,Chapter 1 – Health Status of Children: Global & National
Perspectives — Primary Care vs Primary Prevention
Stem: A 4-year-old comes for a well-child visit. The parent asks
why the clinician emphasizes anticipatory guidance (nutrition,
safety counseling) in addition to treating illnesses. As an NCLEX-
prepared nurse, which statement best describes the difference
between primary care and primary prevention?
A. Primary care focuses only on chronic disease management;
primary prevention only treats acute illnesses.
B. Primary care is episodic treatment of illness; primary
prevention focuses on policies at national levels only.
C. Primary care provides comprehensive continuous care to
promote health; primary prevention reduces disease incidence
through anticipatory guidance and immunization.
D. Primary care is provided exclusively by specialists; primary
prevention is done only by public health agencies.
Correct answer: C
Rationale — correct: Burns emphasizes that primary care
delivers continuous, comprehensive services (assessment,
management, coordination) while primary prevention aims to
prevent disease onset through anticipatory guidance, safety
counseling, and immunization — interventions commonly
delivered during well-child visits. This integration is
fundamental to pediatric primary care. (Elsevier Health)
,Distractor explanations:
A. Incorrect — primary care includes prevention and
management, not only chronic disease.
B. Incorrect — primary care is not only episodic; primary
prevention occurs in clinical and community settings.
D. Incorrect — primary care is often delivered by primary care
providers, not exclusively specialists; prevention is multi-
sectoral.
Teaching point: Well-child care combines continuous primary
care with primary prevention.
Question 2
Chapter & Subtopic: Chapter 2 – Unique Issues in Pediatrics —
Family-Centered Care & Communication
Stem: During a clinic visit, a 10-year-old with asthma shows
anxiety and hesitates to speak with the clinician while the
parent answers all questions. Which nursing action best
demonstrates family-centered care while respecting the child’s
voice?
A. Continue to direct all questions to the parent to save time.
B. Ask the child open-ended questions at an age-appropriate
level and invite the parent to add details.
C. Tell the parent to step out immediately and speak to the child
alone for the entire visit.
D. Ignore the child’s cues and focus on the clinical exam only.
, Correct answer: B
Rationale — correct: Burns highlights family-centered care that
includes the child’s voice appropriate to developmental level;
nurses should engage children with open-ended, age-
appropriate questions while involving parents as partners. This
promotes accurate assessment and therapeutic alliance.
(Elsevier Health)
Distractor explanations:
A. Incorrect — directing only to the parent marginalizes the
child and misses developmental input.
C. Incorrect — some private time may be appropriate, but
excluding the parent the whole visit may not be family-
centered.
D. Incorrect — ignoring psychosocial cues misses essential
assessment data.
Teaching point: Engage the child with age-appropriate
questions while involving the family.
Question 3
Chapter & Subtopic: Chapter 7 – Children with Special
Healthcare Needs (CYSHCN) — Care Coordination
Stem: A 6-year-old with cerebral palsy, gastrostomy tube, and
frequent hospitalizations presents for routine follow-up. Which
nursing action most improves continuity and outcomes for this
child?
Perspectives — Primary Care vs Primary Prevention
Stem: A 4-year-old comes for a well-child visit. The parent asks
why the clinician emphasizes anticipatory guidance (nutrition,
safety counseling) in addition to treating illnesses. As an NCLEX-
prepared nurse, which statement best describes the difference
between primary care and primary prevention?
A. Primary care focuses only on chronic disease management;
primary prevention only treats acute illnesses.
B. Primary care is episodic treatment of illness; primary
prevention focuses on policies at national levels only.
C. Primary care provides comprehensive continuous care to
promote health; primary prevention reduces disease incidence
through anticipatory guidance and immunization.
D. Primary care is provided exclusively by specialists; primary
prevention is done only by public health agencies.
Correct answer: C
Rationale — correct: Burns emphasizes that primary care
delivers continuous, comprehensive services (assessment,
management, coordination) while primary prevention aims to
prevent disease onset through anticipatory guidance, safety
counseling, and immunization — interventions commonly
delivered during well-child visits. This integration is
fundamental to pediatric primary care. (Elsevier Health)
,Distractor explanations:
A. Incorrect — primary care includes prevention and
management, not only chronic disease.
B. Incorrect — primary care is not only episodic; primary
prevention occurs in clinical and community settings.
D. Incorrect — primary care is often delivered by primary care
providers, not exclusively specialists; prevention is multi-
sectoral.
Teaching point: Well-child care combines continuous primary
care with primary prevention.
Question 2
Chapter & Subtopic: Chapter 2 – Unique Issues in Pediatrics —
Family-Centered Care & Communication
Stem: During a clinic visit, a 10-year-old with asthma shows
anxiety and hesitates to speak with the clinician while the
parent answers all questions. Which nursing action best
demonstrates family-centered care while respecting the child’s
voice?
A. Continue to direct all questions to the parent to save time.
B. Ask the child open-ended questions at an age-appropriate
level and invite the parent to add details.
C. Tell the parent to step out immediately and speak to the child
alone for the entire visit.
D. Ignore the child’s cues and focus on the clinical exam only.
, Correct answer: B
Rationale — correct: Burns highlights family-centered care that
includes the child’s voice appropriate to developmental level;
nurses should engage children with open-ended, age-
appropriate questions while involving parents as partners. This
promotes accurate assessment and therapeutic alliance.
(Elsevier Health)
Distractor explanations:
A. Incorrect — directing only to the parent marginalizes the
child and misses developmental input.
C. Incorrect — some private time may be appropriate, but
excluding the parent the whole visit may not be family-
centered.
D. Incorrect — ignoring psychosocial cues misses essential
assessment data.
Teaching point: Engage the child with age-appropriate
questions while involving the family.
Question 3
Chapter & Subtopic: Chapter 7 – Children with Special
Healthcare Needs (CYSHCN) — Care Coordination
Stem: A 6-year-old with cerebral palsy, gastrostomy tube, and
frequent hospitalizations presents for routine follow-up. Which
nursing action most improves continuity and outcomes for this
child?
