Burns’ Pediatric Primary Care (8th Ed.) — Complete Chapter-
by-Chapter Test Bank: Verified Answers & Detailed Rationales
(New Edition)
Chapter 1: Pediatric Primary Care
Chapter 1 – Primary Care versus Primary Prevention
Key concept: immunization as primary prevention
A 2-month-old infant arrives for a well-child visit. The nurse
prepares to give DTaP, IPV, and Hib per schedule and counsels
the parents on safe sleep. Which action best exemplifies
primary prevention?
A. Reviewing newborn metabolic screening results
B. Administering DTaP and IPV immunizations today
C. Referring for early intervention if developmental delay
suspected
D. Ordering a lead level because of home renovation exposure
Correct: B
Rationale (correct): Administering age-appropriate vaccines
prevents disease before it occurs and is the hallmark of primary
prevention in pediatric primary care (well-child visit). This aligns
,with Burns’ discussion of prevention in primary care. Elsevier
Health
Distractors:
A — Newborn screening identifies disease early (secondary
prevention), not primary prevention.
C — Referral after identifying a delay is tertiary/secondary
action (intervention), not prevention.
D — Lead screening is important when risk present (secondary
prevention or targeted screening), not classic primary
prevention.
Teaching Point: Vaccination during well-child visits is
foundational primary prevention.
2) Chapter 1 — Pediatric Primary Care: The Pediatric Medical
Home
Key concept: care coordination for children with special health
care needs (CSHCHN)
A 7-year-old child with cerebral palsy (complex needs, multiple
specialists) is new to your clinic. The family asks what the
primary care provider (PCP) will do to help. The best NP
response is:
A. “We will manage all specialist care ourselves.”
B. “We’ll coordinate a shared plan of care and serve as your
medical home.”
C. “You should continue with specialists; we only do routine
,vaccines.”
D. “We’ll schedule a single yearly visit and otherwise refer to
specialists.”
Correct: B
Rationale (correct): The medical home model emphasizes care
coordination, shared plans, and central PCP responsibility to
integrate specialty care and family priorities for children with
special health care needs. Burns endorses the medical home as
core to primary care for CSHCN. AAP guidance likewise supports
the medical home approach. Elsevier Health+1
Distractors:
A — PCPs do not replace specialists but coordinate care.
C — Limiting care to vaccines ignores coordination and
continuity needs.
D — One annual visit fails to provide ongoing coordination
required for CSHCN.
Teaching Point: The medical home coordinates specialty care
and family-centered plans for CSHCN.
3) Chapter 5 — Pediatric & Family Assessment: Growth
Measurement & Interpretation
Key concept: interpreting significant percentile drop (failure to
thrive vs physiologic variation)
, A 9-month-old presents with weight at the 75th percentile at 6
months and now at the 20th percentile with normal height.
Parents report reduced feeding over the past 6 weeks. What is
the nurse’s first action?
A. Reassure parents that percentiles fluctuate normally
B. Obtain a detailed feeding history and calculate weight-for-age
z-score
C. Order extensive metabolic testing immediately
D. Start high-calorie formula without further assessment
Correct: B
Rationale (correct): A significant, sustained decline in weight
percentile requires immediate assessment — feeding history,
growth chart z-scores, and focused exam — to determine cause
before lab testing or interventions. Burns emphasizes
systematic assessment when growth deviates. Elsevier Health
Distractors:
A — Sudden, sustained drops are not normal and need
assessment.
C — Extensive testing may be premature without targeted
assessment.
D — Empiric feeding changes without assessment risk masking
underlying causes.
Teaching Point: Sudden percentile drops require prompt,
structured feeding and growth assessment.
by-Chapter Test Bank: Verified Answers & Detailed Rationales
(New Edition)
Chapter 1: Pediatric Primary Care
Chapter 1 – Primary Care versus Primary Prevention
Key concept: immunization as primary prevention
A 2-month-old infant arrives for a well-child visit. The nurse
prepares to give DTaP, IPV, and Hib per schedule and counsels
the parents on safe sleep. Which action best exemplifies
primary prevention?
A. Reviewing newborn metabolic screening results
B. Administering DTaP and IPV immunizations today
C. Referring for early intervention if developmental delay
suspected
D. Ordering a lead level because of home renovation exposure
Correct: B
Rationale (correct): Administering age-appropriate vaccines
prevents disease before it occurs and is the hallmark of primary
prevention in pediatric primary care (well-child visit). This aligns
,with Burns’ discussion of prevention in primary care. Elsevier
Health
Distractors:
A — Newborn screening identifies disease early (secondary
prevention), not primary prevention.
C — Referral after identifying a delay is tertiary/secondary
action (intervention), not prevention.
D — Lead screening is important when risk present (secondary
prevention or targeted screening), not classic primary
prevention.
Teaching Point: Vaccination during well-child visits is
foundational primary prevention.
2) Chapter 1 — Pediatric Primary Care: The Pediatric Medical
Home
Key concept: care coordination for children with special health
care needs (CSHCHN)
A 7-year-old child with cerebral palsy (complex needs, multiple
specialists) is new to your clinic. The family asks what the
primary care provider (PCP) will do to help. The best NP
response is:
A. “We will manage all specialist care ourselves.”
B. “We’ll coordinate a shared plan of care and serve as your
medical home.”
C. “You should continue with specialists; we only do routine
,vaccines.”
D. “We’ll schedule a single yearly visit and otherwise refer to
specialists.”
Correct: B
Rationale (correct): The medical home model emphasizes care
coordination, shared plans, and central PCP responsibility to
integrate specialty care and family priorities for children with
special health care needs. Burns endorses the medical home as
core to primary care for CSHCN. AAP guidance likewise supports
the medical home approach. Elsevier Health+1
Distractors:
A — PCPs do not replace specialists but coordinate care.
C — Limiting care to vaccines ignores coordination and
continuity needs.
D — One annual visit fails to provide ongoing coordination
required for CSHCN.
Teaching Point: The medical home coordinates specialty care
and family-centered plans for CSHCN.
3) Chapter 5 — Pediatric & Family Assessment: Growth
Measurement & Interpretation
Key concept: interpreting significant percentile drop (failure to
thrive vs physiologic variation)
, A 9-month-old presents with weight at the 75th percentile at 6
months and now at the 20th percentile with normal height.
Parents report reduced feeding over the past 6 weeks. What is
the nurse’s first action?
A. Reassure parents that percentiles fluctuate normally
B. Obtain a detailed feeding history and calculate weight-for-age
z-score
C. Order extensive metabolic testing immediately
D. Start high-calorie formula without further assessment
Correct: B
Rationale (correct): A significant, sustained decline in weight
percentile requires immediate assessment — feeding history,
growth chart z-scores, and focused exam — to determine cause
before lab testing or interventions. Burns emphasizes
systematic assessment when growth deviates. Elsevier Health
Distractors:
A — Sudden, sustained drops are not normal and need
assessment.
C — Extensive testing may be premature without targeted
assessment.
D — Empiric feeding changes without assessment risk masking
underlying causes.
Teaching Point: Sudden percentile drops require prompt,
structured feeding and growth assessment.
