TEST BANK: BURNS’ PEDIATRIC PRIMARY
CARE (8TH EDITION) | 80+ QUESTIONS |
VERIFIED ANSWERS & RATIONALES
UPDATED FOR 2026
Unit I: Foundations of Child Health
1. A 4-year-old child is brought to the clinic for a well-child visit. According to Erikson, which
developmental task should the PNP focus on supporting?
a) Trust vs. Mistrust
b) Autonomy vs. Shame and Doubt
c) Initiative vs. Guilt
d) Industry vs. Inferiority
Answer: c) Initiative vs. Guilt
Rationale: Erikson’s stages place the preschooler (ages 3-5) in the Initiative vs. Guilt stage. This is
characterized by the child asserting control and power over their environment through play and social
interaction. Trust vs. Mistrust is infancy (0-1), Autonomy vs. Shame is toddlerhood (1-3), and Industry vs.
Inferiority is school-age (6-11).
2. Which of the following represents a primary prevention strategy in pediatric primary care?
a) Screening for lead poisoning at 12 months
b) Administering the MMR vaccine at 12 months
c) Prescribing albuterol for a child with an asthma exacerbation
d) Referring a child with scoliosis for orthopedic evaluation
Answer: b) Administering the MMR vaccine at 12 months
Rationale: Primary prevention aims to prevent disease before it occurs (e.g., immunizations). Lead
,screening (A) is secondary prevention (early detection). Asthma treatment (C) and scoliosis referral (D)
are tertiary prevention (management of existing disease).
3. A PNP is assessing the family structure. Which scenario represents a "kin family"?
a) Two parents and two biological children living in the same home.
b) A single mother and her child living with the maternal grandmother.
c) A father and his two children following a divorce.
d) A married couple with no children.
Answer: b) A single mother and her child living with the maternal grandmother.
Rationale: A "kin family" is a multigenerational family structure where extended family members
(grandparents, aunts) play a primary role in child-rearing alongside or instead of the biological parents.
Unit II: Developmental and Behavioral Health
4. During a 15-month well-child visit, the parent reports the child uses a "pincer grasp." The PNP
understands this milestone is significant because it indicates:
a) Readiness for potty training
b) Development of fine motor control
c) Resolution of primitive reflexes
d) Proximodistal development completion
Answer: b) Development of fine motor control
Rationale: The pincer grasp (using thumb and forefinger to pick up small objects) is a key fine motor
milestone that typically emerges around 9-10 months and is refined by 12-15 months. It indicates
maturation of the neuromuscular system.
5. A 7-year-old is brought in for a school physical. The parents are concerned because the child
stutters occasionally when excited. The PNP knows that developmental stuttering:
a) Usually indicates a need for immediate speech therapy
b) Is most common in children with cognitive delays
c) Often resolves spontaneously in the school-age years
d) Is a sign of emotional trauma
Answer: c) Often resolves spontaneously in the school-age years
Rationale: Developmental stuttering (dysfluency) is common between ages 2 and 5 during rapid
language expansion. By age 7, most children outgrow it. Therapy is indicated if it persists beyond 6
months, causes anxiety, or is accompanied by secondary behaviors (eye blinking, facial tension).
6. Which finding in a 4-month-old infant would be a red flag for possible developmental delay
requiring further evaluation?
, a) Unable to roll over
b) Persistent head lag when pulled to sit
c) Coos and gurgles
d) Grasps rattle placed in hand
Answer: b) Persistent head lag when pulled to sit
Rationale: Head lag should resolve by 3-4 months of age. Persistent head lag at 4 months suggests poor
neck and trunk tone, which may indicate a neuromuscular disorder or global developmental delay.
Rolling over (A) is a 4-6 month milestone; cooing (C) is expected; grasping (D) is a 3-4 month reflex/fine
motor skill.
Unit III: Communication and Health Promotion
7. When providing anticipatory guidance to parents of a 2-month-old, the PNP should prioritize
counseling on:
a) Water safety and pool fencing
b) Car seat safety (rear-facing) and safe sleep
c) Reading to the child and discipline strategies
d) Bike helmets and stranger danger
Answer: b) Car seat safety (rear-facing) and safe sleep
Rationale: For a 2-month-old, the highest risks are SIDS and motor vehicle accidents. Anticipatory
guidance focuses on "Back to Sleep" (supine positioning) and appropriate rear-facing car seat use. Water
safety (A) is relevant for toddlers; reading (C) is important but not a safety priority at 2 months; bike
helmets (D) are for older children.
8. Using the "FLACC" scale, the PNP assesses a post-operative 3-year-old who is kicking, crying
inconsolably, and consolable only briefly by the parent. What is the appropriate action?
a) Document "no pain" as the child is consolable.
b) Administer prescribed analgesic.
c) Ignore the behavior as attention-seeking.
d) Restrain the child for vital signs.
Answer: b) Administer prescribed analgesic.
Rationale: The FLACC (Face, Legs, Activity, Cry, Consolability) scale is a validated behavioral pain
assessment for children 2 months to 7 years. A score of 4 or higher (based on the described behaviors)
warrants pain intervention. Consolability is a component, not the sole indicator.
