Burns' Pediatric Primary Care 8th Edition Test Bank | 20
MCQs per Chapter
Pediatric Primary Care Test Bank & NCLEX-HESI
Review | Burns' 8th Edition
Question 1:
A 3-week-old infant arrives for a routine well-child visit. The
family expresses concerns about feeding and sleep, and the
nurse practitioner performs a developmental screen while
discussing immunizations and safe sleep. Which statement best
distinguishes “primary prevention” from “primary care” in this
clinical encounter?
A. Primary prevention is provided only by public health
agencies, whereas primary care is delivered in clinics.
B. Primary prevention focuses on preventing disease or injury
before it occurs, while primary care provides ongoing
comprehensive health services including prevention, diagnosis,
and management.
C. Primary prevention consists solely of immunizations, and
primary care consists only of treating acute illnesses.
D. Primary prevention is only for communities; primary care is
only for individuals and families.
Correct Answer: B
Rationale: The correct answer clarifies that primary prevention
aims to prevent disease or injury (e.g., immunizations, safe
,sleep counseling) and is part of the broader scope of primary
care, which includes ongoing, comprehensive services
(preventive, diagnostic, and management). Option A is incorrect
because both primary prevention and primary care can be
provided in clinical and public health settings. Option C is
incorrect because primary prevention is more than
immunizations (also includes anticipatory guidance, safety
counseling), and primary care includes prevention as well as
acute/chronic care. Option D is incorrect because primary
prevention can target individuals, families, and communities—
and primary care similarly addresses individuals/families within
community contexts.
Question 2:
During a well-child visit for a 9-month-old, the caregiver asks
why the clinician asked about household smoking, parental
depression, and housing stability. Which goal most directly
reflects the “two-generation (dual patient)” approach in
pediatric primary care?
A. To evaluate the household income to determine eligibility for
services.
B. To identify caregiver needs that influence the child’s health
and address caregiver and child together.
C. To collect social history solely for research purposes.
D. To prioritize the child’s needs while ignoring caregiver health
to avoid complicating care.
Correct Answer: B
Rationale: The two-generation approach treats the child and
,caregiver(s) as interconnected patients—addressing caregiver
health (e.g., depression, smoking cessation) because it directly
impacts child outcomes. Option A is too narrow—while income
may inform services, it does not capture the essence of two-
generation care. Option C is incorrect: social history is gathered
to inform direct care, not solely research. Option D contradicts
the two-generation principle; caregiver health is integral to
child health and must not be ignored.
Question 3:
A 15-year-old with complex congenital heart disease is
transitioning from pediatric cardiology to adult services. Which
action by the pediatric nurse practitioner best supports an
effective transition to adult care?
A. Discharge the patient from pediatric clinic at age 18 without
forwarding records; let the patient find an adult cardiologist
independently.
B. Initiate transition planning early, assess self-management
skills, coordinate with adult providers, and provide a portable
summary of the medical care plan.
C. Wait until the patient requests transition help and then send
a single referral letter to adult cardiology.
D. Transfer medications to adult dosing regimens immediately
at age 18 without consulting the cardiologist.
Correct Answer: B
Rationale: Effective transition is a planned, gradual process that
begins in adolescence, includes skill assessment, care
coordination, and providing a portable medical summary—
, consistent with AAP/Bright Futures recommendations. Option A
is inappropriate and risks loss to follow-up and adverse
outcomes. Option C is reactive rather than proactive; waiting
undermines continuity. Option D is dangerous—medication
changes require specialist collaboration and individualized
assessment.
Question 4:
A 6-year-old with spina bifida is followed in primary care. The
patient’s family reports difficulty coordinating multiple specialty
appointments, therapies, and school accommodations.
According to best practices for Caring for Children and Youth
with Special Healthcare Needs (CYSHCN), which role should the
pediatric primary care clinician prioritize?
A. Focus only on acute illnesses and leave coordination to the
family.
B. Serve as the medical home: coordinate care, ensure
communication among specialists, and support family-centered
planning.
C. Refer the family to the emergency department for nonurgent
coordination needs.
D. Delay care coordination until the child is medically stable for
at least one year.
