Burns’ Pediatric Primary Care (8th Ed.) — Complete Chapter-
by-Chapter Test Bank: Verified Answers & Detailed Rationales
(New Edition)
Question 1:
A 3-year-old is brought for a well-child visit. The mother asks
whether immunizations are part of primary prevention or
primary care. Which is the best nursing response that
distinguishes these concepts?
A. “Immunizations are primary care because they are given
during office visits.”
B. “Immunizations are primary prevention because they prevent
disease before it occurs.”
C. “Immunizations are secondary prevention because they
reduce disease severity.”
D. “Immunizations are tertiary prevention because they prevent
complications.”
Correct Answer: B
Rationale: Immunizations are classic primary prevention —
interventions done to prevent initial occurrence of disease (e.g.,
vaccines preventing infections).
Why others are incorrect:
A — While immunizations often occur in primary care settings,
the term “primary care” denotes the setting/role, not the
prevention level. The question asks to distinguish conceptually.
,C — Secondary prevention involves early detection and
treatment to limit progression (e.g., screening). Vaccines do not
detect disease.
D — Tertiary prevention focuses on reducing
disability/complications after disease onset (e.g.,
rehabilitation); vaccines prevent occurrence, not complications.
Question 2:
A NP sees a mother and her newborn for a postpartum visit.
The mother expresses anxiety about her own depression
affecting the baby’s development. Using a two-generation
approach, what is the NP’s best next step?
A. Focus solely on baby’s well-child needs and schedule a
pediatric follow-up.
B. Screen the mother for postpartum depression and
coordinate maternal mental-health referral while addressing
infant care.
C. Provide infant feeding education only and document
maternal anxiety without action.
D. Tell the mother that maternal mood rarely affects infant
outcomes and reassure her.
Correct Answer: B
Rationale: The two-generation (dual patient) approach
addresses both child and caregiver health. Screening the
mother for postpartum depression and coordinating referral
while continuing infant care is best practice because caregiver
,mental health directly affects child well-being and
development.
Why others are incorrect:
A — Ignoring maternal mental health misses a key determinant
of infant outcomes.
C — Documentation without action is inadequate when
screening or concerns exist.
D — Minimizing maternal concerns is inappropriate and
contrary to evidence linking caregiver mood to child outcomes.
Question 3:
An 8-year-old with spina bifida follows in primary care. Which
characteristic best describes the population “Children and
Youth with Special Healthcare Needs (CYSHCN)”?
A. Children who require only routine well child care.
B. Children with chronic physical, developmental, behavioral or
emotional conditions requiring healthcare services beyond that
required by children generally.
C. Children whose needs are strictly educational and not
medical.
D. Children who have only short-term medical issues such as an
acute infection.
Correct Answer: B
Rationale: CYSHCN are defined as children who have or are at
increased risk for chronic physical, developmental, behavioral,
or emotional conditions and who require health and related
, services beyond that required by children generally. This fits
spina bifida.
Why others are incorrect:
A — CYSHCN require more than routine care.
C — Many CYSHCN have medical needs; labeling them strictly
educational is incorrect.
D — Short-term acute issues do not meet the chronicity and
complexity criteria.
Question 4:
During a preventive visit, the NP screens a 6-year-old’s family
for ACEs. The child’s chart shows multiple ACEs (household
substance use and parental incarceration). What is the most
appropriate primary-care action?
A. Record ACEs and provide only general anticipatory guidance.
B. Initiate trauma-informed care strategies, assess for current
safety and developmental concerns, and coordinate referrals
(mental health, social services) as needed.
C. Avoid asking further to prevent re-traumatizing the family.
D. Wait until adolescence to address ACEs since effects manifest
later.
Correct Answer: B
Rationale: High ACE exposure warrants trauma-informed
primary care actions: assess safety, screen for
developmental/behavioral concerns, provide supportive
interventions, and coordinate referrals. Early intervention can
by-Chapter Test Bank: Verified Answers & Detailed Rationales
(New Edition)
Question 1:
A 3-year-old is brought for a well-child visit. The mother asks
whether immunizations are part of primary prevention or
primary care. Which is the best nursing response that
distinguishes these concepts?
A. “Immunizations are primary care because they are given
during office visits.”
B. “Immunizations are primary prevention because they prevent
disease before it occurs.”
C. “Immunizations are secondary prevention because they
reduce disease severity.”
D. “Immunizations are tertiary prevention because they prevent
complications.”
Correct Answer: B
Rationale: Immunizations are classic primary prevention —
interventions done to prevent initial occurrence of disease (e.g.,
vaccines preventing infections).
Why others are incorrect:
A — While immunizations often occur in primary care settings,
the term “primary care” denotes the setting/role, not the
prevention level. The question asks to distinguish conceptually.
,C — Secondary prevention involves early detection and
treatment to limit progression (e.g., screening). Vaccines do not
detect disease.
D — Tertiary prevention focuses on reducing
disability/complications after disease onset (e.g.,
rehabilitation); vaccines prevent occurrence, not complications.
Question 2:
A NP sees a mother and her newborn for a postpartum visit.
The mother expresses anxiety about her own depression
affecting the baby’s development. Using a two-generation
approach, what is the NP’s best next step?
A. Focus solely on baby’s well-child needs and schedule a
pediatric follow-up.
B. Screen the mother for postpartum depression and
coordinate maternal mental-health referral while addressing
infant care.
C. Provide infant feeding education only and document
maternal anxiety without action.
D. Tell the mother that maternal mood rarely affects infant
outcomes and reassure her.
Correct Answer: B
Rationale: The two-generation (dual patient) approach
addresses both child and caregiver health. Screening the
mother for postpartum depression and coordinating referral
while continuing infant care is best practice because caregiver
,mental health directly affects child well-being and
development.
Why others are incorrect:
A — Ignoring maternal mental health misses a key determinant
of infant outcomes.
C — Documentation without action is inadequate when
screening or concerns exist.
D — Minimizing maternal concerns is inappropriate and
contrary to evidence linking caregiver mood to child outcomes.
Question 3:
An 8-year-old with spina bifida follows in primary care. Which
characteristic best describes the population “Children and
Youth with Special Healthcare Needs (CYSHCN)”?
A. Children who require only routine well child care.
B. Children with chronic physical, developmental, behavioral or
emotional conditions requiring healthcare services beyond that
required by children generally.
C. Children whose needs are strictly educational and not
medical.
D. Children who have only short-term medical issues such as an
acute infection.
Correct Answer: B
Rationale: CYSHCN are defined as children who have or are at
increased risk for chronic physical, developmental, behavioral,
or emotional conditions and who require health and related
, services beyond that required by children generally. This fits
spina bifida.
Why others are incorrect:
A — CYSHCN require more than routine care.
C — Many CYSHCN have medical needs; labeling them strictly
educational is incorrect.
D — Short-term acute issues do not meet the chronicity and
complexity criteria.
Question 4:
During a preventive visit, the NP screens a 6-year-old’s family
for ACEs. The child’s chart shows multiple ACEs (household
substance use and parental incarceration). What is the most
appropriate primary-care action?
A. Record ACEs and provide only general anticipatory guidance.
B. Initiate trauma-informed care strategies, assess for current
safety and developmental concerns, and coordinate referrals
(mental health, social services) as needed.
C. Avoid asking further to prevent re-traumatizing the family.
D. Wait until adolescence to address ACEs since effects manifest
later.
Correct Answer: B
Rationale: High ACE exposure warrants trauma-informed
primary care actions: assess safety, screen for
developmental/behavioral concerns, provide supportive
interventions, and coordinate referrals. Early intervention can