Unit IV: Common Illnesses and Acute Care
CARE (8TH EDITION) | 80+ QUESTIONS |
VERIFIED ANSWERS & RATIONALES
UPDATED FOR 2026
Unit I: Foundations of Child Health
1. A 4-year-old child is brought to the clinic for a well-child visit. According to Erikson, which
developmental task should the PNP focus on supporting?
a) Trust vs. Mistrust
b) Autonomy vs. Shame and Doubt
c) Initiative vs. Guilt
d) Industry vs. Inferiority
Answer: c) Initiative vs. Guilt
Rationale: Erikson’s stages place the preschooler (ages 3-5) in the Initiative vs. Guilt stage. This is
characterized by the child asserting control and power over their environment through play and social
interaction. Trust vs. Mistrust is infancy (0-1), Autonomy vs. Shame is toddlerhood (1-3), and Industry vs.
Inferiority is school-age (6-11).
2. Which of the following represents a primary prevention strategy in pediatric primary care?
a) Screening for lead poisoning at 12 months
b) Administering the MMR vaccine at 12 months
c) Prescribing albuterol for a child with an asthma exacerbation
d) Referring a child with scoliosis for orthopedic evaluation
Answer: b) Administering the MMR vaccine at 12 months
Rationale: Primary prevention aims to prevent disease before it occurs (e.g., immunizations). Lead
,screening (A) is secondary prevention (early detection). Asthma treatment (C) and scoliosis referral (D)
are tertiary prevention (management of existing disease).
3. A PNP is assessing the family structure. Which scenario represents a "kin family"?
a) Two parents and two biological children living in the same home.
b) A single mother and her child living with the maternal grandmother.
c) A father and his two children following a divorce.
d) A married couple with no children.
Answer: b) A single mother and her child living with the maternal grandmother.
Rationale: A "kin family" is a multigenerational family structure where extended family members
(grandparents, aunts) play a primary role in child-rearing alongside or instead of the biological parents.
Unit II: Developmental and Behavioral Health
4. During a 15-month well-child visit, the parent reports the child uses a "pincer grasp." The PNP
understands this milestone is significant because it indicates:
a) Readiness for potty training
b) Development of fine motor control
c) Resolution of primitive reflexes
d) Proximodistal development completion
Answer: b) Development of fine motor control
Rationale: The pincer grasp (using thumb and forefinger to pick up small objects) is a key fine motor
milestone that typically emerges around 9-10 months and is refined by 12-15 months. It indicates
maturation of the neuromuscular system.
5. A 7-year-old is brought in for a school physical. The parents are concerned because the child
stutters occasionally when excited. The PNP knows that developmental stuttering:
a) Usually indicates a need for immediate speech therapy
b) Is most common in children with cognitive delays
c) Often resolves spontaneously in the school-age years
d) Is a sign of emotional trauma
Answer: c) Often resolves spontaneously in the school-age years
Rationale: Developmental stuttering (dysfluency) is common between ages 2 and 5 during rapid
language expansion. By age 7, most children outgrow it. Therapy is indicated if it persists beyond 6
months, causes anxiety, or is accompanied by secondary behaviors (eye blinking, facial tension).
6. Which finding in a 4-month-old infant would be a red flag for possible developmental delay
requiring further evaluation?
, a) Unable to roll over
b) Persistent head lag when pulled to sit
c) Coos and gurgles
d) Grasps rattle placed in hand
Answer: b) Persistent head lag when pulled to sit
Rationale: Head lag should resolve by 3-4 months of age. Persistent head lag at 4 months suggests poor
neck and trunk tone, which may indicate a neuromuscular disorder or global developmental delay.
Rolling over (A) is a 4-6 month milestone; cooing (C) is expected; grasping (D) is a 3-4 month reflex/fine
motor skill.
Unit III: Communication and Health Promotion
7. When providing anticipatory guidance to parents of a 2-month-old, the PNP should prioritize
counseling on:
a) Water safety and pool fencing
b) Car seat safety (rear-facing) and safe sleep
c) Reading to the child and discipline strategies
d) Bike helmets and stranger danger
Answer: b) Car seat safety (rear-facing) and safe sleep
Rationale: For a 2-month-old, the highest risks are SIDS and motor vehicle accidents. Anticipatory
guidance focuses on "Back to Sleep" (supine positioning) and appropriate rear-facing car seat use. Water
safety (A) is relevant for toddlers; reading (C) is important but not a safety priority at 2 months; bike
helmets (D) are for older children.
8. Using the "FLACC" scale, the PNP assesses a post-operative 3-year-old who is kicking, crying
inconsolably, and consolable only briefly by the parent. What is the appropriate action?
a) Document "no pain" as the child is consolable.
b) Administer prescribed analgesic.
c) Ignore the behavior as attention-seeking.
d) Restrain the child for vital signs.
Answer: b) Administer prescribed analgesic.
Rationale: The FLACC (Face, Legs, Activity, Cry, Consolability) scale is a validated behavioral pain
assessment for children 2 months to 7 years. A score of 4 or higher (based on the described behaviors)
warrants pain intervention. Consolability is a component, not the sole indicator.
Unit IV: Common Illnesses and Acute Care
