Burns Pediatric Final Exam Study Guide
Already graded A+
1. 4. The parents of a 3-year-old child are concerned that the child has begun refusing
usual foods and wants to eat mashed potatoes and chicken strips at every meal and snack.
The child's rate of weight has slowed, but the child remains at the same percentile for weight
on a growth chart. What will the primary care pediatric nurse practitioner tell the parents to
do?
a. a. Allow the child to choose foods for meals to improve caloric intake.
b. b. Place a variety of nutritious foods on the child's plate at each meal.
c. c. Prepare mashed potatoes and chicken strips for the child at mealtimes.
d. d. Suggest cutting out snacks to improve the child's appetite at mealtimes. - ansANS: B
Young children should have three meals and two nutritious snacks each day. The parents'
responsibility is to provide nutritious foods and allow children to choose how much they will eat.
Children who are allowed to choose foods will likely make selections that are not healthy.
Parents should be discouraged from preparing separate meals for their children. Snacks are
necessary to maintain adequate intake and energy.
1. 5. A school-age child sustained a contusion on the front of one thigh while playing
football and reports some difficulty flexing his foot on the affected side. What will the primary
care pediatric nurse practitioner do to treat this injury?
a. a. Place the child on crutches and limit weight-bearing until symptoms subside.
b. b. Prescribe acetaminophen with hydrocodone along with NSAIDs.
c. c. Recommend rest, ice packs, compression, and elevation of the extremity.
d. d. Refer the child to an orthopedic specialist for immediate evaluation and
treatment. - ansANS: D
Children with contusions that restrict movement or sensation and those affecting the quadriceps
muscle may include compartment syndrome. These children should be referred to orthopedic
specialists immediately so that the compartment pressure does not result in irreplaceable
damage. The other options may be performed in consultation with a specialist.
1. 5. The mother of a 6-year-old child tells the primary care pediatric nurse practitioner
that the child only wants to eat French fries and hamburgers and refuses most vegetables.
What will the nurse practitioner recommend?
a. a. Giving the child a multivitamin since this is a phase
b. b. Having the child eat vegetables before getting the hamburger
c. c. Providing a variety of healthy foods at each meal
d. d. Putting extra lettuce and tomatoes on hamburgers - ansANS: C
Parents are responsible for the foods their children eat, and it is their responsibility to provide
healthful foods. Children should be exposed to a variety of healthy foods but not forced to eat
any of them. However, parents should not bribe children with the reward of getting the unhealthy
food that they want. With a well-balanced diet, not eating a vegetable prepared at one meal, for
example, will not compromise the child's health, so a multivitamin is not necessary if the overall
diet is healthy. Allowing hamburgers and adding desired foods again puts the child in control.
1. 5. The parent of a 24-month-old child asks the primary care pediatric nurse
practitioner when toilet training should begin. How will the pediatric nurse practitioner
respond?
a. a. "Begin by reading to your child about toileting."
b. b. "Most children are capable by age 2 years."
c. c. "Tell me about your child's daily habits."
,Burns Pediatric Final Exam Study Guide
Already graded A+
d. d. "We should assess your child's motor skills." - ansANS: C
To assess the parent's understanding of toilet readiness, the nurse practitioner will ask the
parents about the child's daily habits and routines to see if the child has predictable patterns
that can be the basis for toilet training. While providing storybooks about toileting can help
children learn, the first step is to assess toilet readiness. Even though many children are
capable at this age, evaluating personal readiness is key to beginning toilet training.
Assessment of motor skills may be a second step.
1. 5. The primary care pediatric nurse practitioner is prescribing ibuprofen for a 25 kg
child with JIA who has oligoarthitis. If the child will take 4 doses per day, what is the
maximum amount the child will receive per dose?
a. a. 200 mg
b. b. 250 mg
c. c. 400 mg
d. d. 450 mg - ansANS: B
The maximum dose is 40 mg/kg/day divided into 3 to 4 doses. 25 kg × 40 mg = 1000/4 = 250
mg.
