Burns Pediatric Primary Care 7th Edition Test Bank
Chapter 11 | 2026/2027 Comprehensive Exam:
Developmental Management and Health
Supervision.
Domain 1: Developmental Surveillance & Standardized Screening Tools (14 Questions)
1. Which components are evaluated on the NICHQ Vanderbilt Assessment Scale for ADHD
screening? (Select all that apply.)
A. Inattention symptoms
B. Hyperactivity/Impulsivity symptoms
C. Oppositional-Defiant behaviors
D. Fine motor coordination
E. Academic performance
[CORRECT] A, B, C, E
Rationale: The NICHQ Vanderbilt Assessment Scale is a standardized tool used to evaluate
ADHD symptoms and comorbidities. It screens for inattention (A) and
hyperactivity/impulsivity (B), as well as comorbid conditions like Oppositional-Defiant
Disorder (C) and conduct disorder. It also includes a performance section assessing academic
performance (E) and behavioral performance in the classroom. Fine motor coordination (D) is
not a component of the Vanderbilt scale.
2. A 9-year-old male is being evaluated for ADHD using the NICHQ Vanderbilt Assessment
Scale. The parent form scores in the 93rd percentile for inattention but the teacher form
scores below the 80th percentile. Which action by the Pediatric Nurse Practitioner is most
appropriate?
A. Diagnose ADHD, inattentive type, and initiate stimulant medication.
B. Rule out ADHD based on the discrepancy between informants.
,C. Obtain a third-party informant rating and conduct a clinical interview.
D. Refer the child for a neurological consultation immediately.
[CORRECT] C
Rationale: A score above the 93rd percentile on the parent form indicates a positive screen for
inattention, but a discrepancy with the teacher form requires further clinical evaluation
before a diagnosis can be established. Best practice involves obtaining additional information
(such as a third-party rating or clinical interview) to understand the context of the behaviors,
as symptoms may manifest differently in various settings.
3. The Pediatric Nurse Practitioner is interpreting the results of a Vanderbilt Assessment Scale
completed by a teacher. Which finding meets the threshold for a positive screen for
hyperactivity/impulsivity?
A. A score of 2 or higher on 4 out of 9 hyperactivity items.
B. A score of 3 or higher on 6 out of 9 hyperactivity items.
C. A score at or above the 93rd percentile on the hyperactivity subscale.
D. A total score of 15 on the hyperactivity subscale, regardless of percentile.
[CORRECT] C
Rationale: The Vanderbilt scale is scored by comparing the sum of symptom scores to age and
gender-specific normative data. A positive screen for ADHD symptoms is defined as a score at
or above the 93rd percentile for either inattention or hyperactivity/impulsivity subscales.
Percentile rankings account for developmental variations in behavior.
4. A 7-year-old patient presents with academic difficulties. The parents request a "Vanderbilt
test." Which statement accurately explains the limitations of this tool to the parents?
A. "This tool provides a definitive diagnosis of ADHD after one administration."
B. "This tool requires only the parent input to make a diagnosis."
C. "This tool is a screening measure that requires input from both parents and teachers and
must be interpreted with a clinical interview."
D. "This tool screens for learning disabilities but not behavioral disorders."
, [CORRECT] C
Rationale: The Vanderbilt is a screening tool, not a diagnostic instrument. It requires behavior
ratings from two different settings (home via parent form and school via teacher form) to
assess persistence of symptoms. A comprehensive clinical interview is required to integrate
the data and rule out other causes for the symptoms before establishing a diagnosis.
5. The Pediatric Symptom Checklist (PSC-17) is utilized to screen for psychosocial dysfunction.
Which subscales are included in this screening tool? (Select all that apply.)
A. Internalizing
B. Externalizing
C. Attention
D. Social Withdrawal
E. Psychosis
[CORRECT] A, B, C
Rationale: The PSC-17 is a brief psychosocial screen that yields three subscale scores:
Internalizing (depression/anxiety), Externalizing (conduct/behavior), and Attention. It does
not specifically screen for Social Withdrawal (D) or Psychosis (E) as distinct subscales.
6. A 14-year-old female scores an 8 on the Internalizing subscale of the Pediatric Symptom
Checklist (PSC-17). What is the clinical significance of this finding?
A. The score is within normal limits; no action is required.
B. The score indicates a low risk for depression.
C. The score indicates a need for further assessment for anxiety or depression.
D. The score suggests the patient is malingering.
[CORRECT] C
Rationale: The PSC-17 subscale cutoff score is 7 or higher. A score of 8 on the Internalizing
subscale is a positive screen, indicating the need for further assessment for internalizing
disorders such as anxiety or depression.
