d. Toddlers need more structured play to encourage
interaction and socialization
with others.
3. A school-age child has begun refusing all cooked ANS: B
vegetables. What will the primary care pediatric Children have food jags that are generally self-limited. The parent's responsibility
nurse practitioner recommend to the parent? is to provide three
a. Allow the child to make food choices since this is nutritious meals and two nutritious snacks each day so that all available choices
usually a phase are acceptable. Allowing
b. Ensure that the child has three nutritious meals and food choices may result in an overabundance of non-nutritious foods selected. It
two nutritious snacks each day is not necessary to
c. Prepare vegetables separately for the child to prepare separate dishes for a child who is going through a temporary phase.
encourage adequate intake Teaching the child about
d. Teach the child how important it is to eat healthy fruits nutrition is important but will not likely have much impact during this phase.
and vegetables
, Burns Pediatric Final Exam Study Guide
4. The parent of a 6-year-old child expresses concern ANS: C
that the child may have ADHD. Which screening The Conner's Parent and Teacher Rating Scale is used to assess ADHD
tool will the primary care pediatric nurse practitioner use symptoms in children aged 6 to
to evaluate this possibility? 18 years. The BESS-2 is used to evaluate social emotional and mental health in
a. Behavioral and Emotional Screening System for children. The BASC-2 is
Children (BESS-2) used to further assess children who have positive findings on the BESS-2. The
b. Behavioral Assessment for Children - 2nd ed. (BASC- PSC is used to assess
2) cognitive, emotional, and behavioral problems in children.
c. Conner's 3 Parent and Teacher Rating Scale
d. Pediatric Symptom Checklist (PSC)
4. The primary care pediatric nurse practitioner is ANS: B
performing a well child assessment on a 13-year-old Thelarche, or the development of breast budding, generally precedes menarche
female whose mother asks when her daughter's periods by 2.5 years, so this
may start. Which information will the nurse should be determined when attempting to predict this milestone. The age of the
practitioner use to help estimate the onset of periods? mother at menarche is not
a. The age of the mother's menarche a reliable indicator. Adrenarche is related to adrenal and not gonadal
b. The patient's age at thelarche development and is less valid than
c. When adrenarche occurred other secondary sex characteristics in assessing sexual maturation. Rapid linear
d. Whether linear growth has stopped growth usually begins
after thelarche and peaks about a year later but is not used to predict menarche.
9. The primary care pediatric nurse practitioner is ANS: B
working with a 12-year-old female who has poor When adherence is a concern, the PNP should work with the family or the child
diabetes control. The child tells the nurse practitioner to develop intervention
that the parent forgets to remind her to check strategies appropriate to the skills, needs, and desires of the parents and
her blood sugars. Which action is correct? children. A 12-year-old child is
a. Assess the parent's knowledge about diabetes old enough to take responsibility for checking blood glucose, so the PNP can
management. work with her. The other
b. Help the child develop a strategy to remember without options may be used if the situation does not improve.
parental prompts.
c. Refer to a social worker to help the family overcome
obstacles to care.
d. Remind the child's parent about the importance of
good diabetes control.
12. The primary care pediatric nurse practitioner is ANS: C
counseling a school-age child about asthma In the health belief model, clients need to believe that taking some action will
management strategies. The child states that it is "too reduce the risk of
much trouble" to remember to use an inhaled symptoms and that the benefits of the action will outweigh the costs or effort.
corticosteroid medication twice daily and reports feeling Demonstrating pre- and
fine, in spite of exhibiting expiratory post-treatment spirometry measures can help the child see that symptoms are
wheezes. Which action uses the health belief and self- reversible. Asking the child
efficacy model to teach this child about asthma to make one change may be part of the transtheoretical model, in which small
management? behavior changes may
a. Asking the child to try to use the inhaler at least once precede commitment to the actual plan. Discussing athletics may be useful when
daily using the health
b. Discussing whether the child wants to participate in promotion model to encourage the client to participate in behaviors that will
athletics promote healthy activities,
c. Obtaining pre- and post-treatment spirometry testing such as sports. Providing written information is not part of any of the health
d. Providing written information about inhaled behavior models.
corticosteroids
1. 2. The mother of a 2-month-old infant tells the primary ANS: D
care pediatric nurse Infants have growth spurts about every 3 to 4 weeks that increase their breast
practitioner that she is afraid her breast milk is "drying milk needs. Until
up" because her baby never seems the mother's milk supply catches up, the infant will act hungry and want to nurse
satisfied and wants to nurse all the time. Which action is more
correct? frequently. The PNP should evaluate for this growth spurt and then instruct the
a. a. Recommend pumping her breasts after feedings. mother to feed
b. b. Refer the mother to a lactation consultant. her baby more often to increase her milk supply. Since the infant is hungry, the
c. c. Suggest supplementation with formula. infant should
d. d. Weigh the infant to assess for a growth spurt. nurse. It is not necessary to refer for a lactation consultation or to supplement
with formula.
1. 5. The primary care pediatric nurse practitioner sees a ANS: D
3-day-old nursing infant Infants with galactosemia cannot consume galactose, which is in both cow's milk
whose newborn metabolic screen is positive for and breast
galactosemia. The nurse practitioner refers milk. Since there is a potential for a life-threatening response, the mother should
the newborn to a specialist for immediate evaluation and be instructed to
will tell the mother stop nursing immediately.
a. a. to continue to breastfeed her infant.
b. b. to give the infant a cow's milk formula.
c. c. to supplement breast milk with formula.
d. d. to stop breastfeeding immediately.
