Burns Pediatric Primary Care 7th Edition Complete Study
Guide PDF – Advanced Pediatric Nursing Review Notes,
Clinical Case Studies, Exam Preparation Questions &
Evidence-Based Practice Manual for Pediatric Primary Care
Success in Nursing Exams and Clinical Practice
Question 1: According to the Burns Pediatric Primary Care guidelines, what is the
recommended age for the first well-child visit after hospital discharge for a healthy newborn?
A. 1 week
B. 2 weeks
C. 3 to 5 days
D. 1 month
CORRECT ANSWER: C. 3 to 5 days
Rationale: The American Academy of Pediatrics (AAP) and Burns text recommend an initial
follow-up within 3 to 5 days of birth (or 48 to 72 hours after discharge) to assess feeding,
weight, jaundice, and hydration status.
Question 2: Which developmental milestone is typically expected in a healthy 6-month-old
infant?
A. Walking with support
B. Sitting without support
C. Pincer grasp
D. Saying two-word phrases
CORRECT ANSWER: B. Sitting without support
Rationale: By 6 months, most infants can sit without support. Walking with support occurs
around 9-12 months, pincer grasp around 9 months, and two-word phrases around 18-24
months.
Question 3: When assessing a child for failure to thrive (FTT), which parameter is the most
sensitive indicator of acute nutritional status?
A. Head circumference
B. Height
C. Weight
D. Mid-upper arm circumference
CORRECT ANSWER: C. Weight
Rationale: Weight is the most sensitive indicator of acute changes in nutritional status and is
the primary parameter used to identify FTT. Height and head circumference reflect chronic
status.
Question 4: A parent asks about the safest sleep position for their newborn to prevent
Sudden Infant Death Syndrome (SIDS). What is the correct recommendation?
A. Prone
B. Supine
C. Side-lying
D. Semi-upright in a car seat
CORRECT ANSWER: B. Supine
,Rationale: The "Back to Sleep" campaign recommends placing infants in the supine position for
every sleep to significantly reduce the risk of SIDS. Prone and side-lying positions are associated
with higher risks.
Question 5: Which vaccine is contraindicated in a child with a severe anaphylactic allergy to
gelatin?
A. Hepatitis B
B. MMR (Measles, Mumps, Rubella)
C. DTaP
D. IPV
CORRECT ANSWER: B. MMR (Measles, Mumps, Rubella)
Rationale: The MMR vaccine contains gelatin as a stabilizer. A history of severe anaphylaxis to
gelatin is a contraindication for receiving the MMR vaccine.
Question 6: At what age should universal screening for lead poisoning be considered for
children at high risk?
A. 6 months and 12 months
B. 12 months and 24 months
C. 24 months and 36 months
D. 36 months and 48 months
CORRECT ANSWER: B. 12 months and 24 months
Rationale: CDC and AAP guidelines recommend universal or targeted screening for lead levels
at 12 and 24 months for children at high risk or in areas with high prevalence of lead exposure.
Question 7: A 2-year-old presents with a barking cough and stridor. What is the most likely
diagnosis?
A. Epiglottitis
B. Croup (Laryngotracheobronchitis)
C. Bronchiolitis
D. Pneumonia
CORRECT ANSWER: B. Croup (Laryngotracheobronchitis)
Rationale: A barking cough and inspiratory stridor are classic clinical presentations of croup,
often caused by parainfluenza virus. Epiglottitis presents with drooling and distress, while
bronchiolitis presents with wheezing.
Question 8: Which antibiotic is the first-line treatment for acute otitis media (AOM) in a child
without penicillin allergy?
A. Azithromycin
B. Amoxicillin
C. Cefdinir
D. Clindamycin
CORRECT ANSWER: B. Amoxicillin
Rationale: High-dose amoxicillin is the recommended first-line antibiotic for uncomplicated
AOM in children without a penicillin allergy due to its efficacy against Streptococcus
pneumoniae.
Question 9: What is the primary goal of asthma management in pediatric primary care?