1. 5. The primary care pediatric nurse practitioner sees a 3-day-old nursing infant
whose newborn metabolic screen is positive for galactosemia. The nurse practitioner refers
the newborn to a specialist for immediate evaluation and will tell the mother
a. a. to continue to breastfeed her infant.
b. b. to give the infant a cow's milk formula.
c. c. to supplement breast milk with formula.
d. d. to stop breastfeeding immediately. - ansANS: D
Infants with galactosemia cannot consume galactose, which is in both cow's milk and breast
milk. Since there is a potential for a life-threatening response, the mother should be instructed to
stop nursing immediately.
1. 5. Which label on a CAM therapy product verifies that a product meets standards for
contamination, adulteration, manufacturing processes, and pharmacologic properties?
a. a. Generally Recognized as Safe (GRAS)
b. b. National Sanitation Foundation International (NSF)
c. c. Natural Products Association (NPA)
d. d. United States Pharmacopeia (USP) - ansANS: D
USP labeling verifies meeting of standards for contamination, adulteration, manufacturing
processes, and pharmacologic properties. GRAS labeling recognizes a product as being
generally safe for its intended purpose. NSF labeling sets standards for cleanliness,
maintenance, and documented quality checks. NPA labeling ensures ingredient quality and
purity.
1. 5. While the primary care pediatric nurse practitioner is discussing anticipatory
guidance with the mother of a 12 month old, the child repeatedly pulls objects out of the
mother's purse. Each time, the mother slaps the child's hands as she takes the objects
away. What will the nurse practitioner recommend to help the mother manage this child's
misbehavior in a developmentally appropriate manner?
a. a. Keep her purse up high and out of the child's reach.
b. b. Place acceptable objects in her purse for the child to find.
c. c. Say "No!" instead of slapping the child's hands.
d. d. Use timeout each time the child gets into the purse. - ansANS: A
Parents should provide a developmentally appropriate environment to minimize children's
,Burns Pediatric Final Exam Study Guide
Already graded A+
misbehavior. Children at this age who are naturally curious will explore the environment and will
seek out objects within their reach. It is easier to put the purse up high than to have to
repeatedly say "No." Putting acceptable objects in her purse only reinforces the undesired
behavior.
1. 6. A child has wheat allergies and continues to have problems in spite of consuming
a diet without breads and cereals. What will the primary care pediatric nurse practitioner
caution the parents to look for on product labels that may indicate wheat products are
present in foods?
a. a. Casein
b. b. Malt
c. c. Miso
d. d. Whey - ansANS: B
Malt in a product may signal a hyperallergenic food for a child with wheat allergy. Miso contains
soy. Casein and whey are dairy products.
1. 6. A school-age child who uses a SABA and an inhaled corticosteroid medication is
seen in the clinic for an acute asthma exacerbation. After 4 puffs of an inhaled short-acting
B2-agonist (SABA) every 20 minutes for three treatments, spirometry testing shows an FEV1
of 60% of the child's personal best. What will the primary care pediatric nurse practitioner do
next?
a. a. Administer an oral corticosteroid and repeat the three treatments of the
inhaled SABA.
b. b. Admit the child to the hospital for every 2 hour inhaled SABA and intravenous
steroids.
c. c. Give the child 2 mg/kg of an oral corticosteroid and have the child taken to the
emergency department.
d. d. Order an oral corticosteroid, continue the SABA every 3 to 4 hours, and follow
closely. - ansANS: D
Children with an incomplete response (FEV1 between 40% and 69% of personal best) should
be given oral steroids and instructed to continue the SABA every 3 to 4 hours with close follow-
up. Hospitalization is not necessary unless severe distress occurs. An FEV1 less than 40% after
treatment indicates a need to be seen in the ED.
