Burns’ Pediatric Primary Care (8th Ed.) — Complete Chapter-
by-Chapter Test Bank: Verified Answers & Detailed Rationales
(New Edition)
Question 1:
A 9-month-old infant arrives for a well-child visit. The family
asks about ways to prevent future dental caries and obesity. The
nurse practitioner counsels on limiting sugary drinks, putting
the infant to bed without a bottle, and introducing varied solids.
Which concept best describes these counseling actions?
A. Primary care
B. Secondary prevention
C. Primary prevention
D. Tertiary prevention
Correct Answer: C
Rationale: Primary prevention aims to prevent disease or injury
before it occurs through risk reduction and health promotion
(e.g., limiting sugars to prevent caries and obesity). Primary care
is the setting or system (A) rather than the prevention level.
Secondary prevention (B) involves early detection and
treatment of asymptomatic disease (e.g., screening for anemia).
Tertiary prevention (D) reduces complications of established
disease (e.g., rehabilitation after stroke).
,Question 2:
A 15-year-old with congenital heart disease is transitioning to
adult cardiology. Which action by the pediatric nurse
practitioner most directly supports a successful transition?
A. Scheduling the last pediatric visit one week before transfer
and sending the chart summary the day after.
B. Teaching the adolescent medication names, indications, and
how to obtain refills, and arranging a joint appointment with
adult cardiology.
C. Reassuring the family that adult providers will automatically
assume care without further coordination.
D. Advising the adolescent to call only if symptoms recur after
transition.
Correct Answer: B
Rationale: Successful transition requires self-management
education (medication knowledge), preparation, and
coordinated handoff (joint appointment) to ensure continuity.
Option A is insufficient and poorly timed (sending summary
after) — handoff needs advance coordination. Option C is
incorrect because assuming automatic transfer is unreliable;
active coordination is required. Option D is passive and places
responsibility solely on the adolescent without preparation.
Question 3:
A 3-year-old with developmental delay is brought for routine
,immunizations. The family discloses difficulty juggling multiple
medical appointments and the parent’s own depression. Which
model best describes the NP’s approach when addressing both
the child’s medical needs and parent’s mental health resources?
A. Disease-centered care
B. Family-centered care
C. Single-generation care
D. Episodic care
Correct Answer: B
Rationale: Family-centered care recognizes the family as central
to the child’s health; addressing parent mental health supports
child outcomes. Disease-centered (A) focuses narrowly on the
illness, not family context. Single-generation care (C) ignores
parental needs; the two-generation or dual-patient approach
explicitly includes parent well-being but the best concise
answer here is family-centered care. Episodic care (D) addresses
discrete problems rather than holistic family needs.
Question 4:
During a visit, a 12-year-old reveals exposure to several adverse
childhood experiences (ACEs). Which statement best reflects
the long-term implications of ACEs?
A. ACEs primarily influence behavior only during childhood and
have no impact on adult health.
B. High ACE exposure increases lifetime risk for chronic physical
and mental health conditions.
, C. ACEs always resolve naturally without intervention if the
child is placed in a new school.
D. ACE scores determine a child’s destiny and cannot be
mitigated.
Correct Answer: B
Rationale: Evidence shows high ACEs increase risk for poor
mental and physical health across the lifespan (e.g., depression,
heart disease). A is false—effects extend into adulthood. C is
incorrect—changing school alone is unlikely to resolve ACE-
related impacts and may need trauma-informed interventions.
D is incorrect and deterministic—while ACEs raise risk,
protective factors and interventions (resilience, services) can
mitigate outcomes.
Question 5:
A primary care clinic is designing services for children and youth
with special healthcare needs (CYSHCN). Which practice most
directly improves access for this population?
A. Requiring families to use only an online patient portal to
request appointments.
B. Offering flexible appointment times, longer visit slots, and
care coordination with specialists.
