Burns’ Pediatric Primary Care (8th Ed.) — Complete Chapter-
by-Chapter Test Bank: Verified Answers & Detailed Rationales
(New Edition)
1.
Reference: Ch. 10, Section: Developmental Management
Question Stem:
A 4-year-old child is brought to the clinic for a well-child visit.
The parent is concerned because the child consistently draws
people as a head with legs, without a torso. Which
interpretation of this finding is most accurate for the child's
developmental stage?
Options:
A. It is a possible indicator of a visual-motor integration deficit.
B. It is a typical representation for a preschool-aged child.
C. It suggests a lack of fine motor skill opportunity at home.
D. It is a red flag for cognitive developmental delay.
Correct Answer: B
Rationales:
• Correct: During the preschool years (3-5 years), children's
drawings progress from scribbles to more recognizable
forms. A "tadpole" person, consisting of a head and legs, is
, a typical and expected developmental milestone for a 4-
year-old.
• Incorrect A: A visual-motor deficit would present with
much more significant impairments and is not diagnosed
based on a single, age-typical drawing characteristic.
• Incorrect C: While exposure to drawing materials
influences skill, the "tadpole" figure is a universal stage in
graphic development, not primarily a reflection of
opportunity.
• Incorrect D: This is a normal finding and is not a red flag
for cognitive delay.
Teaching Point: The "tadpole" person is a normal
developmental stage in preschool art.
2.
Reference: Ch. 27, Section: Otitis Media
Question Stem:
A 22-month-old, otherwise healthy child presents with a
temperature of 101.5°F (38.6°C) and mild irritability for 24
hours. Otoscopic examination reveals a bulging, red, immobile
tympanic membrane. The child has no known drug allergies.
What is the most appropriate initial management?
Options:
A. Prescribe amoxicillin 80-90 mg/kg/day in two divided doses
,for 10 days.
B. Recommend watchful waiting with ibuprofen for 48-72 hours
and schedule a follow-up.
C. Prescribe amoxicillin-clavulanate 90 mg/kg/day for 10 days
due to high treatment failure risk.
D. Administer a single dose of intramuscular ceftriaxone and re-
evaluate in 24 hours.
Correct Answer: A
Rationales:
• Correct: For children 6 months and older with severe
symptoms (fever ≥102.2°F / 39°C or otalgia) OR non-severe
bilateral AOM in children <24 months, antibiotic treatment
is recommended. Amoxicillin (80-90 mg/kg/day) is the
first-line agent for uncomplicated AOM.
• Incorrect B: Watchful waiting is an option for non-severe,
unilateral AOM in children 6-23 months, but this child has
a fever and is under 2 years old with a confirmed bulging
TM, indicating AOM, warranting antibiotics.
• Incorrect C: Amoxicillin-clavulanate is reserved for cases of
treatment failure, recent amoxicillin use, or concurrent
purulent conjunctivitis.
• Incorrect D: IM ceftriaxone is a second-line option for
children who cannot tolerate oral medications or have
failed initial therapy.
, Teaching Point: High-dose amoxicillin remains first-line for
uncomplicated AOM meeting criteria for treatment.
3.
Reference: Ch. 12, Section: Pediatric Hypertension
Management
Question Stem:
During a well-child visit for a 12-year-old, you obtain a blood
pressure reading that is at the 95th percentile for age, gender,
and height. The reading is confirmed on two subsequent
occasions. The physical exam is unremarkable. What is the most
appropriate next step in the evaluation of this newly diagnosed
hypertension?
Options:
A. Initiate a trial of lifestyle modification and recheck in 6
months.
B. Order a renal ultrasound and an echocardiogram.
C. Prescribe a low-dose ACE inhibitor and schedule a follow-up
in 1 month.
D. Refer immediately to a pediatric cardiologist for
management.