Chapter 11 | 2026/2027 Comprehensive Exam:
Developmental Management and Health
Supervision.
Domain 1: Developmental Surveillance & Standardized Screening Tools (14 Questions)
1. Which components are evaluated on the NICHQ Vanderbilt Assessment Scale for ADHD
screening? (Select all that apply.)
A. Inattention symptoms
B. Hyperactivity/Impulsivity symptoms
C. Oppositional-Defiant behaviors
D. Fine motor coordination
E. Academic performance
[CORRECT] A, B, C, E
Rationale: The NICHQ Vanderbilt Assessment Scale is a standardized tool used to evaluate
ADHD symptoms and comorbidities. It screens for inattention (A) and
hyperactivity/impulsivity (B), as well as comorbid conditions like Oppositional-Defiant
Disorder (C) and conduct disorder. It also includes a performance section assessing academic
performance (E) and behavioral performance in the classroom. Fine motor coordination (D) is
not a component of the Vanderbilt scale.
2. A 9-year-old male is being evaluated for ADHD using the NICHQ Vanderbilt Assessment
Scale. The parent form scores in the 93rd percentile for inattention but the teacher form
scores below the 80th percentile. Which action by the Pediatric Nurse Practitioner is most
appropriate?
A. Diagnose ADHD, inattentive type, and initiate stimulant medication.
B. Rule out ADHD based on the discrepancy between informants.
,C. Obtain a third-party informant rating and conduct a clinical interview.
D. Refer the child for a neurological consultation immediately.
[CORRECT] C
Rationale: A score above the 93rd percentile on the parent form indicates a positive screen for
inattention, but a discrepancy with the teacher form requires further clinical evaluation
before a diagnosis can be established. Best practice involves obtaining additional information
(such as a third-party rating or clinical interview) to understand the context of the behaviors,
as symptoms may manifest differently in various settings.
3. The Pediatric Nurse Practitioner is interpreting the results of a Vanderbilt Assessment Scale
completed by a teacher. Which finding meets the threshold for a positive screen for
hyperactivity/impulsivity?
A. A score of 2 or higher on 4 out of 9 hyperactivity items.
B. A score of 3 or higher on 6 out of 9 hyperactivity items.
C. A score at or above the 93rd percentile on the hyperactivity subscale.
D. A total score of 15 on the hyperactivity subscale, regardless of percentile.
[CORRECT] C
Rationale: The Vanderbilt scale is scored by comparing the sum of symptom scores to age and
gender-specific normative data. A positive screen for ADHD symptoms is defined as a score at
or above the 93rd percentile for either inattention or hyperactivity/impulsivity subscales.
Percentile rankings account for developmental variations in behavior.
4. A 7-year-old patient presents with academic difficulties. The parents request a "Vanderbilt
test." Which statement accurately explains the limitations of this tool to the parents?
A. "This tool provides a definitive diagnosis of ADHD after one administration."
B. "This tool requires only the parent input to make a diagnosis."
C. "This tool is a screening measure that requires input from both parents and teachers and
must be interpreted with a clinical interview."
D. "This tool screens for learning disabilities but not behavioral disorders."
, [CORRECT] C
Rationale: The Vanderbilt is a screening tool, not a diagnostic instrument. It requires behavior
ratings from two different settings (home via parent form and school via teacher form) to
assess persistence of symptoms. A comprehensive clinical interview is required to integrate
the data and rule out other causes for the symptoms before establishing a diagnosis.
5. The Pediatric Symptom Checklist (PSC-17) is utilized to screen for psychosocial dysfunction.
Which subscales are included in this screening tool? (Select all that apply.)
A. Internalizing
B. Externalizing
C. Attention
D. Social Withdrawal
E. Psychosis
[CORRECT] A, B, C
Rationale: The PSC-17 is a brief psychosocial screen that yields three subscale scores:
Internalizing (depression/anxiety), Externalizing (conduct/behavior), and Attention. It does
not specifically screen for Social Withdrawal (D) or Psychosis (E) as distinct subscales.
6. A 14-year-old female scores an 8 on the Internalizing subscale of the Pediatric Symptom
Checklist (PSC-17). What is the clinical significance of this finding?
A. The score is within normal limits; no action is required.
B. The score indicates a low risk for depression.
C. The score indicates a need for further assessment for anxiety or depression.
D. The score suggests the patient is malingering.
[CORRECT] C
Rationale: The PSC-17 subscale cutoff score is 7 or higher. A score of 8 on the Internalizing
subscale is a positive screen, indicating the need for further assessment for internalizing
disorders such as anxiety or depression.
