Burns' Pediatric Primary Care 7th Edition Test Bank: Chapter 1 & 2 Questions and Answers, Exams of Nursing

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BURNS' PEDIATRIC PRIMARY CARE 7TH

EDITION TEST BANK 2024 LATEST WITH

ALL POSSIBLE CHAPTERS ( QUESTIONS AND

SOLUTIONS)

Chapter 1: Health Status of Children: Global and National Perspectives

1. Which region globally has the highest infant mortality rate? A. Indonesia B. Southern Asia C. SubSaharan Africa Correct D. Syria
2. The primary care pediatric nurse practitioner understands that, to achievethe greatest worldwide reduction in child mortality from pneumonia and diarrhea, which interventionis most effective? A. Antibiotics B. Optimal nutrition C. Vaccinations Correct D. Water purification
3. Which is true about the health status of children in the United States? . 1334841385 6 A. Globalism has relatively little impact on child health measures in the U.S.

B. Obesity rates among 2to5yearolds have shown a recentsignificant decrease. Correct . C. The rate of household poverty is lower than in other economicallydeveloped nations. D. Young children who attend preschool or day care have higher foodinsecurity.

4. The primary care pediatric nurse practitioner understands that a majorchild health outcome associated with worldwide climate change is A. cost of living. B. education. C. nutrition. Correct D. pollution.
5. When providing well child care for an infant in the first year of life, theprimary care pediatric nurse practitioner is adhering to the most recent AmericanAcademy of Pediatrics Recommendations for Preventive Pediatric Health Care guidelinesby A. focusing less on development and more on illness prevention andnutrition. B. following guidelines established by the Bright Futures publication. C. scheduling wellbaby visits to coincide with key developmentalmilestones. Correct D. seeing the infant at ages 2, 4, 6, and 12 months when immunizations aredue. Chapter 2. Unique Issues in Pediatrics
6. A nurse is explaining the therapeutic milieu to a new nurse. The bestexplanation of this term would be:
7. The place where the child is receiving care.

2. Group therapy.
3. Personal interactions between patients and staff.
4. All of the above are correct.ANS: 4
5. A 16-year-old male has received a pink-slip from the police for inpatient psychiatric treatment. The teen has been expressing thoughts of hanging himself because Life sucks. Thenursing staff should consider placing the child:
6. With peers.
7. In an area where he can be watched one-on-one.
8. With a roommate that is expressing the same concerns.
9. In an area close to an external door.ANS: 2
10. Learning disabilities in children have scientifically been linked to:
11. Poor nutrition.
12. The environment in which the child lives.
13. Genetics.
14. Watching more than four hours of television a day.ANS: 3
15. A mental health nurse has assessed a child and determined that the childexhibits behavioral challenges. When the school nurse explains this to a teacher, the best description wouldbe: .
16. The child may exhibit physical outbursts.
17. The child may exhibit violence toward others.
18. The child may be defiant or have tantrums.
19. The child will need special interventions for learning.ANS: 3

5. A child that has not exhibited enuresis in four years has exhibited thisbehavior pattern for the last week. The reason a child may revert back to this behavior pattern is because of:
6. Hallucinations.
7. Behavioral challenges.
8. Delusions.
9. Stress .ANS: 4
10. An 18 - year-old male has called the crisis line for help. The crisis nurse recognizes the intervention needs may consist of all of the following except:
11. Discussing the individuals everyday activities.
12. Recognizing that the patient may be in a catharsis state.
13. Expressing empathy toward the caller.
14. Avoiding entropy.ANS: 1
15. An 8 - year-old boy with a history of hallucinations and violent behavior hasbeen place in a seclusion room at the hospital because he has been hurting others. The nurse checks on thepatient and realizes she must take him out of the seclusion room when:
16. He is crying to be released.