Correct Answer: B
Rationales:
• Correct: For a child with confirmed primary hypertension,
the initial evaluation should focus on identifying target
by-Chapter Test Bank: Verified Answers & Detailed Rationales
(New Edition)
1.
Reference: Ch. 10, Section: Developmental Management
Question Stem:
A 4-year-old child is brought to the clinic for a well-child visit.
The parent is concerned because the child consistently draws
people as a head with legs, without a torso. Which
interpretation of this finding is most accurate for the child's
developmental stage?
Options:
A. It is a possible indicator of a visual-motor integration deficit.
B. It is a typical representation for a preschool-aged child.
C. It suggests a lack of fine motor skill opportunity at home.
D. It is a red flag for cognitive developmental delay.
Correct Answer: B
Rationales:
• Correct: During the preschool years (3-5 years), children's
drawings progress from scribbles to more recognizable
forms. A "tadpole" person, consisting of a head and legs, is
, a typical and expected developmental milestone for a 4-
year-old.
• Incorrect A: A visual-motor deficit would present with
much more significant impairments and is not diagnosed
based on a single, age-typical drawing characteristic.
• Incorrect C: While exposure to drawing materials
influences skill, the "tadpole" figure is a universal stage in
graphic development, not primarily a reflection of
opportunity.
• Incorrect D: This is a normal finding and is not a red flag
for cognitive delay.
Teaching Point: The "tadpole" person is a normal
developmental stage in preschool art.
2.
Reference: Ch. 27, Section: Otitis Media
Question Stem:
A 22-month-old, otherwise healthy child presents with a
temperature of 101.5°F (38.6°C) and mild irritability for 24
hours. Otoscopic examination reveals a bulging, red, immobile
tympanic membrane. The child has no known drug allergies.
What is the most appropriate initial management?
Options:
A. Prescribe amoxicillin 80-90 mg/kg/day in two divided doses
,for 10 days.
B. Recommend watchful waiting with ibuprofen for 48-72 hours
and schedule a follow-up.
C. Prescribe amoxicillin-clavulanate 90 mg/kg/day for 10 days
due to high treatment failure risk.
D. Administer a single dose of intramuscular ceftriaxone and re-
evaluate in 24 hours.
Correct Answer: A
Rationales:
• Correct: For children 6 months and older with severe
symptoms (fever ≥102.2°F / 39°C or otalgia) OR non-severe
bilateral AOM in children <24 months, antibiotic treatment
is recommended. Amoxicillin (80-90 mg/kg/day) is the
first-line agent for uncomplicated AOM.
• Incorrect B: Watchful waiting is an option for non-severe,
unilateral AOM in children 6-23 months, but this child has
a fever and is under 2 years old with a confirmed bulging
TM, indicating AOM, warranting antibiotics.
• Incorrect C: Amoxicillin-clavulanate is reserved for cases of
treatment failure, recent amoxicillin use, or concurrent
purulent conjunctivitis.
• Incorrect D: IM ceftriaxone is a second-line option for
children who cannot tolerate oral medications or have
failed initial therapy.
, Teaching Point: High-dose amoxicillin remains first-line for
uncomplicated AOM meeting criteria for treatment.
3.
Reference: Ch. 12, Section: Pediatric Hypertension
Management
Question Stem:
During a well-child visit for a 12-year-old, you obtain a blood
pressure reading that is at the 95th percentile for age, gender,
and height. The reading is confirmed on two subsequent
occasions. The physical exam is unremarkable. What is the most
appropriate next step in the evaluation of this newly diagnosed
hypertension?
Options:
A. Initiate a trial of lifestyle modification and recheck in 6
months.
B. Order a renal ultrasound and an echocardiogram.
C. Prescribe a low-dose ACE inhibitor and schedule a follow-up
in 1 month.
D. Refer immediately to a pediatric cardiologist for
management.
Correct Answer: B
Rationales:
• Correct: For a child with confirmed primary hypertension,
the initial evaluation should focus on identifying target
