BURNS PEDIATRIC FINAL EXAM STUDY GUIDE 2026/2027 WITH COMPLETE
SOLUTION//ALREADY PASSED
Question 1
The primary care pediatric nurse practitioner understands that a major child health outcome
associated with worldwide climate change is:
A) cost of living.
B) education.
C) nutrition.
D) pollution.
E) housing availability.
Correct Answer: C) nutrition.
Rationale: There is growing evidence that climate change is having a dramatic effect on
food crops, which leads to food distribution issues and food insecurity among families
worldwide.
Question 2
To achieve the greatest worldwide reduction in child mortality from pneumonia and diarrhea,
which intervention is most effective?
A) Antibiotics
B) Optimal nutrition
C) Vaccinations
D) Water purification
E) Hand-washing education
Correct Answer: C) Vaccinations
Rationale: Rotavirus is the most common cause of diarrhea and Strep pneumonia is the
leading cause of pneumonia globally. Both are vaccine-preventable diseases. While other
interventions help, vaccination prevents the diseases from occurring initially.
Question 3
When providing well-child care for an infant in the first year of life, the primary care pediatric
nurse practitioner adheres to the most recent AAP Recommendations by:
A) focusing less on development and more on illness prevention.
B) following guidelines established solely by the Bright Futures publication.
C) scheduling well-baby visits to coincide with key developmental milestones.
D) seeing the infant at ages 2, 4, 6, and 12 months when immunizations are due.
E) prioritizing physical growth over behavioral screenings.
Correct Answer: C) scheduling well-baby visits to coincide with key developmental
milestones.
Rationale: The most recent AAP recommendations place a greater emphasis on behavioral
and developmental issues, suggesting that visits be based on child and family development
rather than just the periodicity of immunization schedules.
, 2
Question 4
Which statement is true regarding the health status of children in the United States?
A) Globalism has relatively little impact on child health measures in the U.S.
B) Obesity rates among 2- to 5-year-olds have shown a recent significant decrease.
C) The rate of household poverty is lower than in other economically developed nations.
D) Young children who attend preschool or day care have higher food insecurity.
E) Infectious disease is the leading cause of death in U.S. children.
Correct Answer: B) Obesity rates among 2- to 5-year-olds have shown a recent significant
decrease.
Rationale: While obesity remains a concern, rates stabilized and showed a decline among
the 2- to 5-year-old demographic between 2004 and 2013. U.S. poverty rates are actually
higher than in many other developed nations.
Question 5
Which region globally has the highest infant mortality rate?
A) Indonesia
B) Southern Asia
C) Sub-Saharan Africa
D) Syria
E) Central America
Correct Answer: C) Sub-Saharan Africa
Rationale: Although Sub-Saharan Africa and Southern Asia together account for 81% of
infant mortality globally, Sub-Saharan Africa maintains the highest infant mortality rate in
the world.
Question 6
A parent of a toddler is concerned about autism. The M-CHAT tool indicates several areas of
concern. What is the next step for the PNP?
A) Administer a Childhood Autism Rating Scale (CARS) in the clinic immediately.
B) Consult a specialist to determine early intervention strategies.
C) Refer the child to a behavioral specialist for further evaluation.
D) Tell the parent that this result indicates that the child has autism.
E) Repeat the M-CHAT in six months to check for progress.
Correct Answer: C) Refer the child to a behavioral specialist for further evaluation.
Rationale: The M-CHAT is a screening tool, not a diagnostic one. If behaviors are detected,
the PNP should refer the child to a specialist for assessment using more specific diagnostic
tools.
Question 7
A mother of a newborn is worried her child will develop allergies and asthma. Which tool will
the nurse practitioner use to evaluate this specific risk?
, 3
A) Three-generation pedigree
B) Review of systems
C) Genogram
D) Ecomap
E) Patient-centered interview
Correct Answer: A) Three-generation pedigree
Rationale: A three-generation pedigree is used to map out risks for genetic diseases as well
as conditions with modifiable risk factors within a family history.
Question 8
A 20-month-old child, born 4 weeks premature, has achieved milestones for a 15-month-old
according to the parent. What is the correct action?
A) Perform an in-depth developmental assessment screen at this visit.
B) Reassure the parent that the child will catch up by age 2 years.
C) Re-evaluate this child’s development at the 24-month visit.
D) Refer the child immediately to a specialty clinic for developmental delay.
E) Tell the parent to enroll the child in an intensive preschool program.
Correct Answer: A) Perform an in-depth developmental assessment screen at this visit to
evaluate this child.
Rationale: Using the adjusted age for prematurity, this child is 19 months old. Being at a 15-
month level means the child is 4 months behind, which warrants a more in-depth screen
rather than waiting.
