Burns’ Pediatric Primary Care (8th Ed.) — Complete Chapter-
by-Chapter Test Bank: Verified Answers & Detailed Rationales
(New Edition)
Chapter 1: Pediatric Primary Care
Chapter 1 – Primary Care versus Primary Prevention
Key concept: Anticipatory guidance & well-child visits
Stem: A 2-week-old infant attends the first well-child visit. The
nurse’s best priority for this visit that exemplifies primary
prevention is to:
A. Teach parents signs of colic and when to return to clinic.
B. Administer the first dose of hepatitis B vaccine and counsel
on feeding.
C. Perform a full skin assessment and order a bilirubin level.
D. Discuss sleep positioning and safe sleep practices with
caregivers.
Correct answer: D
Rationale (correct): Discussing safe sleep practices (supine
positioning, smoke-free environment) is classic anticipatory
guidance that prevents SIDS and injury — a primary-prevention
,nursing intervention emphasized in well-child care (Burns, Ch.1,
Primary Prevention). AAP Bright Futures recommends
anticipatory guidance at early visits. AAP+1
Rationale (incorrect):
A. Teaching colic signs is anticipatory but is secondary
(managing symptoms) rather than the highest-priority primary
prevention at 2 weeks.
B. Hepatitis B vaccination is primary prevention — a reasonable
action — but counseling on safe sleep (D) directly targets the
highest immediate mortality risk (SIDS) at this age.
C. Skin assessment and bilirubin ordering are
assessment/diagnostic measures (tertiary/secondary focus if
abnormal), not anticipatory primary prevention.
Teaching point: Anticipatory guidance (safe sleep) is a
cornerstone of early primary prevention.
2) Chapter & Subtopic
Chapter 1 – Pediatric Primary Care, Unique Issues in Pediatrics
— Key concept: Growth/Development surveillance
Stem: During a 9-month well visit, a nurse notes the infant has
not begun pulling to stand and the parents express concern.
The nurse’s best next action is to:
A. Reassure parents that development varies and schedule a
routine 12-month visit.
B. Refer immediately to early intervention for a multidisciplinary
,evaluation.
C. Perform focused developmental screening and ask about
home environment and any regression.
D. Tell the parents to try more tummy time and return in 3
months.
Correct answer: C
Rationale (correct): Initial nursing role is developmental
surveillance and focused screening, including history of
regression and environmental factors; this directs appropriate
referrals. Burns emphasizes the nurse’s role in surveillance and
timely screening. AAP Bright Futures supports screening when
concerns arise. AAP Publications
Rationale (incorrect):
A. Passive reassurance delays needed evaluation when delay is
suspected.
B. Immediate referral may be premature without screening
data; screening guides urgency.
D. Tummy time is useful but inadequate as the only response to
a possible delay.
Teaching point: Use screening tools and history to triage
developmental concerns before referral.
3) Chapter & Subtopic
, Chapter 1 – Pediatric Primary Care, Caring for Children &
Youth With Special Healthcare Needs (CYSHCN) — Key
concept: Care coordination
Stem: A school-age child with cerebral palsy and multiple
specialists is frequently missing appointments. Which nurse
action best supports care coordination?
A. Call families weekly to remind them of appointments.
B. Create a shared care plan with contacts, goals, and next steps
and share with family and team.
C. Schedule all specialist visits on the same day to reduce travel.
D. Encourage the family to use telehealth only for specialty
care.
Correct answer: B
Rationale (correct): Creating and sharing a coordinated care
plan (medical home approach) aligns teams and families,
reduces fragmentation, and is an evidence-based nursing
intervention for CYSHCN (Burns, Ch.1). AAP resources
emphasize care coordination and medical-home tools. AAP+1
Rationale (incorrect):
A. Reminders help adherence but don’t address communication
or system-level coordination.
C. Scheduling same-day visits may be impractical with specialty
availability and therapeutic needs.