2. He states, I will be a good boy now. .
3. He starts headbutting the window.
4. He complains that his parents will file a lawsuit.ANS: 3
5. A child has been exhibiting the MacDonald Triad. These behaviors include:
6. Enuresis, pushing others, and pyromania.
7. Swinging a cat by the tail, bed-wetting, and lighting paper on fire in thetrash can.
8. Playing with other children, laughing, and conversing with adults.
9. Playing with a campfire, watching television, and seeking adult attention.ANS: 2
10. A teenager diagnosed with borderline personality disorder should havedischarge planning instructions of:
11. A consistent caregiver.
12. Monitoring of media, such as the Internet, television, and video games.
13. Obtaining support from family and friends.
14. Seeking medical attention when the teenager feels good.ANS: 3
15. A mental health nurse is teaching the mother of a child with executivefunctioning issues ways to help her child. Interventions the mother should use include:
16. Placing visual aids on the bathroom mirror so that the child will follow themorning routine.
17. Give the child a choice in foods to eat.
18. Allowing the child to ask for help when needed.
19. Reminding the child to be nice to others.ANS: 1 .

11. Ellie, a 9-year-old girl, was adopted by a family at the age of 4 after several years of severe neglect by her birth family. The adoptive family hasbeen reporting that Ellie is angry a lot, manipulative with her teachers, and does not seek positive attention. The nurse working with Elliewill need to:
12. Provide education on decreasing stimuli in the home environment thattriggers the anger.
13. Realize Ellie may have attachment issues related to her previous historyand will need to encourage the family to be active in her care.
14. Support the family in the decision-making process of continuing to let Ellielive in the home.
15. Discuss inpatient therapy to decrease Ellies manipulative behaviorpatterns. ANS: 2
16. An infant displays depression by:
17. Smiling at strangers.
18. Bonding to someone other than the immediate family.
19. Crying more than an average infant.
20. Looks away when an adult attempts to play with the infant.ANS: 4

13. A father reports that his adolescent daughter has gotten good grades upuntil the last quarter of school. She has been hanging out by herself and does not want to talk to him anymore. The mental health nurse should:
14. Realize that this is a natural part of growing up.
15. Perform a mental health screening to check for depression.
16. Attempt to get the adolescent to discuss why she does not like her fatheranymore.
17. Let the adolescent talk when she is ready.ANS: 2
18. A teen should be checked for depression at physician visit(s).
19. Every .
20. One
21. Monthly
22. Bi- yearly ANS: 1
23. When using the SAD FACES depression screen, it is important to assess:
24. Anhedonia.
25. Suicidal ideations.
26. Sleep patterns.
27. All of the aboveANS: 4
28. A school nurse is giving an in-service to teachers on bullycide. The mainreason for the teaching is so that:
29. Teachers are aware bullying occurs.

2. Teachers are able to identify students who are risk.
3. Teachers can be aware of the fact that suicides can happen due to bullyingby others.
4. Teachers are aware of their role in causing bullycide.ANS: 3
5. An adolescent with a known history of bipolar disorder is in the schoolnurses office because a teacher reported that she was talking fast and acting like she was God. The schoolnurse assesses the girl and notes that:
6. She is probably in a manic phase and needs to be treated professionally.
7. She has had too much sleep and is now hyperactive.
8. She forgot to take her medications today.
9. She requires some food and rest before going back to class.ANS: 1 Chapter 3. Genetics and Child Health Questions
10. What is true about haploid cells? . 1334840764 4 C. Each contains 23 paired chromosomes. D. Each one contains 23 chromosomes. Correct E. Replication produces two identical cells.