,A. Cure the underlying condition
B. Achieve and maintain control of symptoms
C. Prevent all respiratory infections
D. Eliminate the need for rescue inhalers entirely
CORRECT ANSWER: B. Achieve and maintain control of symptoms
Rationale: Asthma is a chronic condition that cannot be cured. The goal of management is to
achieve control, minimize symptoms, prevent exacerbations, and maintain normal activity
levels.
Question 10: A 4-year-old child is being evaluated for ADHD. Which setting must symptoms
be present in to meet diagnostic criteria?
A. Home only
B. School only
C. Two or more settings
D. Healthcare setting only
CORRECT ANSWER: C. Two or more settings
Rationale: DSM-5 criteria for ADHD require that symptoms be present in two or more settings
(e.g., home, school, with friends) to rule out situational behaviors and confirm pervasiveness.
Question 11: Which finding in a newborn requires immediate referral to a specialist?
A. Mongolian spots
B. Bilious vomiting
C. Erythema toxicum
D. Milia
CORRECT ANSWER: B. Bilious vomiting
Rationale: Bilious vomiting in a newborn is a medical emergency suggestive of intestinal
obstruction (e.g., malrotation with volvulus) and requires immediate surgical evaluation.
Question 12: What is the recommended daily vitamin D supplementation for exclusively
breastfed infants?
A. 200 IU
B. 400 IU
C. 600 IU
D. 800 IU
CORRECT ANSWER: B. 400 IU
Rationale: The AAP recommends 400 IU of vitamin D daily for all exclusively breastfed infants
starting shortly after birth to prevent rickets, as breast milk is low in vitamin D.
Question 13: A child presents with a sandpaper-like rash and strawberry tongue. Which
diagnosis is most likely?
A. Scarlet Fever
B. Fifth Disease
C. Roseola
D. Hand, Foot, and Mouth Disease
CORRECT ANSWER: A. Scarlet Fever
, Rationale: Scarlet fever, caused by Group A Streptococcus, typically presents with a fine,
sandpaper-like rash and a strawberry tongue, often following strep pharyngitis.
Question 14: When counseling parents about toilet training, what is the most important
factor for success?
A. Starting before age 2
B. Child's developmental readiness
C. Use of punitive measures
D. Strict scheduling
CORRECT ANSWER: B. Child's developmental readiness
Rationale: Successful toilet training depends on the child's physical and psychological readiness,
typically occurring between 18 and 30 months, rather than a specific calendar age or strict
regimen.
Question 15: Which condition is characterized by a "slapped cheek" rash?
A. Measles
B. Erythema Infectiosum (Fifth Disease)
C. Rubella
D. Varicella
CORRECT ANSWER: B. Erythema Infectiosum (Fifth Disease)
Rationale: Erythema Infectiosum, caused by Parvovirus B19, is classically identified by a bright
red "slapped cheek" rash followed by a lacy reticular rash on the body.
Question 16: What is the most common cause of gastroenteritis in children worldwide?
A. Salmonella
B. Rotavirus
C. Norovirus
D. Giardia
CORRECT ANSWER: B. Rotavirus
Rationale: Historically, Rotavirus was the leading cause. With vaccination, Norovirus has
become very common, but Rotavirus remains a primary cause globally and a key focus of
prevention in pediatric care guidelines. (Note: In vaccinated populations, Norovirus is often #1,
but Rotavirus is the classic textbook answer for severe dehydrating gastroenteritis preventable
by vaccine).
Question 17: A 15-year-old female presents with primary amenorrhea. What is the definition
of primary amenorrhea?
A. No menses by age 13 without secondary sexual characteristics
B. No menses by age 15 with secondary sexual characteristics
C. No menses for 3 cycles
D. No menses by age 10
CORRECT ANSWER: B. No menses by age 15 with secondary sexual characteristics
Rationale: Primary amenorrhea is defined as the absence of menarche by age 15 in the
presence of normal secondary sexual characteristics, or by age 13 without secondary sexual
characteristics.
