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Burns' Pediatric Primary Care 2026-2027 BANK QUESTIONS
WITH DETAILED VERIFIED ANSWERS EXAM QUESTIONS
WILL COME FROM HERE (100% CORRECT ANSWERS A+
GRADED
1. A mother brings her 2-week-old infant for a weight check. The infant
was born at 39 weeks weighing 3.2 kg and was discharged at 3.0 kg.
Today the infant weighs 3.1 kg. The mother reports breastfeeding every
2 to 3 hours with adequate wet diapers. What is the most appropriate
next step?
A. Recommend supplementing with formula after each breastfeeding
session
B. Reassure the mother that weight gain is within normal limits
C. Order a metabolic panel and complete blood count
D. Refer to a lactation consultant for weighted feed evaluation
Answer: B. Weight loss of up to 10% in the first week is common, and
birth weight should be regained by 10 to 14 days. This infant has nearly
regained birth weight at 14 days, indicating adequate caloric intake.
Reassurance and continued monitoring are appropriate when infant is
otherwise well, with good output.
2. A father is concerned that his 9-month-old daughter is not crawling.
She sits without support, transfers objects between hands, and bears
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weight on her legs when held. Pull-to-sit shows no head lag. What
should the primary care provider advise?
A. Refer to early intervention for gross motor delay
B. Order magnetic resonance imaging of the brain
C. Explain that many normal infants never crawl and may proceed
directly to walking
D. Evaluate for hip dysplasia with radiographs
Answer: C. Crawling is not a universal milestone. Many typically
developing infants skip crawling and proceed to pulling to stand and
cruising. The skills described are age-appropriate. As long as there is
progression in motor skills and no asymmetry or regression,
intervention is not indicated.
3. A 4-year-old boy is brought for a well-child visit. His speech is 50%
intelligible to unfamiliar listeners. He uses 4-word sentences and asks
"why" questions. He can pedal a tricycle. What domain of development
requires further evaluation?
A. Fine motor
B. Gross motor
C. Speech and language
D. Social-emotional
Answer: C. By age 4, speech should be 100% intelligible to strangers.
Fifty percent intelligibility is typical for a 2-year-old. This child's
expressive language warrants formal hearing evaluation and speech-
language pathology referral to assess for articulation disorder or
phonological delay.
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4. An adolescent female presents for a sports physical. Her mother
reports she is an excellent student but recently quit the soccer team
despite being a top player. The patient reports constant worry about
making mistakes and difficulty falling asleep. She denies substance use.
What is the most likely diagnosis?
A. Generalized anxiety disorder
B. Major depressive disorder
C. Attention-deficit hyperactivity disorder
D. Adjustment disorder
Answer: A. Generalized anxiety disorder is characterized by excessive,
difficult-to-control worry across multiple domains, with associated
symptoms such as sleep disturbance. The functional impairment of
quitting a previously enjoyed activity suggests clinically significant
anxiety. Depression would feature prominent anhedonia or sadness.
5. A breastfed 6-month-old infant has a hemoglobin of 9.5 g/dL. The
mother asks about starting solid foods. Which food should be
recommended first to address the likely nutritional deficiency?
A. Iron-fortified infant cereal
B. Pureed bananas
C. Whole milk yogurt
D. Strained chicken
Answer: A. Physiologic nadir occurs around 6 to 9 months in exclusively
breastfed infants due to low iron content of breast milk. Iron-fortified
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cereals are the standard first-line complementary food to prevent iron
deficiency anemia. Meat is an alternative but cereal is the traditional
first introduction.
6. A 15-year-old male with moderate persistent asthma reports
nighttime coughing 3 times per week and uses albuterol 4 times weekly
for symptoms. His current medication is low-dose inhaled fluticasone.
What step-up in therapy is most appropriate according to the National
Asthma Education and Prevention Program guidelines?
A. Add a long-acting beta-agonist
B. Increase to high-dose inhaled corticosteroid
C. Add a leukotriene receptor antagonist
D. Add theophylline
Answer: A. For moderate persistent asthma uncontrolled on a low-dose
inhaled corticosteroid, the preferred step-up in adolescents and adults
is adding a long-acting beta-agonist. This combination therapy is
superior to increasing the ICS dose alone for improving lung function
and symptom control.
7. A newborn screening result returns positive for congenital
hypothyroidism with a thyroid-stimulating hormone of 45 mIU/L. The
infant is 10 days old. What is the most urgent next step?