1. 6. The mother of a nursing infant expresses concern about whether high-cholesterol
foods will increase her infant's risk of hyperlipidemia. What will the primary care pediatric
nurse practitioner tell her?
a. a. Breastfed infants have lower serum cholesterol levels than those who are not
breastfed.
b. b. Maternal cholesterol levels affect the cardiovascular risk of breastfed babies.
c. c. Maternal dietary cholesterol intake does not affect the infant's serum
cholesterol values.
d. d. She should limit her dietary cholesterol to prevent hyperlipidemia in her infant. - ansANS: C
Changes in the maternal diet do not produce changes in cholesterol values in infants. Breastfed
infants tend to have higher cholesterol levels than other infants, but cholesterol is necessary for
brain and retinal development.
1. 6. The primary care pediatric nurse practitioner is counseling the parents of a toddler
about appropriate discipline. The parents report that the child is very active and curious, and
, Burns Pediatric Final Exam Study Guide
Already graded A+
they are worried about the potential for injury. What will the pediatric nurse practitioner
recommend?
a. a. Allow the child to explore and experiment while providing appropriate limits.
b. b. Be present while the child plays to continually teach the child what is
appropriate.
c. c. Let the child experiment at will and to make mistakes in order to learn.
d. d. Say "no" whenever the child does something that is not acceptable. - ansANS: A
The child who is securely attached uses the parents as a base from which to safely explore the
world. Toddlers learn by doing and need to experiment to gain mastery over the environment. It
is important that parents are present for safety, but parents should not be ever-present and
controlling. Parents should be close by and should intervene if the child is at risk for injury.
Continual criticism and the use of the word "no" can make the toddler feel powerless.
1. 6. The primary care pediatric nurse practitioner is preparing to close a laceration on
a child's forehead using topical skin adhesive. What is the correct way to apply this product?
a. a. Apply the adhesive between the wound margins and then hold the edges
together.
b. b. Apply the adhesive to the wound and then secure the edges with surgical
tape.
c. c. Have the child remain still for 15 to 20 minutes after the adhesive is applied.
d. d. Hold the wound edges together and apply the adhesive on top of the skin. - ansANS: D
Topical adhesive is applied by holding the wound edges together (approximating the wound
edges) and then applying the adhesive on top, often requiring two or three applications of the
adhesive but allowing skin cooling between applications. The adhesive should not be applied
between the wound margins or in the wound. Surgical tape and bandages are not used with
topical adhesive. It is not necessary for the child to remain still after the adhesive is applied,
since it dries quickly.
1. 6. The primary care pediatric nurse practitioner provides anticipatory guidance for a
6-month-old infant who is breastfed who takes 400 IU of vitamin D daily. The parent reports
that the infant has begun taking cereals, fruits, and vegetables in addition to nursing. What
will the nurse practitioner recommend to promote healthy nutrition?
a. a. Begin supplementing with iron.
b. b. Continue to nurse as long as desired.
c. c. Discontinue the vitamin D supplement.
d. d. Stop breastfeeding at 1 year of age. - ansANS: B
Infants who are breastfed should exclusively nurse until age 6 months and then may continue
breastfeeding, supplemented with appropriate foods for 1 year or longer as long as desired by
both infant and mother. It is not necessary to supplement with iron unless there is a documented
iron deficiency. Vitamin D supplements should continue for all breastfed infants until 1 year old.
1. 7. A child is bitten on one arm by a neighbor's dog. The dog is immunized against
rabies and the child's last tetanus immunization was 4 years prior. The wound edges are
gaping and avulsed. What is an important initial intervention when treating this injury?
a. a. Administration of rabies prophylaxis and a tetanus booster
b. b. Debriding and suturing the wound to prevent infection
c. c. Irrigation of the wounds with high-pressure normal saline
d. d. Reporting the animal bite to the local animal control authority - ansANS: C
Animal and human bites need to be irrigated with normal saline using >5 psi of pressure. The
animal has been vaccinated for rabies and the child's tetanus is current, so prophylaxis for both
Already graded A+
1. 4. The parents of a 3-year-old child are concerned that the child has begun refusing
usual foods and wants to eat mashed potatoes and chicken strips at every meal and snack.