F. They replicate via the process of mitosis.

2. What does the following genetic notation symbol mean 47,XX,6q? . 1334840765 0 A. Male with deletion of chromosome 6 B. Female with deletion of chromosome 6 C. Male with deletion on the long arm of chromosome 6 D. Female with deletion on the long arm of chromosome 6 Correct
3. A child has a recessive genetic disorder that is homozygous for thatmutation. . 1334840764 6 What is most likely about this child’s parents? A. Neither parent has a copy of that gene mutation. B. Only the mother has a copy of that gene mutation. C. Only the father has a copy of that gene mutation. D. Each parent has one copy of that gene mutation. Correct
4. Which type of mutation is responsible for many singlegenegenetic disorders? . 1334840763 6 A. Copy number variations B. Nucleotide repeat expansions C. Point mutations Correct D. Single nucleotide polymorphisms (SNP) .
5. Cystic fibrosis is a recessive disease requiring the presence of a genemutation . 1334840763

on both alleles inherited from the parents. Which type of genetic disorder isthis? A. Chromosome B. Mitochondrial C. Monogenetic Correct D. Multifactorial .

6. The primary care pediatric nurse practitioner is counseling a couple aboutgenetic risks and learns that one parent has neurofibromatosis, an autosomal dominant disorder, and the other parent does not. What will the nurse practitioner include when discussingthis disorder and its transmission? C. Children must inherit a gene from both parents to develop the disease. D. Each child born to this couple will have a 50% risk of having thedisease. Correct E. This type of disorder characteristically skips generations. F. Unaffected offspring may still pass on the disease to their offspring.
7. A family medical history conducted during a well baby exam for a newborngirl reveals that hemophilia A, an Xlinked

recessive disorder, is present in males in three previous generations in the mother’s family, whose father had the disease. What willthe primary care pediatric nurse practitioner tell the parents about the risk of this disease intheir children? E. All of their sons will be affected by the disease. F. Any sons they have will not be affected by the disease. G. Daughters have a 50% chance of being carriers of the disease.Correct H. Their daughter has a 25% chance of having the disease.

8. What is an important responsibility of the primary care pediatric nursepractitioner. to help determine genetic risk factors in families? E. Assessing physical characteristics of genetic disorders F. Knowing which genetic screening tests to perform G. Making appropriate referrals to pediatric geneticists D. Obtaining a threegeneration pedigree for each family Correct
9. Which diagnostic study may be ordered when the provider wishes todetect the . presence of additional genetic material on a chromosome? A. Chromosomal microarray B. FISH Correct D. Karyotype E. Molecular testing
10. Which type of testing will the primary care pediatric nurse practitionerrecommend. for a couple concerned about the potential for having children with cysticfibrosis? A. Biochemical testing

B. Carrier testing Correct C. FISH testing D. Karyotype testing Chapter 4. Environmental IssuesQuestions

1. What has been the result of passage of the Toxic Substances Control Act.(TSCA) of 1976? G. A mandate for corporations to disclose known toxic chemicals H. A requirement that all manufactured chemicals undergo toxicity testing I. Authorization of the EPA to require testing and reporting of somechemicals Correct J. Development of a mechanism to report reactions to toxic chemicals
2. Many European nations use the “precautionary principle” to help regulatepotentially toxic chemicals. What does this mean? G. Chemicals must be proven to be safe before being introducedinto the

environment. Correct H. Corporations may be exempt from testing if their costs in doing soare too high. I. Regulators must demonstrate risk to the public before banning achemical. J. Without a strong risk, corporations need not release data about theirproducts.

3. During a clinic visit, a child’s rapid capillary screening test for lead revealsa level of 11 mcg/dL. What will the primary care pediatric nurse practitioner donext? I. Institute lead abatement measures in the child’s home. J. Monitor lead levels monthly until decreased. K. Order a venous sample to test for lead levels. Correct L. Test the child’s siblings and parents for lead.
4. A child has a lead level of 25 mcg/dL. Once lead abatement measures areinstituted, what is an important intervention to help prevent permanent damage H. Chelation therapy I. Dietary changes C. Followup testing Correct . D. Testing family members
5. A child whose parent works in a factory pr esents with swelling of theextremities, pain and weakness in the pelvis, and an erythematous maculopapular rash. Which industrial toxin will the primary care pediatric nurse practitioner suspect inthis child? A. Lead B. Mercury C. Organophosphates Correct