D. Telehealth is a useful adjunct but not the sole solution for
comprehensive coordination.
by-Chapter Test Bank: Verified Answers & Detailed Rationales
(New Edition)
Chapter 1: Pediatric Primary Care
Chapter 1 – Primary Care versus Primary Prevention
Key concept: Anticipatory guidance & well-child visits
Stem: A 2-week-old infant attends the first well-child visit. The
nurse’s best priority for this visit that exemplifies primary
prevention is to:
A. Teach parents signs of colic and when to return to clinic.
B. Administer the first dose of hepatitis B vaccine and counsel
on feeding.
C. Perform a full skin assessment and order a bilirubin level.
D. Discuss sleep positioning and safe sleep practices with
caregivers.
Correct answer: D
Rationale (correct): Discussing safe sleep practices (supine
positioning, smoke-free environment) is classic anticipatory
guidance that prevents SIDS and injury — a primary-prevention
,nursing intervention emphasized in well-child care (Burns, Ch.1,
Primary Prevention). AAP Bright Futures recommends
anticipatory guidance at early visits. AAP+1
Rationale (incorrect):
A. Teaching colic signs is anticipatory but is secondary
(managing symptoms) rather than the highest-priority primary
prevention at 2 weeks.
B. Hepatitis B vaccination is primary prevention — a reasonable
action — but counseling on safe sleep (D) directly targets the
highest immediate mortality risk (SIDS) at this age.
C. Skin assessment and bilirubin ordering are
assessment/diagnostic measures (tertiary/secondary focus if
abnormal), not anticipatory primary prevention.
Teaching point: Anticipatory guidance (safe sleep) is a
cornerstone of early primary prevention.
2) Chapter & Subtopic
Chapter 1 – Pediatric Primary Care, Unique Issues in Pediatrics
— Key concept: Growth/Development surveillance
Stem: During a 9-month well visit, a nurse notes the infant has
not begun pulling to stand and the parents express concern.
The nurse’s best next action is to:
A. Reassure parents that development varies and schedule a
routine 12-month visit.
B. Refer immediately to early intervention for a multidisciplinary
,evaluation.
C. Perform focused developmental screening and ask about
home environment and any regression.
D. Tell the parents to try more tummy time and return in 3
months.
Correct answer: C
Rationale (correct): Initial nursing role is developmental
surveillance and focused screening, including history of
regression and environmental factors; this directs appropriate
referrals. Burns emphasizes the nurse’s role in surveillance and
timely screening. AAP Bright Futures supports screening when
concerns arise. AAP Publications
Rationale (incorrect):
A. Passive reassurance delays needed evaluation when delay is
suspected.
B. Immediate referral may be premature without screening
data; screening guides urgency.
D. Tummy time is useful but inadequate as the only response to
a possible delay.
Teaching point: Use screening tools and history to triage
developmental concerns before referral.
3) Chapter & Subtopic
, Chapter 1 – Pediatric Primary Care, Caring for Children &
Youth With Special Healthcare Needs (CYSHCN) — Key
concept: Care coordination
Stem: A school-age child with cerebral palsy and multiple
specialists is frequently missing appointments. Which nurse
action best supports care coordination?
A. Call families weekly to remind them of appointments.
B. Create a shared care plan with contacts, goals, and next steps
and share with family and team.
C. Schedule all specialist visits on the same day to reduce travel.
D. Encourage the family to use telehealth only for specialty
care.
Correct answer: B
Rationale (correct): Creating and sharing a coordinated care
plan (medical home approach) aligns teams and families,
reduces fragmentation, and is an evidence-based nursing
intervention for CYSHCN (Burns, Ch.1). AAP resources
emphasize care coordination and medical-home tools. AAP+1
Rationale (incorrect):
A. Reminders help adherence but don’t address communication
or system-level coordination.
C. Scheduling same-day visits may be impractical with specialty
availability and therapeutic needs.
D. Telehealth is a useful adjunct but not the sole solution for
comprehensive coordination.
