by-Chapter Test Bank: Verified Answers & Detailed Rationales
(New Edition)
Chapter 1: Pediatric Primary Care & Influences on Child Health
Question 1
Chapter & Subtopic: Chapter 1 – Pediatric Primary Care, Unique
Issues in Pediatrics
Stem: The parent of a 6-year-old child expresses frustration that
their child refuses to sit still during the physical exam. Which
statement by the pediatric primary care nurse demonstrates an
understanding of a unique aspect of pediatric care?
Options:
A. "We will need to reschedule the appointment for a time
when the child is more cooperative."
B. "Let's try having the child sit on your lap while I listen to their
heart first with my warm stethoscope."
C. "I will need you to hold the child down firmly so I can
complete the examination quickly."
D. "This behavior is unacceptable; we will skip the exam today
and just focus on the immunizations."
Correct Answer: B
Rationale:
, • Correct (B): This approach is developmentally appropriate,
using parental proximity (a safe base) and a non-
threatening technique (warming the stethoscope) to build
trust and gain cooperation, which is a core principle of
pediatric assessment (Burns, Ch. 1).
• Incorrect (A): Rescheduling punishes the child and parent
for normal behavior and delays care.
• Incorrect (C): Forcible restraint is traumatic, destroys trust,
and is ethically inappropriate for a non-emergent situation.
• Incorrect (D): Skipping the exam neglects the
comprehensive nature of the visit and fails to address the
child's fear.
Teaching Point: Pediatric care requires adapting
techniques to the child's developmental stage to build
trust and ensure effective assessment.
Question 2
Chapter & Subtopic: Chapter 1 – Primary Care Versus Primary
Prevention
Stem: A pediatric primary care nurse is planning a community
health fair. Which activity best represents the concept of
primary prevention?
Options:
A. Screening adolescents for depression using a standardized
questionnaire.
,B. Providing hands-only CPR training to parents and caregivers.
C. Referring a child with obesity to a nutritionist for weight
management.
D. Administering the seasonal influenza vaccine to a healthy 4-
year-old.
Correct Answer: D
Rationale:
• Correct (D): Immunizations are a classic example of
primary prevention, which aims to prevent a disease
before it occurs (Burns, Ch. 1).
• Incorrect (A): Screening is a form of secondary prevention
(early detection).
• Incorrect (B): While beneficial, CPR is an emergency
intervention, not a primary prevention for a specific
disease.
• Incorrect (C): Managing an existing condition like obesity is
tertiary prevention (preventing complications).
Teaching Point: Primary prevention aims to prevent
disease onset, with immunizations being a cornerstone
intervention.
Question 3
Chapter & Subtopic: Chapter 1 – Caring for Children and Youth
with Special Healthcare Needs (CYSHCN)
Stem: The pediatric primary care nurse is using a medical home
, model for a child with cerebral palsy. Which action is most
consistent with this model's principles?
Options:
A. Coordinating a referral to a physical therapist and sharing the
assessment findings with the family.
B. Managing all aspects of the child's complex care
independently to ensure consistency.
C. Focusing clinic visits solely on the neurological aspects of
cerebral palsy.
D. Advising the family to use the emergency department for all
acute illnesses.
Correct Answer: A
Rationale:
• Correct (A): The medical home model emphasizes care
that is accessible, family-centered, coordinated,
comprehensive, and compassionate. Coordination of
specialty care is a key function (Burns, Ch. 1).
• Incorrect (B): The medical home is a central hub for
coordination, not for providing all specialty care
independently.
• Incorrect (C): Care must be comprehensive, addressing all
needs (developmental, psychosocial, etc.), not just the
primary diagnosis.
• Incorrect (D): This reflects fragmented, not coordinated,
care and increases healthcare costs and family stress.
Teaching Point: The medical home model ensures