Correct Answer: B
Rationale: The medical home model positions the primary care
clinician to coordinate multidisciplinary care, facilitate
communication among specialists, and support family-centered
decision-making—key for CYSHCN. Option A is incorrect
MCQs per Chapter
Pediatric Primary Care Test Bank & NCLEX-HESI
Review | Burns' 8th Edition
Question 1:
A 3-week-old infant arrives for a routine well-child visit. The
family expresses concerns about feeding and sleep, and the
nurse practitioner performs a developmental screen while
discussing immunizations and safe sleep. Which statement best
distinguishes “primary prevention” from “primary care” in this
clinical encounter?
A. Primary prevention is provided only by public health
agencies, whereas primary care is delivered in clinics.
B. Primary prevention focuses on preventing disease or injury
before it occurs, while primary care provides ongoing
comprehensive health services including prevention, diagnosis,
and management.
C. Primary prevention consists solely of immunizations, and
primary care consists only of treating acute illnesses.
D. Primary prevention is only for communities; primary care is
only for individuals and families.
Correct Answer: B
Rationale: The correct answer clarifies that primary prevention
aims to prevent disease or injury (e.g., immunizations, safe
,sleep counseling) and is part of the broader scope of primary
care, which includes ongoing, comprehensive services
(preventive, diagnostic, and management). Option A is incorrect
because both primary prevention and primary care can be
provided in clinical and public health settings. Option C is
incorrect because primary prevention is more than
immunizations (also includes anticipatory guidance, safety
counseling), and primary care includes prevention as well as
acute/chronic care. Option D is incorrect because primary
prevention can target individuals, families, and communities—
and primary care similarly addresses individuals/families within
community contexts.
Question 2:
During a well-child visit for a 9-month-old, the caregiver asks
why the clinician asked about household smoking, parental
depression, and housing stability. Which goal most directly
reflects the “two-generation (dual patient)” approach in
pediatric primary care?
A. To evaluate the household income to determine eligibility for
services.
B. To identify caregiver needs that influence the child’s health
and address caregiver and child together.
C. To collect social history solely for research purposes.
D. To prioritize the child’s needs while ignoring caregiver health
to avoid complicating care.
Correct Answer: B
Rationale: The two-generation approach treats the child and
,caregiver(s) as interconnected patients—addressing caregiver
health (e.g., depression, smoking cessation) because it directly
impacts child outcomes. Option A is too narrow—while income
may inform services, it does not capture the essence of two-
generation care. Option C is incorrect: social history is gathered
to inform direct care, not solely research. Option D contradicts
the two-generation principle; caregiver health is integral to
child health and must not be ignored.
Question 3:
A 15-year-old with complex congenital heart disease is
transitioning from pediatric cardiology to adult services. Which
action by the pediatric nurse practitioner best supports an
effective transition to adult care?
A. Discharge the patient from pediatric clinic at age 18 without
forwarding records; let the patient find an adult cardiologist
independently.
B. Initiate transition planning early, assess self-management
skills, coordinate with adult providers, and provide a portable
summary of the medical care plan.
C. Wait until the patient requests transition help and then send
a single referral letter to adult cardiology.
D. Transfer medications to adult dosing regimens immediately
at age 18 without consulting the cardiologist.
Correct Answer: B
Rationale: Effective transition is a planned, gradual process that
begins in adolescence, includes skill assessment, care
coordination, and providing a portable medical summary—
, consistent with AAP/Bright Futures recommendations. Option A
is inappropriate and risks loss to follow-up and adverse
outcomes. Option C is reactive rather than proactive; waiting
undermines continuity. Option D is dangerous—medication
changes require specialist collaboration and individualized
assessment.
Question 4:
A 6-year-old with spina bifida is followed in primary care. The
patient’s family reports difficulty coordinating multiple specialty
appointments, therapies, and school accommodations.
According to best practices for Caring for Children and Youth
with Special Healthcare Needs (CYSHCN), which role should the
pediatric primary care clinician prioritize?
A. Focus only on acute illnesses and leave coordination to the
family.
B. Serve as the medical home: coordinate care, ensure
communication among specialists, and support family-centered
planning.
C. Refer the family to the emergency department for nonurgent
coordination needs.
D. Delay care coordination until the child is medically stable for
at least one year.
Correct Answer: B
Rationale: The medical home model positions the primary care
clinician to coordinate multidisciplinary care, facilitate
communication among specialists, and support family-centered
decision-making—key for CYSHCN. Option A is incorrect