D. Phthalates

6. When counseling a mother who smokes about preventing exposure tosmokingrelated risks to her nursing newborn, what will the primary care pediatric nurse practitioner tell her? F. If she quits now, her child will not have longtermeffects from exposure. G. Prenatal smoke exposure does not cause respiratory effects after theinfant is born. H. Smoking outdoors or near an open window prevents exposure to tobaccosmoke. I. Thirdhandsmoke exposure risks may last for years even if themother quits now. Correct
7. A child who has been playing in a public park is brought to the clinic withwheezing, vomiting, diarrhea, and drooling. A physical exam reveals a low heart rate and diaphoresis. What will the primary care pediatric nurse practitionersuspect as a cause for these symptoms? B. Arsenic consumption C. Lead poisoning C. Organophosphate exposure Correct D. Phthalate ingestion
8. A parent asks about ways to limit exposure to risks associated withplastics.

Besides avoiding using plastic containers when possible, what else will theprimary care pediatric nurse practitioner recommend? A. Avoid heating foods and liquids in plastic containers. Correct B. Clean plastic containers well using the dishwasher. C. Use only plastics stamped with “#7” on the bottom. D. Used canned food products whenever possible.

9. A parent desires to buy only organic produce to avoid exposing a child topesticides but complains that these foods are expensive. The primary care pediatric nurse practitioner provides a list of foods that are relatively safe whether they areorganic or not. Which foods are on this list? A. Apples, celery, and peaches B. Potatoes, cherry tomatoes, and peaches C. Strawberries, grapes, and cucumbers D. Sweet corn, cantaloupe, and kiwi Correct Chapter 5. Child and Family Health Assessment Questions
10. The primary care pediatric nurse practitioner is obtaining a medical history about a child. To integrate both nursing and medical aspects of primary care, which will be included in the medical history? K. Complementary medications, alternative health practices, and chiefcomplaint L. Developmental delays, nutritional status, and linear growth patterns M. Medication currently taking, allergy information, and family medicalhistory N. Speech and language development, beliefs about health, andprevious illnesses Correct

2. When formulating developmental diagnoses for pediatric patients, theprimary care pediatric nurse practitioner may use which resource? A. DC: 03R Correct K. ICD10CM L. ICSD M. NANDA International
3. The primary care pediatric nurse practitioner sees a 3yearoldchild who chronically withholds stools, in spite of the parents’ attempts to stop the behavior, requiring frequent treatments with laxative medications. Whichdiagnosis will the nurse practitioner use to facilitate thirdparty reimbursement? M. Altered elimination pattern N. Elimination disorder C. Encopresis Correct D. Parenting alteration
4. The primary care pediatric nurse practitioner is assessing a toddler whoseweight and body mass index (BMI) are below the 3rd percentile for age. The nurse practitioner learns that the child does not have regular mealtimes and is allowed to carrya bottle of juice around at all times. The nurse practitioner plans to work with this family todevelop improved meal patterns. Which diagnosis will the nurse practitioner use for this problem?

J. Failure to thrive K. Home care resources inadequate L. Nutrition alteration – less than required D. Parenting alteration Correct .

5. The primary care pediatric nurse practitioner is p erforming a well childcheckup on a 20monthold child. The child was 4 weeks premature and, according to a parentcompleteddevelopmental questionnaire, has achieved milestones for a 15monthold infant. Which action is correct? J. Perform an indepth developmental assessment screen at this visitto evaluate this child. Correct K. Reassure the parent that the child will catch up to normal development byage 2 years. L. Reevaluate this child’s development and milestone achievements at the2year visit. M. Refer the child to a specialty clinic for evaluation and treatment ofdevelopmental delay.
6. The primary care pediatric nurse practitioner performs a developmental assessment on a 3yearold child and notes normal cognitive, finemotor, andgrossmotor abilities. The child responds appropriately to verbal commands during theassessment but refuses to speak when asked questions. The parent tells the nurse practitioner that the child talks at home and that most other adults can understand what the child says. Thenurse practitioner will D. ask the parent to consider a possible speech delay and report anyconcerns.

