,
,Burns: Pediatric Primary Care, 6th Edition
Chapter 2: Child and Family Health Assessment
Test Bank
Multiple Choice
1. The parent of a toddler is concerned that the child may have autism. The primary care
pediatric nurse practitioner completes a Modified Checklist for Autism in Toddlers
(M-CHAT) tool, which indicates several areas of concern. What will the nurse
practitioner do?
a. Administer a Childhood Autism Rating Scale (CARS) in the clinic.
b. Consult a specialist to determine appropriate early intervention strategies.
c. Refer the child to a behavioral specialist for further evaluation.
d. Tell the parent that this result indicates that the child has autism.
ANS: C
The M-CHAT is a screening tool and is useful for detecting behaviors that may indicate
autism. This instrument has been found to have acceptable sensitivity, specificity, and
significant positive predictive value. If these behaviors are detected, the PNP should refer
the child to a specialist for further assessment, using more diagnostic tools. The CARS
may be used but requires specialty training and proper credentials. Until the diagnosis is
determined, strategies for intervention are not discussed. The M-CHAT is a screening
tool and is not diagnostic.
2. The mother of a newborn tells the primary care pediatric nurse practitioner that she is
worried that her child will develop allergies and asthma. Which tool will the nurse
practitioner use to evaluate this risk?
a. Three-generation pedigree
b. Review of systems
c. Genogram
d. Ecomap
ANS: A
The three-generation pedigree is used to map out risks for genetic diseases in families, as
well as conditions with modifiable risk factors. The review of systems is used to evaluate
the history of the child’s body systems. The genogram is an approach to developing a
family database to provide a graphic representation of family structure, roles, and
problems of recurring significance in a family. The ecomap is used to identify
relationships in the family and community that are supportive or harmful.
Copyright © 2017, Elsevier Limited. All rights reserved.
, Test Bank 2
3. The primary care pediatric nurse practitioner is performing a well child check-up on a
20-month-old child. The child was 4 weeks premature and, according to a parent-
completed developmental questionnaire, has achieved milestones for a 15-month-old
infant. Which action is correct?
a. Perform an in-depth developmental assessment screen at this visit to evaluate this
child.
b. Reassure the parent that the child will catch up to normal development by age 2
years.
c. Re-evaluate this child’s development and milestone achievements at the 2-year
visit.
d. Refer the child to a specialty clinic for evaluation and treatment of developmental
delay.
ANS: A
This child should be at a 19-month adjusted age for prematurity so, according to the
parent screen, is 4 months behind. The PNP should perform a more in-depth screen to
evaluate this delay. Waiting to see if the child will “catch up” or assuring the parent that
this will happen will cause the delays to become more severe. A referral to a specialty
clinic should not be made solely on the basis of the parent-completed questionnaire but
only after further evaluation of possible delays.
4. When formulating developmental diagnoses for pediatric patients, the primary care
pediatric nurse practitioner may use which resource?
a. DC: 0-3R
b. ICD-10-CM
c. ICSD-3
d. NANDA International
ANS: A
The DC: 0-3R refers to the Diagnostic Classification of Mental Health and
Developmental Disorders of Infancy and Early Childhood and is useful for
developmental problem diagnosis. The ICD-10-CM is the International Classification of
Diseases-Tenth Revision, Clinical Modification and is useful for identifying physiologic
diseases. The ICSD-3 is the International Classification of Sleep Disorders – 3rd edition.
NANDA International is used to label problems in the functional health domain.
5. The primary care pediatric nurse practitioner is evaluating health literacy in the
mother of a new preschool-age child. How will the nurse practitioner assess this?
a. Ask the child how many books he has at home.
b. Ask the mother about her highest grade in school.
c. Ask the mother to determine the correct dose of a drug from a label.
d. Ask the mother to read a health information handout aloud.
ANS: A
Copyright © 2017, Elsevier Limited. All rights reserved.
