MCQs per Chapter
Pediatric Primary Care Test Bank & NCLEX-HESI
Review | Burns' 8th Edition
Question 1:
A 9-month-old infant comes for a well-child visit. The family
expresses concern about the number of recommended
anticipatory guidance topics to address in one visit. Which
action best reflects the role of the pediatric primary care
provider during a preventive visit?
A. Prioritize a single topic—vaccination—and defer other
guidance to the next visit to avoid overwhelming the family.
B. Use the visit to provide age-appropriate anticipatory
guidance, screen for key risks, and coordinate follow-up as part
of comprehensive care.
C. Focus solely on the physical examination and immunizations;
anticipatory guidance is the responsibility of community health
workers.
D. Give the family printed handouts covering all possible topics
and end the visit early to respect their time.
Correct Answer: B
Rationale: The pediatric primary care provider’s role in
preventive visits includes delivering age-appropriate
anticipatory guidance, screening (developmental/behavioral),
,and coordinating follow-up or referrals as needed—this is core
to comprehensive primary care and Bright Futures–based
health supervision. Option A is incorrect because deferring
most guidance fragments care and misses opportunities for
early intervention. Option C is incorrect because anticipatory
guidance is a primary care responsibility, not something to
delegate entirely. Option D is suboptimal: printed materials can
supplement counseling but cannot substitute for individualized,
interactive guidance and care coordination.
Question 2:
Which statement best distinguishes primary prevention from
primary care in pediatric practice?
A. Primary prevention is the annual well-child visit; primary care
is immunization.
B. Primary prevention focuses on preventing disease or injury
(e.g., immunization, safety counseling), while primary care
provides continuous, comprehensive health services including
prevention, acute care, and care coordination.
C. Primary prevention is treating acute infections early; primary
care is managing chronic illnesses only.
D. Primary prevention and primary care are interchangeable
terms in pediatrics.
Correct Answer: B
Rationale: Primary prevention comprises activities to prevent
disease/injury before it occurs (immunizations, injury
,prevention counseling, anticipatory guidance). Primary care is
broader — continuous, comprehensive services that include
prevention, acute and chronic care, and coordination. Option A
reverses concepts; option C mislabels prevention as treatment;
option D is false — terms are distinct.
Question 3:
During a 2-year visit, a nurse practitioner follows the Bright
Futures periodicity schedule. Which of the following activities is
most appropriate to include at this visit according to Bright
Futures principles?
A. Conduct no developmental surveillance — only perform it at
4 years.
B. Perform developmental screening, provide anticipatory
guidance for toilet training and nutrition, and check
immunization status.
C. Delay discussing healthy screen time until school age.
D. Only focus on immunizations; developmental concerns
should be handled by a pediatrician at a separate visit.
Correct Answer: B
Rationale: Bright Futures recommends developmental
surveillance at every well-child visit with formal developmental
screening at recommended ages (including around 18–24
months), anticipatory guidance (toilet training, nutrition,
safety), and immunization review as part of the periodicity
schedule. This integrated approach optimizes early
, identification and intervention. Option A is incorrect—
developmental surveillance should occur routinely and
screening at key ages. Option C is incorrect — guidance on
screen time is appropriate in early childhood. Option D
fragments care and misses early detection opportunities. AAP
Question 4:
A 7-year-old with mild asthma receives most care from a
pediatrician but occasionally sees a school nurse and a
pulmonology specialist. Which feature is most consistent with
the “medical home” model in pediatric primary care?
A. The parent must independently contact each provider and
manage all care coordination.
B. The pediatrician acts as the central hub providing family-
centered, coordinated care and connecting the child with
community, school, and specialty services.
C. Specialists manage all preventive care, while the pediatrician
only sees the child during exacerbations.
D. The school nurse assumes responsibility for all chronic
disease management during the school year.
Correct Answer: B
Rationale: The medical home model centers on a primary care
clinician coordinating accessible, family-centered, continuous,
comprehensive, and coordinated care across settings (including
school and specialists). Option A places the burden solely on
families, contrary to the medical home. Option C incorrectly