Question 9
When formulating developmental diagnoses for pediatric patients, which resource is most
appropriate?
A) DC: 0-3R
B) ICD-10-CM
C) ICSD-3
D) NANDA International
E) DSM-5
Correct Answer: A) DC: 0-3R
Rationale: The DC: 0-3R (Diagnostic Classification of Mental Health and Developmental
Disorders of Infancy and Early Childhood) is specifically useful for developmental problem
diagnosis.
Question 10
The nurse practitioner is evaluating health literacy in the mother of a preschool-age child. How is
this most efficiently assessed?
A) Ask the child how many books he has at home.
B) Ask the mother about her highest grade in school.
, 4
C) Ask the mother to determine the correct dose of a drug from a label.
D) Ask the mother to read a health information handout aloud.
E) Check the mother's employment status.
Correct Answer: A) Ask the child how many books he has at home.
Rationale: The "newest vital sign" for health literacy can be determined by the number of
books in the home. Having more than 10 books is a positive predictor of adequate health
literacy.
Question 11
The mother of a 3-year-old child has been treated for depression for 5 years. Which aspect of
development is of most concern for this child?
A) Fine motor
B) Gross motor
C) Social/emotional
D) Speech and language
E) Cognitive logic
Correct Answer: D) Speech and language
Rationale: Maternal depression during the first year of a child's life has been specifically
associated with poorer language development at age 3.
Question 12
A 3-year-old child chronically withholds stools despite interventions. Which diagnosis will the
PNP use to facilitate third-party reimbursement?
A) Altered elimination pattern
B) Elimination disorder
C) Encopresis
D) Parenting alteration
E) Functional constipation
Correct Answer: C) Encopresis
Rationale: Encopresis is a medical diagnosis classified in the ICD-10-CM and is recognized
for reimbursement purposes, unlike NANDA or developmental-only labels.
Question 13
A child in the clinic for an asthma plan evaluation is extremely anxious. What should the PNP do
initially?
A) Ask the parent why the child is so anxious.
B) Perform a physical assessment to rule out shortness of breath.
C) Reassure the child that there is nothing to be afraid of.
D) Review the purpose of this visit and any anticipated procedures.
E) Postpone the visit until the child is calmer.
Correct Answer: D) Review the purpose of this visit and any anticipated procedures.
SOLUTION//ALREADY PASSED
Question 1
The primary care pediatric nurse practitioner understands that a major child health outcome
associated with worldwide climate change is:
A) cost of living.
B) education.
C) nutrition.
D) pollution.
E) housing availability.
Correct Answer: C) nutrition.
Rationale: There is growing evidence that climate change is having a dramatic effect on
food crops, which leads to food distribution issues and food insecurity among families
worldwide.
Question 2
To achieve the greatest worldwide reduction in child mortality from pneumonia and diarrhea,
which intervention is most effective?
A) Antibiotics
B) Optimal nutrition
C) Vaccinations
D) Water purification
E) Hand-washing education
Correct Answer: C) Vaccinations
Rationale: Rotavirus is the most common cause of diarrhea and Strep pneumonia is the
leading cause of pneumonia globally. Both are vaccine-preventable diseases. While other
interventions help, vaccination prevents the diseases from occurring initially.
Question 3
When providing well-child care for an infant in the first year of life, the primary care pediatric
nurse practitioner adheres to the most recent AAP Recommendations by:
A) focusing less on development and more on illness prevention.
B) following guidelines established solely by the Bright Futures publication.
C) scheduling well-baby visits to coincide with key developmental milestones.
D) seeing the infant at ages 2, 4, 6, and 12 months when immunizations are due.
E) prioritizing physical growth over behavioral screenings.
Correct Answer: C) scheduling well-baby visits to coincide with key developmental
milestones.
Rationale: The most recent AAP recommendations place a greater emphasis on behavioral
and developmental issues, suggesting that visits be based on child and family development
rather than just the periodicity of immunization schedules.
, 2
Question 4
Which statement is true regarding the health status of children in the United States?
A) Globalism has relatively little impact on child health measures in the U.S.
B) Obesity rates among 2- to 5-year-olds have shown a recent significant decrease.
C) The rate of household poverty is lower than in other economically developed nations.
D) Young children who attend preschool or day care have higher food insecurity.
E) Infectious disease is the leading cause of death in U.S. children.
Correct Answer: B) Obesity rates among 2- to 5-year-olds have shown a recent significant
decrease.
Rationale: While obesity remains a concern, rates stabilized and showed a decline among
the 2- to 5-year-old demographic between 2004 and 2013. U.S. poverty rates are actually
higher than in many other developed nations.