C. Limiting same-day visits to reduce clinic flow interruptions.
D. Centralizing all care in tertiary hospitals only.
Correct Answer: B
Rationale: CYSHCN benefit from flexible scheduling, extended
by-Chapter Test Bank: Verified Answers & Detailed Rationales
(New Edition)
Question 1:
A 9-month-old infant arrives for a well-child visit. The family
asks about ways to prevent future dental caries and obesity. The
nurse practitioner counsels on limiting sugary drinks, putting
the infant to bed without a bottle, and introducing varied solids.
Which concept best describes these counseling actions?
A. Primary care
B. Secondary prevention
C. Primary prevention
D. Tertiary prevention
Correct Answer: C
Rationale: Primary prevention aims to prevent disease or injury
before it occurs through risk reduction and health promotion
(e.g., limiting sugars to prevent caries and obesity). Primary care
is the setting or system (A) rather than the prevention level.
Secondary prevention (B) involves early detection and
treatment of asymptomatic disease (e.g., screening for anemia).
Tertiary prevention (D) reduces complications of established
disease (e.g., rehabilitation after stroke).
,Question 2:
A 15-year-old with congenital heart disease is transitioning to
adult cardiology. Which action by the pediatric nurse
practitioner most directly supports a successful transition?
A. Scheduling the last pediatric visit one week before transfer
and sending the chart summary the day after.
B. Teaching the adolescent medication names, indications, and
how to obtain refills, and arranging a joint appointment with
adult cardiology.
C. Reassuring the family that adult providers will automatically
assume care without further coordination.
D. Advising the adolescent to call only if symptoms recur after
transition.
Correct Answer: B
Rationale: Successful transition requires self-management
education (medication knowledge), preparation, and
coordinated handoff (joint appointment) to ensure continuity.
Option A is insufficient and poorly timed (sending summary
after) — handoff needs advance coordination. Option C is
incorrect because assuming automatic transfer is unreliable;
active coordination is required. Option D is passive and places
responsibility solely on the adolescent without preparation.
Question 3:
A 3-year-old with developmental delay is brought for routine
,immunizations. The family discloses difficulty juggling multiple
medical appointments and the parent’s own depression. Which
model best describes the NP’s approach when addressing both
the child’s medical needs and parent’s mental health resources?
A. Disease-centered care
B. Family-centered care
C. Single-generation care
D. Episodic care
Correct Answer: B
Rationale: Family-centered care recognizes the family as central
to the child’s health; addressing parent mental health supports
child outcomes. Disease-centered (A) focuses narrowly on the
illness, not family context. Single-generation care (C) ignores
parental needs; the two-generation or dual-patient approach
explicitly includes parent well-being but the best concise
answer here is family-centered care. Episodic care (D) addresses
discrete problems rather than holistic family needs.
Question 4:
During a visit, a 12-year-old reveals exposure to several adverse
childhood experiences (ACEs). Which statement best reflects
the long-term implications of ACEs?
A. ACEs primarily influence behavior only during childhood and
have no impact on adult health.
B. High ACE exposure increases lifetime risk for chronic physical
and mental health conditions.
, C. ACEs always resolve naturally without intervention if the
child is placed in a new school.
D. ACE scores determine a child’s destiny and cannot be
mitigated.
Correct Answer: B
Rationale: Evidence shows high ACEs increase risk for poor
mental and physical health across the lifespan (e.g., depression,
heart disease). A is false—effects extend into adulthood. C is
incorrect—changing school alone is unlikely to resolve ACE-
related impacts and may need trauma-informed interventions.
D is incorrect and deterministic—while ACEs raise risk,
protective factors and interventions (resilience, services) can
mitigate outcomes.
Question 5:
A primary care clinic is designing services for children and youth
with special healthcare needs (CYSHCN). Which practice most
directly improves access for this population?
A. Requiring families to use only an online patient portal to
request appointments.
B. Offering flexible appointment times, longer visit slots, and
care coordination with specialists.
C. Limiting same-day visits to reduce clinic flow interruptions.
D. Centralizing all care in tertiary hospitals only.
Correct Answer: B
Rationale: CYSHCN benefit from flexible scheduling, extended
