Burns’ Pediatric Primary Care (8th Ed.) — Complete Chapter-
by-Chapter Test Bank: Verified Answers & Detailed Rationales
(New Edition)
Question 1
Reference: Ch. 9, Section: Developmental Management
Question Stem:
A 4-year-old child is brought to the clinic for a well-child visit.
The parent expresses concern that the child, while very verbal,
cannot correctly name the colors red and blue and often draws
a person as a "tadpole" figure (a circle with lines for limbs).
Which response by the PNP is most appropriate?
Options:
A. "This is a significant developmental delay; we should initiate
a referral for early intervention services immediately."
B. "These are typical artistic and cognitive expressions for a 4-
year-old; let's discuss other developmental milestones."
,C. "Your child may have a color vision deficiency; we should
schedule a formal ophthalmology evaluation."
D. "This suggests a fine motor delay; we will focus on pre-
writing skill exercises at home."
Correct Answer: B
Rationales:
• Correct (B): At 4 years of age, a tadpole drawing of a
person and emerging, but not yet fully mastered, color
naming are within the expected range of normal
development. The PNP should reassure the parent while
conducting a full developmental assessment.
• Incorrect (A): This is an overreaction to typical findings and
is not indicated without further assessment of other
developmental domains.
• Incorrect (C): While color vision deficits are possible, the
inability to consistently name colors at this age is more
likely a cognitive/language milestone issue rather than a
definitive sign of color blindness.
• Incorrect (D): The tadpole drawing is a normal
developmental stage of pre-symbolic representation, not a
fine motor delay.
Teaching Point: Tadpole drawings and emerging color naming
are typical for preschoolers and represent normal cognitive and
artistic development.
,Question 2
Reference: Ch. 10, Section: Nutrition
Question Stem:
A 6-month-old infant, exclusively breastfed since birth, presents
for a well-child visit. The infant was born at term and is growing
appropriately along the 50th percentile. What is the most
appropriate initial dietary recommendation from the PNP?
Options:
A. Continue exclusive breastfeeding until 12 months of age, as it
provides complete nutrition.
B. Introduce iron-fortified infant cereals or pureed meats to
provide a dietary source of iron.
C. Begin whole cow's milk to ensure adequate calcium and
vitamin D intake.
D. Start pureed fruits and vegetables, avoiding cereals and
meats to prevent allergies.
Correct Answer: B
Rationales:
• Correct (B): Around 6 months of age, iron stores from birth
are depleted. Iron-fortified cereals and pureed meats are
recommended as first foods to prevent iron deficiency
anemia.
, • Incorrect (A): While breast milk is ideal, its iron content
becomes insufficient to meet the infant's needs after
about 6 months, necessitating complementary foods.
• Incorrect (C): Whole cow's milk is not recommended
before 12 months of age due to the risk of causing iron
deficiency and its high renal solute load.
• Incorrect (D): While fruits and vegetables can be
introduced, prioritizing iron-rich foods is critical. Delaying
allergenic foods is no longer recommended for prevention.
Teaching Point: At 6 months, introduce iron-rich
complementary foods first to replenish diminishing iron stores.
Question 3
Reference: Ch. 13, Section: Immunizations
Question Stem:
A 2-month-old infant presents for the first well-child visit since
hospital discharge. The parent is ready for vaccinations but
states, "I'm terrified she will get autism from the MMR vaccine."
What is the PNP's best initial response?
Options:
A. "You must vaccinate your child; it is required by state law for
public health safety."
B. "That theory has been thoroughly disproven by numerous
large-scale scientific studies."
by-Chapter Test Bank: Verified Answers & Detailed Rationales
(New Edition)
Question 1
Reference: Ch. 9, Section: Developmental Management
Question Stem:
A 4-year-old child is brought to the clinic for a well-child visit.
The parent expresses concern that the child, while very verbal,
cannot correctly name the colors red and blue and often draws
a person as a "tadpole" figure (a circle with lines for limbs).
Which response by the PNP is most appropriate?
Options:
A. "This is a significant developmental delay; we should initiate
a referral for early intervention services immediately."
B. "These are typical artistic and cognitive expressions for a 4-
year-old; let's discuss other developmental milestones."
,C. "Your child may have a color vision deficiency; we should
schedule a formal ophthalmology evaluation."
D. "This suggests a fine motor delay; we will focus on pre-
writing skill exercises at home."
Correct Answer: B
Rationales:
• Correct (B): At 4 years of age, a tadpole drawing of a
person and emerging, but not yet fully mastered, color
naming are within the expected range of normal
development. The PNP should reassure the parent while
conducting a full developmental assessment.
• Incorrect (A): This is an overreaction to typical findings and
is not indicated without further assessment of other
developmental domains.
• Incorrect (C): While color vision deficits are possible, the
inability to consistently name colors at this age is more
likely a cognitive/language milestone issue rather than a
definitive sign of color blindness.
• Incorrect (D): The tadpole drawing is a normal
developmental stage of pre-symbolic representation, not a
fine motor delay.
Teaching Point: Tadpole drawings and emerging color naming
are typical for preschoolers and represent normal cognitive and
artistic development.
,Question 2
Reference: Ch. 10, Section: Nutrition
Question Stem:
A 6-month-old infant, exclusively breastfed since birth, presents
for a well-child visit. The infant was born at term and is growing
appropriately along the 50th percentile. What is the most
appropriate initial dietary recommendation from the PNP?
Options:
A. Continue exclusive breastfeeding until 12 months of age, as it
provides complete nutrition.
B. Introduce iron-fortified infant cereals or pureed meats to
provide a dietary source of iron.
C. Begin whole cow's milk to ensure adequate calcium and
vitamin D intake.
D. Start pureed fruits and vegetables, avoiding cereals and
meats to prevent allergies.
Correct Answer: B
Rationales:
• Correct (B): Around 6 months of age, iron stores from birth
are depleted. Iron-fortified cereals and pureed meats are
recommended as first foods to prevent iron deficiency
anemia.
, • Incorrect (A): While breast milk is ideal, its iron content
becomes insufficient to meet the infant's needs after
about 6 months, necessitating complementary foods.
• Incorrect (C): Whole cow's milk is not recommended
before 12 months of age due to the risk of causing iron
deficiency and its high renal solute load.
• Incorrect (D): While fruits and vegetables can be
introduced, prioritizing iron-rich foods is critical. Delaying
allergenic foods is no longer recommended for prevention.
Teaching Point: At 6 months, introduce iron-rich
complementary foods first to replenish diminishing iron stores.
Question 3
Reference: Ch. 13, Section: Immunizations
Question Stem:
A 2-month-old infant presents for the first well-child visit since
hospital discharge. The parent is ready for vaccinations but
states, "I'm terrified she will get autism from the MMR vaccine."
What is the PNP's best initial response?
Options:
A. "You must vaccinate your child; it is required by state law for
public health safety."
B. "That theory has been thoroughly disproven by numerous
large-scale scientific studies."