Guide PDF – Advanced Pediatric Nursing Review Notes,
Clinical Case Studies, Exam Preparation Questions &
Evidence-Based Practice Manual for Pediatric Primary Care
Success in Nursing Exams and Clinical Practice
Question 1: According to the Burns Pediatric Primary Care guidelines, what is the
recommended age for the first well-child visit after hospital discharge for a healthy newborn?
A. 1 week
B. 2 weeks
C. 3 to 5 days
D. 1 month
CORRECT ANSWER: C. 3 to 5 days
Rationale: The American Academy of Pediatrics (AAP) and Burns text recommend an initial
follow-up within 3 to 5 days of birth (or 48 to 72 hours after discharge) to assess feeding,
weight, jaundice, and hydration status.
Question 2: Which developmental milestone is typically expected in a healthy 6-month-old
infant?
A. Walking with support
B. Sitting without support
C. Pincer grasp
D. Saying two-word phrases
CORRECT ANSWER: B. Sitting without support
Rationale: By 6 months, most infants can sit without support. Walking with support occurs
around 9-12 months, pincer grasp around 9 months, and two-word phrases around 18-24
months.
Question 3: When assessing a child for failure to thrive (FTT), which parameter is the most
sensitive indicator of acute nutritional status?
A. Head circumference
B. Height
C. Weight
D. Mid-upper arm circumference
CORRECT ANSWER: C. Weight
Rationale: Weight is the most sensitive indicator of acute changes in nutritional status and is
the primary parameter used to identify FTT. Height and head circumference reflect chronic
status.
Question 4: A parent asks about the safest sleep position for their newborn to prevent
Sudden Infant Death Syndrome (SIDS). What is the correct recommendation?
A. Prone
B. Supine
C. Side-lying
D. Semi-upright in a car seat
CORRECT ANSWER: B. Supine
,Rationale: The "Back to Sleep" campaign recommends placing infants in the supine position for
every sleep to significantly reduce the risk of SIDS. Prone and side-lying positions are associated
with higher risks.
Question 5: Which vaccine is contraindicated in a child with a severe anaphylactic allergy to
gelatin?
A. Hepatitis B
B. MMR (Measles, Mumps, Rubella)
C. DTaP
D. IPV
CORRECT ANSWER: B. MMR (Measles, Mumps, Rubella)
Rationale: The MMR vaccine contains gelatin as a stabilizer. A history of severe anaphylaxis to
gelatin is a contraindication for receiving the MMR vaccine.
Question 6: At what age should universal screening for lead poisoning be considered for
children at high risk?
A. 6 months and 12 months
B. 12 months and 24 months
C. 24 months and 36 months
D. 36 months and 48 months
CORRECT ANSWER: B. 12 months and 24 months
Rationale: CDC and AAP guidelines recommend universal or targeted screening for lead levels
at 12 and 24 months for children at high risk or in areas with high prevalence of lead exposure.
Question 7: A 2-year-old presents with a barking cough and stridor. What is the most likely
diagnosis?
A. Epiglottitis
B. Croup (Laryngotracheobronchitis)
C. Bronchiolitis
D. Pneumonia
CORRECT ANSWER: B. Croup (Laryngotracheobronchitis)
Rationale: A barking cough and inspiratory stridor are classic clinical presentations of croup,
often caused by parainfluenza virus. Epiglottitis presents with drooling and distress, while
bronchiolitis presents with wheezing.
Question 8: Which antibiotic is the first-line treatment for acute otitis media (AOM) in a child
without penicillin allergy?
A. Azithromycin
B. Amoxicillin
C. Cefdinir
D. Clindamycin
CORRECT ANSWER: B. Amoxicillin
Rationale: High-dose amoxicillin is the recommended first-line antibiotic for uncomplicated
AOM in children without a penicillin allergy due to its efficacy against Streptococcus
pneumoniae.
Question 9: What is the primary goal of asthma management in pediatric primary care?