,Burns: Pediatric Primary Care, 6th Edition
Chapter 2: Child and Family Health Assessment
Test Bank
Multiple Choice
1. The parent of a toddler is concerned that the child may have autism. The primary care
pediatric nurse practitioner completes a Modified Checklist for Autism in Toddlers
(M-CHAT) tool, which indicates several areas of concern. What will the nurse
practitioner do?
a. Administer a Childhood Autism Rating Scale (CARS) in the clinic.
b. Consult a specialist to determine appropriate early intervention strategies.
c. Refer the child to a behavioral specialist for further evaluation.
d. Tell the parent that this result indicates that the child has autism.
ANS: C
The M-CHAT is a screening tool and is useful for detecting behaviors that may indicate
autism. This instrument has been found to have acceptable sensitivity, specificity, and
significant positive predictive value. If these behaviors are detected, the PNP should refer
the child to a specialist for further assessment, using more diagnostic tools. The CARS
may be used but requires specialty training and proper credentials. Until the diagnosis is
determined, strategies for intervention are not discussed. The M-CHAT is a screening
tool and is not diagnostic.
2. The mother of a newborn tells the primary care pediatric nurse practitioner that she is
worried that her child will develop allergies and asthma. Which tool will the nurse
practitioner use to evaluate this risk?
a. Three-generation pedigree
b. Review of systems
c. Genogram
d. Ecomap
ANS: A
The three-generation pedigree is used to map out risks for genetic diseases in families, as
well as conditions with modifiable risk factors. The review of systems is used to evaluate
the history of the child’s body systems. The genogram is an approach to developing a
family database to provide a graphic representation of family structure, roles, and
problems of recurring significance in a family. The ecomap is used to identify
relationships in the family and community that are supportive or harmful.
Copyright © 2017, Elsevier Limited. All rights reserved.
, Test Bank 2
3. The primary care pediatric nurse practitioner is performing a well child check-up on a
20-month-old child. The child was 4 weeks premature and, according to a parent-
completed developmental questionnaire, has achieved milestones for a 15-month-old
infant. Which action is correct?
a. Perform an in-depth developmental assessment screen at this visit to evaluate this
child.
b. Reassure the parent that the child will catch up to normal development by age 2
years.
c. Re-evaluate this child’s development and milestone achievements at the 2-year
visit.
d. Refer the child to a specialty clinic for evaluation and treatment of developmental
delay.
ANS: A
This child should be at a 19-month adjusted age for prematurity so, according to the
parent screen, is 4 months behind. The PNP should perform a more in-depth screen to
evaluate this delay. Waiting to see if the child will “catch up” or assuring the parent that
this will happen will cause the delays to become more severe. A referral to a specialty
clinic should not be made solely on the basis of the parent-completed questionnaire but
only after further evaluation of possible delays.
4. When formulating developmental diagnoses for pediatric patients, the primary care
pediatric nurse practitioner may use which resource?
a. DC: 0-3R
b. ICD-10-CM
c. ICSD-3
d. NANDA International
ANS: A
The DC: 0-3R refers to the Diagnostic Classification of Mental Health and
Developmental Disorders of Infancy and Early Childhood and is useful for
developmental problem diagnosis. The ICD-10-CM is the International Classification of
Diseases-Tenth Revision, Clinical Modification and is useful for identifying physiologic
diseases. The ICSD-3 is the International Classification of Sleep Disorders – 3rd edition.
NANDA International is used to label problems in the functional health domain.
5. The primary care pediatric nurse practitioner is evaluating health literacy in the
mother of a new preschool-age child. How will the nurse practitioner assess this?
a. Ask the child how many books he has at home.
b. Ask the mother about her highest grade in school.
c. Ask the mother to determine the correct dose of a drug from a label.
d. Ask the mother to read a health information handout aloud.
ANS: A
Copyright © 2017, Elsevier Limited. All rights reserved.