The child's rate of weight has slowed, but the child remains at the same percentile for weight
on a growth chart. What will the primary care pediatric nurse practitioner tell the parents to
do?
a. a. Allow the child to choose foods for meals to improve caloric intake.
b. b. Place a variety of nutritious foods on the child's plate at each meal.
c. c. Prepare mashed potatoes and chicken strips for the child at mealtimes.
d. d. Suggest cutting out snacks to improve the child's appetite at mealtimes. - ansANS: B
Young children should have three meals and two nutritious snacks each day. The parents'
responsibility is to provide nutritious foods and allow children to choose how much they will eat.
Children who are allowed to choose foods will likely make selections that are not healthy.
Parents should be discouraged from preparing separate meals for their children. Snacks are
necessary to maintain adequate intake and energy.
1. 5. A school-age child sustained a contusion on the front of one thigh while playing
football and reports some difficulty flexing his foot on the affected side. What will the primary
care pediatric nurse practitioner do to treat this injury?
a. a. Place the child on crutches and limit weight-bearing until symptoms subside.
b. b. Prescribe acetaminophen with hydrocodone along with NSAIDs.
c. c. Recommend rest, ice packs, compression, and elevation of the extremity.
d. d. Refer the child to an orthopedic specialist for immediate evaluation and
treatment. - ansANS: D
Children with contusions that restrict movement or sensation and those affecting the quadriceps
muscle may include compartment syndrome. These children should be referred to orthopedic
specialists immediately so that the compartment pressure does not result in irreplaceable
damage. The other options may be performed in consultation with a specialist.
1. 5. The mother of a 6-year-old child tells the primary care pediatric nurse practitioner
that the child only wants to eat French fries and hamburgers and refuses most vegetables.
What will the nurse practitioner recommend?
a. a. Giving the child a multivitamin since this is a phase
b. b. Having the child eat vegetables before getting the hamburger
c. c. Providing a variety of healthy foods at each meal
d. d. Putting extra lettuce and tomatoes on hamburgers - ansANS: C
Parents are responsible for the foods their children eat, and it is their responsibility to provide
healthful foods. Children should be exposed to a variety of healthy foods but not forced to eat
any of them. However, parents should not bribe children with the reward of getting the unhealthy
food that they want. With a well-balanced diet, not eating a vegetable prepared at one meal, for
example, will not compromise the child's health, so a multivitamin is not necessary if the overall
diet is healthy. Allowing hamburgers and adding desired foods again puts the child in control.
1. 5. The parent of a 24-month-old child asks the primary care pediatric nurse
practitioner when toilet training should begin. How will the pediatric nurse practitioner
respond?
a. a. "Begin by reading to your child about toileting."
b. b. "Most children are capable by age 2 years."
c. c. "Tell me about your child's daily habits."
,Burns Pediatric Final Exam Study Guide
Already graded A+
d. d. "We should assess your child's motor skills." - ansANS: C
To assess the parent's understanding of toilet readiness, the nurse practitioner will ask the
parents about the child's daily habits and routines to see if the child has predictable patterns
that can be the basis for toilet training. While providing storybooks about toileting can help
children learn, the first step is to assess toilet readiness. Even though many children are
capable at this age, evaluating personal readiness is key to beginning toilet training.
Assessment of motor skills may be a second step.
1. 5. The primary care pediatric nurse practitioner is prescribing ibuprofen for a 25 kg
child with JIA who has oligoarthitis. If the child will take 4 doses per day, what is the
maximum amount the child will receive per dose?
a. a. 200 mg
b. b. 250 mg
c. c. 400 mg
d. d. 450 mg - ansANS: B
The maximum dose is 40 mg/kg/day divided into 3 to 4 doses. 25 kg × 40 mg = 1000/4 = 250
mg.