A. Repeat newborn screening filter paper test
B. Begin levothyroxine immediately
C. Order thyroid ultrasound
Burns' Pediatric Primary Care 2026-2027 BANK QUESTIONS
WITH DETAILED VERIFIED ANSWERS EXAM QUESTIONS
WILL COME FROM HERE (100% CORRECT ANSWERS A+
GRADED
1. A mother brings her 2-week-old infant for a weight check. The infant
was born at 39 weeks weighing 3.2 kg and was discharged at 3.0 kg.
Today the infant weighs 3.1 kg. The mother reports breastfeeding every
2 to 3 hours with adequate wet diapers. What is the most appropriate
next step?
A. Recommend supplementing with formula after each breastfeeding
session
B. Reassure the mother that weight gain is within normal limits
C. Order a metabolic panel and complete blood count
D. Refer to a lactation consultant for weighted feed evaluation
Answer: B. Weight loss of up to 10% in the first week is common, and
birth weight should be regained by 10 to 14 days. This infant has nearly
regained birth weight at 14 days, indicating adequate caloric intake.
Reassurance and continued monitoring are appropriate when infant is
otherwise well, with good output.
2. A father is concerned that his 9-month-old daughter is not crawling.
She sits without support, transfers objects between hands, and bears
,2|Page
weight on her legs when held. Pull-to-sit shows no head lag. What
should the primary care provider advise?
A. Refer to early intervention for gross motor delay
B. Order magnetic resonance imaging of the brain
C. Explain that many normal infants never crawl and may proceed
directly to walking
D. Evaluate for hip dysplasia with radiographs
Answer: C. Crawling is not a universal milestone. Many typically
developing infants skip crawling and proceed to pulling to stand and
cruising. The skills described are age-appropriate. As long as there is
progression in motor skills and no asymmetry or regression,
intervention is not indicated.
3. A 4-year-old boy is brought for a well-child visit. His speech is 50%
intelligible to unfamiliar listeners. He uses 4-word sentences and asks
"why" questions. He can pedal a tricycle. What domain of development
requires further evaluation?
A. Fine motor
B. Gross motor
C. Speech and language
D. Social-emotional
Answer: C. By age 4, speech should be 100% intelligible to strangers.
Fifty percent intelligibility is typical for a 2-year-old. This child's
expressive language warrants formal hearing evaluation and speech-
language pathology referral to assess for articulation disorder or
phonological delay.
,3|Page
4. An adolescent female presents for a sports physical. Her mother
reports she is an excellent student but recently quit the soccer team
despite being a top player. The patient reports constant worry about
making mistakes and difficulty falling asleep. She denies substance use.
What is the most likely diagnosis?
A. Generalized anxiety disorder
B. Major depressive disorder
C. Attention-deficit hyperactivity disorder
D. Adjustment disorder
Answer: A. Generalized anxiety disorder is characterized by excessive,
difficult-to-control worry across multiple domains, with associated
symptoms such as sleep disturbance. The functional impairment of
quitting a previously enjoyed activity suggests clinically significant
anxiety. Depression would feature prominent anhedonia or sadness.
5. A breastfed 6-month-old infant has a hemoglobin of 9.5 g/dL. The
mother asks about starting solid foods. Which food should be
recommended first to address the likely nutritional deficiency?
A. Iron-fortified infant cereal
B. Pureed bananas
C. Whole milk yogurt
D. Strained chicken
Answer: A. Physiologic nadir occurs around 6 to 9 months in exclusively
breastfed infants due to low iron content of breast milk. Iron-fortified
, 4|Page
cereals are the standard first-line complementary food to prevent iron
deficiency anemia. Meat is an alternative but cereal is the traditional
first introduction.
6. A 15-year-old male with moderate persistent asthma reports
nighttime coughing 3 times per week and uses albuterol 4 times weekly
for symptoms. His current medication is low-dose inhaled fluticasone.
What step-up in therapy is most appropriate according to the National
Asthma Education and Prevention Program guidelines?
A. Add a long-acting beta-agonist
B. Increase to high-dose inhaled corticosteroid
C. Add a leukotriene receptor antagonist
D. Add theophylline
Answer: A. For moderate persistent asthma uncontrolled on a low-dose
inhaled corticosteroid, the preferred step-up in adolescents and adults
is adding a long-acting beta-agonist. This combination therapy is
superior to increasing the ICS dose alone for improving lung function
and symptom control.
7. A newborn screening result returns positive for congenital
hypothyroidism with a thyroid-stimulating hormone of 45 mIU/L. The
infant is 10 days old. What is the most urgent next step?
A. Repeat newborn screening filter paper test
B. Begin levothyroxine immediately
C. Order thyroid ultrasound