Question 5
Which region globally has the highest infant mortality rate?
A) Indonesia
B) Southern Asia
C) Sub-Saharan Africa
D) Syria
E) Central America
Correct Answer: C) Sub-Saharan Africa
Rationale: Although Sub-Saharan Africa and Southern Asia together account for 81% of
infant mortality globally, Sub-Saharan Africa maintains the highest infant mortality rate in
the world.
Question 6
A parent of a toddler is concerned about autism. The M-CHAT tool indicates several areas of
concern. What is the next step for the PNP?
A) Administer a Childhood Autism Rating Scale (CARS) in the clinic immediately.
B) Consult a specialist to determine early intervention strategies.
C) Refer the child to a behavioral specialist for further evaluation.
D) Tell the parent that this result indicates that the child has autism.
E) Repeat the M-CHAT in six months to check for progress.
Correct Answer: C) Refer the child to a behavioral specialist for further evaluation.
Rationale: The M-CHAT is a screening tool, not a diagnostic one. If behaviors are detected,
the PNP should refer the child to a specialist for assessment using more specific diagnostic
tools.
Question 7
A mother of a newborn is worried her child will develop allergies and asthma. Which tool will
the nurse practitioner use to evaluate this specific risk?
, 3
A) Three-generation pedigree
B) Review of systems
C) Genogram
D) Ecomap
E) Patient-centered interview
Correct Answer: A) Three-generation pedigree
Rationale: A three-generation pedigree is used to map out risks for genetic diseases as well
as conditions with modifiable risk factors within a family history.
Question 8
A 20-month-old child, born 4 weeks premature, has achieved milestones for a 15-month-old
according to the parent. What is the correct action?
A) Perform an in-depth developmental assessment screen at this visit.
B) Reassure the parent that the child will catch up by age 2 years.
C) Re-evaluate this child’s development at the 24-month visit.
D) Refer the child immediately to a specialty clinic for developmental delay.
E) Tell the parent to enroll the child in an intensive preschool program.
Correct Answer: A) Perform an in-depth developmental assessment screen at this visit to
evaluate this child.
Rationale: Using the adjusted age for prematurity, this child is 19 months old. Being at a 15-
month level means the child is 4 months behind, which warrants a more in-depth screen
rather than waiting.
Question 9
When formulating developmental diagnoses for pediatric patients, which resource is most
appropriate?
A) DC: 0-3R
B) ICD-10-CM
C) ICSD-3
D) NANDA International
E) DSM-5
Correct Answer: A) DC: 0-3R
Rationale: The DC: 0-3R (Diagnostic Classification of Mental Health and Developmental
Disorders of Infancy and Early Childhood) is specifically useful for developmental problem
diagnosis.
Question 10
The nurse practitioner is evaluating health literacy in the mother of a preschool-age child. How is
this most efficiently assessed?
A) Ask the child how many books he has at home.
B) Ask the mother about her highest grade in school.
, 4
C) Ask the mother to determine the correct dose of a drug from a label.
D) Ask the mother to read a health information handout aloud.
E) Check the mother's employment status.
Correct Answer: A) Ask the child how many books he has at home.
Rationale: The "newest vital sign" for health literacy can be determined by the number of
books in the home. Having more than 10 books is a positive predictor of adequate health
literacy.
Question 11
The mother of a 3-year-old child has been treated for depression for 5 years. Which aspect of
development is of most concern for this child?
A) Fine motor
B) Gross motor
C) Social/emotional
D) Speech and language
E) Cognitive logic
Correct Answer: D) Speech and language
Rationale: Maternal depression during the first year of a child's life has been specifically
associated with poorer language development at age 3.
Question 12
A 3-year-old child chronically withholds stools despite interventions. Which diagnosis will the
PNP use to facilitate third-party reimbursement?
A) Altered elimination pattern
B) Elimination disorder
C) Encopresis
D) Parenting alteration
E) Functional constipation
Correct Answer: C) Encopresis
Rationale: Encopresis is a medical diagnosis classified in the ICD-10-CM and is recognized
for reimbursement purposes, unlike NANDA or developmental-only labels.
Question 13
A child in the clinic for an asthma plan evaluation is extremely anxious. What should the PNP do
initially?
A) Ask the parent why the child is so anxious.
B) Perform a physical assessment to rule out shortness of breath.
C) Reassure the child that there is nothing to be afraid of.
D) Review the purpose of this visit and any anticipated procedures.
E) Postpone the visit until the child is calmer.
Correct Answer: D) Review the purpose of this visit and any anticipated procedures.