1. 5. The primary care pediatric nurse practitioner sees a 3-day-old nursing infant
whose newborn metabolic screen is positive for galactosemia. The nurse practitioner refers
the newborn to a specialist for immediate evaluation and will tell the mother
a. a. to continue to breastfeed her infant.
b. b. to give the infant a cow's milk formula.
c. c. to supplement breast milk with formula.
d. d. to stop breastfeeding immediately. - ansANS: D
Infants with galactosemia cannot consume galactose, which is in both cow's milk and breast
milk. Since there is a potential for a life-threatening response, the mother should be instructed to
stop nursing immediately.
1. 5. Which label on a CAM therapy product verifies that a product meets standards for
contamination, adulteration, manufacturing processes, and pharmacologic properties?
a. a. Generally Recognized as Safe (GRAS)
b. b. National Sanitation Foundation International (NSF)
c. c. Natural Products Association (NPA)
d. d. United States Pharmacopeia (USP) - ansANS: D
USP labeling verifies meeting of standards for contamination, adulteration, manufacturing
processes, and pharmacologic properties. GRAS labeling recognizes a product as being
generally safe for its intended purpose. NSF labeling sets standards for cleanliness,
maintenance, and documented quality checks. NPA labeling ensures ingredient quality and
purity.
1. 5. While the primary care pediatric nurse practitioner is discussing anticipatory
guidance with the mother of a 12 month old, the child repeatedly pulls objects out of the
mother's purse. Each time, the mother slaps the child's hands as she takes the objects
away. What will the nurse practitioner recommend to help the mother manage this child's
misbehavior in a developmentally appropriate manner?
a. a. Keep her purse up high and out of the child's reach.
b. b. Place acceptable objects in her purse for the child to find.
c. c. Say "No!" instead of slapping the child's hands.
d. d. Use timeout each time the child gets into the purse. - ansANS: A
Parents should provide a developmentally appropriate environment to minimize children's
,Burns Pediatric Final Exam Study Guide
Already graded A+
misbehavior. Children at this age who are naturally curious will explore the environment and will
seek out objects within their reach. It is easier to put the purse up high than to have to
repeatedly say "No." Putting acceptable objects in her purse only reinforces the undesired
behavior.
1. 6. A child has wheat allergies and continues to have problems in spite of consuming
a diet without breads and cereals. What will the primary care pediatric nurse practitioner
caution the parents to look for on product labels that may indicate wheat products are
present in foods?
a. a. Casein
b. b. Malt
c. c. Miso
d. d. Whey - ansANS: B
Malt in a product may signal a hyperallergenic food for a child with wheat allergy. Miso contains
soy. Casein and whey are dairy products.
1. 6. A school-age child who uses a SABA and an inhaled corticosteroid medication is
seen in the clinic for an acute asthma exacerbation. After 4 puffs of an inhaled short-acting
B2-agonist (SABA) every 20 minutes for three treatments, spirometry testing shows an FEV1
of 60% of the child's personal best. What will the primary care pediatric nurse practitioner do
next?
a. a. Administer an oral corticosteroid and repeat the three treatments of the
inhaled SABA.
b. b. Admit the child to the hospital for every 2 hour inhaled SABA and intravenous
steroids.
c. c. Give the child 2 mg/kg of an oral corticosteroid and have the child taken to the
emergency department.
d. d. Order an oral corticosteroid, continue the SABA every 3 to 4 hours, and follow
closely. - ansANS: D
Children with an incomplete response (FEV1 between 40% and 69% of personal best) should
be given oral steroids and instructed to continue the SABA every 3 to 4 hours with close follow-
up. Hospitalization is not necessary unless severe distress occurs. An FEV1 less than 40% after
treatment indicates a need to be seen in the ED.