,A. Cure the underlying condition
B. Achieve and maintain control of symptoms
C. Prevent all respiratory infections
D. Eliminate the need for rescue inhalers entirely
CORRECT ANSWER: B. Achieve and maintain control of symptoms
Rationale: Asthma is a chronic condition that cannot be cured. The goal of management is to
achieve control, minimize symptoms, prevent exacerbations, and maintain normal activity
levels.
Question 10: A 4-year-old child is being evaluated for ADHD. Which setting must symptoms
be present in to meet diagnostic criteria?
A. Home only
B. School only
C. Two or more settings
D. Healthcare setting only
CORRECT ANSWER: C. Two or more settings
Rationale: DSM-5 criteria for ADHD require that symptoms be present in two or more settings
(e.g., home, school, with friends) to rule out situational behaviors and confirm pervasiveness.
Question 11: Which finding in a newborn requires immediate referral to a specialist?
A. Mongolian spots
B. Bilious vomiting
C. Erythema toxicum
D. Milia
CORRECT ANSWER: B. Bilious vomiting
Rationale: Bilious vomiting in a newborn is a medical emergency suggestive of intestinal
obstruction (e.g., malrotation with volvulus) and requires immediate surgical evaluation.
Question 12: What is the recommended daily vitamin D supplementation for exclusively
breastfed infants?
A. 200 IU
B. 400 IU
C. 600 IU
D. 800 IU
CORRECT ANSWER: B. 400 IU
Rationale: The AAP recommends 400 IU of vitamin D daily for all exclusively breastfed infants
starting shortly after birth to prevent rickets, as breast milk is low in vitamin D.
Question 13: A child presents with a sandpaper-like rash and strawberry tongue. Which
diagnosis is most likely?
A. Scarlet Fever
B. Fifth Disease
C. Roseola
D. Hand, Foot, and Mouth Disease
CORRECT ANSWER: A. Scarlet Fever
, Rationale: Scarlet fever, caused by Group A Streptococcus, typically presents with a fine,
sandpaper-like rash and a strawberry tongue, often following strep pharyngitis.
Question 14: When counseling parents about toilet training, what is the most important
factor for success?
A. Starting before age 2
B. Child's developmental readiness
C. Use of punitive measures
D. Strict scheduling
CORRECT ANSWER: B. Child's developmental readiness
Rationale: Successful toilet training depends on the child's physical and psychological readiness,
typically occurring between 18 and 30 months, rather than a specific calendar age or strict
regimen.
Question 15: Which condition is characterized by a "slapped cheek" rash?
A. Measles
B. Erythema Infectiosum (Fifth Disease)
C. Rubella
D. Varicella
CORRECT ANSWER: B. Erythema Infectiosum (Fifth Disease)
Rationale: Erythema Infectiosum, caused by Parvovirus B19, is classically identified by a bright
red "slapped cheek" rash followed by a lacy reticular rash on the body.
Question 16: What is the most common cause of gastroenteritis in children worldwide?
A. Salmonella
B. Rotavirus
C. Norovirus
D. Giardia
CORRECT ANSWER: B. Rotavirus
Rationale: Historically, Rotavirus was the leading cause. With vaccination, Norovirus has
become very common, but Rotavirus remains a primary cause globally and a key focus of
prevention in pediatric care guidelines. (Note: In vaccinated populations, Norovirus is often #1,
but Rotavirus is the classic textbook answer for severe dehydrating gastroenteritis preventable
by vaccine).
Question 17: A 15-year-old female presents with primary amenorrhea. What is the definition
of primary amenorrhea?
A. No menses by age 13 without secondary sexual characteristics
B. No menses by age 15 with secondary sexual characteristics
C. No menses for 3 cycles
D. No menses by age 10
CORRECT ANSWER: B. No menses by age 15 with secondary sexual characteristics
Rationale: Primary amenorrhea is defined as the absence of menarche by age 15 in the
presence of normal secondary sexual characteristics, or by age 13 without secondary sexual
characteristics.
