Burns’ Pediatric Primary Care (8th Ed.) — Complete Chapter-
by-Chapter Test Bank: Verified Answers & Detailed Rationales
(New Edition)
Question 1
Reference: Ch. 10, Section: Developmental Surveillance and
Screening
Question Stem:
A 4-year-old child presents for a well-child visit. The parent has
no developmental concerns. According to established
guidelines, which action by the pediatric primary care provider
is most appropriate for developmental surveillance at this visit?
Options:
A. Reassure the parent that development is likely normal since
there are no concerns.
B. Administer a standardized, validated developmental
screening tool.
,C. Refer the child immediately to a developmental specialist for
a full evaluation.
D. Use a milestone checklist based solely on clinical observation
during the visit.
Correct Answer: B
Rationales:
• Correct: The American Academy of Pediatrics (AAP) and
textbook guidelines recommend administering a formal,
validated developmental screening tool at the 4-year well-
child visit, even in the absence of parental concern, to
identify potential delays.
• Incorrect A: Relying solely on parental concern or clinical
judgment is insufficient, as it can miss subtle or emerging
delays. Structured screening is a standard of care.
• Incorrect C: A specialist referral is not indicated for routine
surveillance without any red flags or a positive screening
result.
• Incorrect D: While observation is part of surveillance, it is
not a substitute for a standardized, psychometrically valid
screening tool at recommended ages.
Teaching Point: Standardized developmental screening is
mandatory at 4 years, regardless of clinical impression.
Citation: Burns, C. E. et al. (2023). Burns’ Pediatric Primary
Care (8th ed.). Elsevier. Ch. 10.
,Question 2
Reference: Ch. 12, Section: Pediatric Hypertension
Management
Question Stem:
An asymptomatic 16-year-old male has a blood pressure
reading at the 96th percentile for his age, height, and sex on
three separate occasions. The initial workup, including renal
ultrasound and echocardiogram, is normal. What is the most
appropriate first-line pharmacological intervention?
Options:
A. Lisinopril, an ACE inhibitor
B. Furosemide, a loop diuretic
C. Metoprolol, a beta-blocker
D. Amlodipine, a calcium channel blocker
Correct Answer: A
Rationales:
• Correct: ACE inhibitors (or ARBs) are the preferred first-line
pharmacologic agents for hypertension in adolescents,
especially when monotherapy is initiated, due to their
efficacy and safety profile.
• Incorrect B: Diuretics are not typically first-line in
adolescents unless there is a specific indication like fluid
overload.
, • Incorrect C: Beta-blockers are less favored as first-line due
to side effects like fatigue and exercise intolerance, which
can impact adolescent quality of life.
• Incorrect D: While calcium channel blockers can be used,
ACE inhibitors are generally preferred as first-line therapy
in this age group.
Teaching Point: ACE inhibitors are the first-line drug class for
pharmacologic management of adolescent hypertension.
Citation: Burns, C. E. et al. (2023). Burns’ Pediatric Primary
Care (8th ed.). Elsevier. Ch. 12.
Question 3
Reference: Ch. 24, Section: Acute Otitis Media (AOM)
Question Stem:
A 2-year-old, otherwise healthy female presents with 48 hours
of otalgia and fever to 38.5°C (101.3°F). On otoscopic exam, the
tympanic membrane is bulging, erythematous, and has poor
mobility. She attends daycare but has no history of AOM in the
past year. What is the most appropriate initial management?
Options:
A. Prescribe a 10-day course of high-dose amoxicillin.
B. Initiate a 5-day course of amoxicillin-clavulanate.
C. Recommend analgesic therapy and observe for 48-72 hours
without antibiotics.
by-Chapter Test Bank: Verified Answers & Detailed Rationales
(New Edition)
Question 1
Reference: Ch. 10, Section: Developmental Surveillance and
Screening
Question Stem:
A 4-year-old child presents for a well-child visit. The parent has
no developmental concerns. According to established
guidelines, which action by the pediatric primary care provider
is most appropriate for developmental surveillance at this visit?
Options:
A. Reassure the parent that development is likely normal since
there are no concerns.
B. Administer a standardized, validated developmental
screening tool.
,C. Refer the child immediately to a developmental specialist for
a full evaluation.
D. Use a milestone checklist based solely on clinical observation
during the visit.
Correct Answer: B
Rationales:
• Correct: The American Academy of Pediatrics (AAP) and
textbook guidelines recommend administering a formal,
validated developmental screening tool at the 4-year well-
child visit, even in the absence of parental concern, to
identify potential delays.
• Incorrect A: Relying solely on parental concern or clinical
judgment is insufficient, as it can miss subtle or emerging
delays. Structured screening is a standard of care.
• Incorrect C: A specialist referral is not indicated for routine
surveillance without any red flags or a positive screening
result.
• Incorrect D: While observation is part of surveillance, it is
not a substitute for a standardized, psychometrically valid
screening tool at recommended ages.
Teaching Point: Standardized developmental screening is
mandatory at 4 years, regardless of clinical impression.
Citation: Burns, C. E. et al. (2023). Burns’ Pediatric Primary
Care (8th ed.). Elsevier. Ch. 10.
,Question 2
Reference: Ch. 12, Section: Pediatric Hypertension
Management
Question Stem:
An asymptomatic 16-year-old male has a blood pressure
reading at the 96th percentile for his age, height, and sex on
three separate occasions. The initial workup, including renal
ultrasound and echocardiogram, is normal. What is the most
appropriate first-line pharmacological intervention?
Options:
A. Lisinopril, an ACE inhibitor
B. Furosemide, a loop diuretic
C. Metoprolol, a beta-blocker
D. Amlodipine, a calcium channel blocker
Correct Answer: A
Rationales:
• Correct: ACE inhibitors (or ARBs) are the preferred first-line
pharmacologic agents for hypertension in adolescents,
especially when monotherapy is initiated, due to their
efficacy and safety profile.
• Incorrect B: Diuretics are not typically first-line in
adolescents unless there is a specific indication like fluid
overload.
, • Incorrect C: Beta-blockers are less favored as first-line due
to side effects like fatigue and exercise intolerance, which
can impact adolescent quality of life.
• Incorrect D: While calcium channel blockers can be used,
ACE inhibitors are generally preferred as first-line therapy
in this age group.
Teaching Point: ACE inhibitors are the first-line drug class for
pharmacologic management of adolescent hypertension.
Citation: Burns, C. E. et al. (2023). Burns’ Pediatric Primary
Care (8th ed.). Elsevier. Ch. 12.
Question 3
Reference: Ch. 24, Section: Acute Otitis Media (AOM)
Question Stem:
A 2-year-old, otherwise healthy female presents with 48 hours
of otalgia and fever to 38.5°C (101.3°F). On otoscopic exam, the
tympanic membrane is bulging, erythematous, and has poor
mobility. She attends daycare but has no history of AOM in the
past year. What is the most appropriate initial management?
Options:
A. Prescribe a 10-day course of high-dose amoxicillin.
B. Initiate a 5-day course of amoxicillin-clavulanate.
C. Recommend analgesic therapy and observe for 48-72 hours
without antibiotics.
