Prevention
Stem: A 3-year-old child presents for a well-child visit. The
nurse-practitioner explains the visit includes anticipatory
guidance, immunizations, and developmental screening. Which
statement best illustrates primary prevention in pediatric
primary care?
A. Diagnosing language delay and arranging speech therapy.
B. Administering age-appropriate immunizations during the
visit.
C. Referring a child with recurrent wheeze for pulmonary
function testing.
D. Treating otitis media with antibiotics.
Correct answer: B
Rationale — Correct: Administering immunizations prevents
disease occurrence and is a classic primary prevention activity
in pediatric primary care (Burns, Ch. 1 — Primary care vs
prevention). Immunizations reduce population and individual
disease risk. (Elsevier Shop)
Rationales — Incorrect:
A. Diagnosing/treating language delay is secondary/tertiary
(early detection and intervention), not primary prevention.
C. Pulmonary function testing is diagnostic evaluation —
secondary/tertiary care focus.
,D. Treating otitis media is clinical management of existing
disease (tertiary/secondary), not prevention.
Teaching Point: Primary prevention prevents disease before it
starts (e.g., immunizations, safety counseling).
Question 2
Chapter 1 – Pediatric Primary Care, Unique Issues in Pediatrics
Stem: When communicating with parents during a newborn
visit, which approach best addresses unique pediatric
communication needs?
A. Use medical jargon to appear authoritative.
B. Provide brief, developmentally appropriate teaching and
written handouts.
C. Offer all information at once to ensure completeness.
D. Delay parental education until the child is older.
Correct answer: B
Rationale — Correct: Pediatric primary care requires clear,
concise, developmentally appropriate teaching directed at
caregivers; written materials reinforce verbal instruction (Burns,
Ch. 1 — Communication & family-centered care). Effective
teaching supports adherence and safety. (Elsevier Shop)
Rationales — Incorrect:
A. Medical jargon hinders understanding and trust.
C. Overloading parents with information reduces retention and
increases anxiety.
, D. Delaying education misses critical prevention opportunities
in infancy.
Teaching Point: Use clear, brief, caregiver-focused education
plus written resources.
Question 3
Chapter 1 – Caring for Children & Youth With Special Healthcare
Needs (CSHCN)
Stem: A 7-year-old child with cerebral palsy (complex care
needs) requires immunization and medication reconciliation.
Which is the priority nursing action in primary care for CSHCN?
A. Schedule future appointments only when acute problems
arise.
B. Conduct a coordinated care plan and involve the family in
goal setting.
C. Defer preventive care until a specialist visit is completed.
D. Rely solely on caregiver memory for the medication list.
Correct answer: B
Rationale — Correct: CSHCN require coordinated, family-
centered care plans in primary care, addressing anticipatory
guidance, medication reconciliation, and coordination with
specialists (Burns, Ch. 1 — Caring for CSHCN). Active family
involvement improves outcomes. (Elsevier Shop)
Rationales — Incorrect:
A. Reactive scheduling misses preventive opportunities and