PEDIATRIC 09/13/2026
PRIMARY Exam
BURNS' PEDIATRIC PRIMARY CARE 8TH
EDITION TEST BANK 1 Questions and Answers|
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1. The primary care pediatric nurse practitioner is performing a well child exam on an 8-year-old girl
and notes the presence of breast buds. What will the nurse practitioner include when initiating
anticipatory guidance for this patient?
a. A discussion about the risks of pregnancy and sexually transmitted diseases
b. Information about sexual maturity and menstrual periods
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PEDIATRIC 09/13/2026
PRIMARY Exam
c. Material about the human papillomavirus vaccine
d. Sexual orientation and the nature of sexual relationships –
Correct Answer :ANS: B
Since this child is 8 years old, it is early to discuss sexual behavior and reproduction given the level of the
child's cognition and understanding. However, with these early changes in telearche marking the onset of
puberty, it is wise to discuss menstruation in an age-appropriate manner before it occurs so that the child
can be prepared. Since this child is showing signs of early puberty, this information can be included in
anticipatory guidance.
2. The mother of a 3-month-old male infant tells the primary care pediatric nurse practitioner that she
occasionally notices he has a penile erection just after nursing. What will the nurse practitioner tell the
mother?
a. Infants should be prevented from masturbating.
b. The infant is conscious of the pleasure associated with nursing.
c. This is a form of infantile priapism.
d. This is a normal, reflexive behavior at this age. –
Correct Answer :ANS: D
Newborn infants are reflexive beings, and sexual reflexes, which are present prenatally, are easily
stimulated. A penile erection may occur while nursing. Infants explore with their hands and may touch
their own genitalia for pleasure and for the purpose of soothing, and this is normal. A penile erection at
this young age is reflexive and not conscious and intentional. It is not a form of priapism.
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PRIMARY Exam
3. During a well child exam on a 13-year-old female, the primary care pediatric nurse practitioner notes
that the child is at Tanner Stage 3. During the exam, when the nurse practitioner initiates a
conversation about healthy sexuality education, the parent states that this topic is "off limits." What
will the nurse practitioner do?
a. Ask the adolescent whether she wishes to discuss these matters since she is becoming an adult.
b. Separate the parent from the adolescent to discuss the adolescent's concerns in private.
c. Spend private time with the parent to discuss how sexuality education reduces the risk of early
sexual intercourse and risky sexual behaviors.
d. Tell the parent that this information is a routine part of adolescent well child examinations and
must be included. –
Correct Answer :ANS: C
Research has shown that sexuality education leads to a reduction in early onset of sexual intercourse and
risky sexual behaviors. It is important for the PNP to be sensitive to the values of the family but also to
advocate for the child. The child should be told, especially when she shows an interest in sexual
relationships, that she may seek care independently of her parent and that it will remain confidential.
When possible, the parent's wishes should be taken into account and both the adolescent and the parent
should be encouraged to begin an open dialogue about these matters.
4. The primary care pediatric nurse practitioner is counseling the parents of a 13-year-old female who
has Down syndrome about sexual maturation. What will the nurse practitioner tell these parents?
a. It is important to discuss and support healthy sexuality.
b. Providing too much information about sexuality may be confusing given the child's cognitive
level of understanding.
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PRIMARY Exam
c. Suppressing periods with contraceptives will lessen their daughter's distress.
d. They should give her information about periods but not about sexuality.
- Correct Answer :ANS: A
Persons with disabilities have the same desires to make decisions and foster fulfilling relationships with
others as other people have. Unless healthy sexuality is taught and supported, unhealthy and abusive
sexuality is more likely to occur. Parents should give information when it is desired and delivered in a
manner appropriate to the child's level of understanding. Suppressing periods only ignores the issue but
does not change the increased feelings that accompany puberty.
5. During a well child examination of a 6-year-old girl, the primary care pediatric nurse practitioner
notes that the child becomes embarrassed and resists taking off her underwear for the exam. What
should the nurse practitioner infer from this observation?
a. The child has been sexually molested.
b. The child is feeling violated by the examiner.
c. The parent is exhibiting regressive behavior.
d. This is a normal reaction in a child of this age. - Correct Answer :ANS: D
Young school-age children can be extremely modest and embarrassed and resist taking off their clothes
for an examiner. Since this is normal, it does not indicate a history of sexual abuse unless other signs are
present. Older school-age children more commonly feel violated during an exam, not younger children.
This response of increased modesty is age-appropriate and not regressive.
6. The primary care pediatric nurse practitioner is providing anticipatory guidance to the parent of a
school-age boy. The parent expresses concerns that the child prefers to play with dolls, is worried that
the child will be a homosexual, and asks what can be done to prevent this from happening. What will
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