1. 6. The mother of a nursing infant expresses concern about whether high-cholesterol
foods will increase her infant's risk of hyperlipidemia. What will the primary care pediatric
nurse practitioner tell her?
a. a. Breastfed infants have lower serum cholesterol levels than those who are not
breastfed.
b. b. Maternal cholesterol levels affect the cardiovascular risk of breastfed babies.
c. c. Maternal dietary cholesterol intake does not affect the infant's serum
cholesterol values.
d. d. She should limit her dietary cholesterol to prevent hyperlipidemia in her infant. - ansANS: C
Changes in the maternal diet do not produce changes in cholesterol values in infants. Breastfed
infants tend to have higher cholesterol levels than other infants, but cholesterol is necessary for
brain and retinal development.
1. 6. The primary care pediatric nurse practitioner is counseling the parents of a toddler
about appropriate discipline. The parents report that the child is very active and curious, and
, Burns Pediatric Final Exam Study Guide
Already graded A+
they are worried about the potential for injury. What will the pediatric nurse practitioner
recommend?
a. a. Allow the child to explore and experiment while providing appropriate limits.
b. b. Be present while the child plays to continually teach the child what is
appropriate.
c. c. Let the child experiment at will and to make mistakes in order to learn.
d. d. Say "no" whenever the child does something that is not acceptable. - ansANS: A
The child who is securely attached uses the parents as a base from which to safely explore the
world. Toddlers learn by doing and need to experiment to gain mastery over the environment. It
is important that parents are present for safety, but parents should not be ever-present and
controlling. Parents should be close by and should intervene if the child is at risk for injury.
Continual criticism and the use of the word "no" can make the toddler feel powerless.
1. 6. The primary care pediatric nurse practitioner is preparing to close a laceration on
a child's forehead using topical skin adhesive. What is the correct way to apply this product?
a. a. Apply the adhesive between the wound margins and then hold the edges
together.
b. b. Apply the adhesive to the wound and then secure the edges with surgical
tape.
c. c. Have the child remain still for 15 to 20 minutes after the adhesive is applied.
d. d. Hold the wound edges together and apply the adhesive on top of the skin. - ansANS: D
Topical adhesive is applied by holding the wound edges together (approximating the wound
edges) and then applying the adhesive on top, often requiring two or three applications of the
adhesive but allowing skin cooling between applications. The adhesive should not be applied
between the wound margins or in the wound. Surgical tape and bandages are not used with
topical adhesive. It is not necessary for the child to remain still after the adhesive is applied,
since it dries quickly.
1. 6. The primary care pediatric nurse practitioner provides anticipatory guidance for a
6-month-old infant who is breastfed who takes 400 IU of vitamin D daily. The parent reports
that the infant has begun taking cereals, fruits, and vegetables in addition to nursing. What
will the nurse practitioner recommend to promote healthy nutrition?
a. a. Begin supplementing with iron.
b. b. Continue to nurse as long as desired.
c. c. Discontinue the vitamin D supplement.
d. d. Stop breastfeeding at 1 year of age. - ansANS: B
Infants who are breastfed should exclusively nurse until age 6 months and then may continue
breastfeeding, supplemented with appropriate foods for 1 year or longer as long as desired by
both infant and mother. It is not necessary to supplement with iron unless there is a documented
iron deficiency. Vitamin D supplements should continue for all breastfed infants until 1 year old.
1. 7. A child is bitten on one arm by a neighbor's dog. The dog is immunized against
rabies and the child's last tetanus immunization was 4 years prior. The wound edges are
gaping and avulsed. What is an important initial intervention when treating this injury?
a. a. Administration of rabies prophylaxis and a tetanus booster
b. b. Debriding and suturing the wound to prevent infection
c. c. Irrigation of the wounds with high-pressure normal saline
d. d. Reporting the animal bite to the local animal control authority - ansANS: C
Animal and human bites need to be irrigated with normal saline using >5 psi of pressure. The
animal has been vaccinated for rabies and the child's tetanus is current, so prophylaxis for both