E. continue to evaluate the child’s speech at subsequent visits.Correct F. refer the child for a speech and hearing evaluation. G. tell the parent to spend more time in interactive conversations withthe child.

7. The parent of a toddler is concerned that the child may have autism. The primary care pediatric nurse practitioner completes a Modified Checklist forAutism in Toddlers (MCHAT) tool, which indicates several areas of concern. What will the nurse practitioner do? E. Administer a Childhood Autism Rating Scale (CARS) in the clinic. F. Consult a specialist to determine appropriate early interventionstrategies. G. Refer the child to a behavioral specialist for further evaluation.Correct H. Tell the parent that this result indicates that the child has autism.
8. The primary care pediatric nurse practitioner learns that the mother of a3yearold child has been treated for depression for over 5 years. Which aspect of thischild’s development will be of the most concern to the nurse practitioner?

D. Fine motor E. Gross motor F. Social/emotional D. Speech and language Correct .

9. When meeting with a new family, the primary care pediatric nursepractitioner develops a database that identifies family members and others living in thehousehold, relationships with others outside the household, and significant behavioraland emotional problems. Which tool will the nurse practitioner use to record thisinformation? C. CRAFFT D. Ecomap C. Genogram Correct D. Pedigree
10. A child is in the clinic for evaluation of an asthma action plan. Theprimary care pediatric nurse practitioner notes that the child’s last visit was for aprekindergarten physical and observes that the child is extremely anxious. What will thenurse practitioner do initially? A. Ask the child’s parent why the child is so anxious. B. Perform a physical assessment to rule out shortness of breath. C. Reassure the child that there is nothing to be afraid of. D. Review the purpose of this visit and any anticipated procedures.Correct
11. The primary care pediatric nurse practitioner is evaluating health literacyin the mother of a new preschoolage

child. How will the nurse practitioner assess C. Ask the child how many books he has at home. Correct D. Ask the mother about her highest grade in school. E. Ask the mother to determine the correct dose of a drug from a label. F. Ask the mother to read a health information handout aloud.

12. The mother of a newborn tells the primary care pediatric nursepractitioner that she is worried that her child will develop allergies and asthma. Which tool will the nurse practitioner use to evaluate this risk? A. Threegeneration pedigree Correct A. Review of systems B. Genogram C. Ecomap 1 3. The primary care pediatric nurse practitioner is performing a well childassessment on an adolescent and is concerned about possible alcohol and tobacco use. Which assessment tool will the nurse practitioner use? A. CRAFFT Correct A. HEEADSSS B. PHQ C. RAAPS

14. The primary care pediatric nurse practitioner evaluates a schoolagechild whose body mass index (BMI) is greater than the 97th percentile. The nursepractitioner is concerned about possible metabolic syndrome and orders laboratory tests to evaluate this. Which diagnosis will the nurse practitionerdocument for this visit? A. Metabolic syndrome B. Nutritional alteration: more than required C. Obesity Correct A. Rule out type 2 diabetes mellitus Chapter 6. Cultural Considerations for Pediatric Primary Care Questions
15. The primary care pediatric nurse practitioner provides well child care for acommunity of immigrant children from Central America. The pediatric nurse practitioner is surprised to learn that some of the families are Jewish and not Catholic. This response is an example of cultural O. collectivism. P. constructivism. Q. essentialism. Correct R. individualism.
16. The primary care pediatric nurse practitioner learns that anAfricanAmerican family lives in a neighborhood with a high crime rate and suggests that theytry moving to another neighborhood for the safety of their children. This is an example of N. cultural sensitivity. O. group bias.

P. individual privilege. Correct Q. racial awareness.

3. The primary care pediatric nurse practitioner cares f or children from aNative American family and learns that they used many herbs to treat and preventillness. Which approach will the pediatric nurse practitioner use to promote optimum healthin the children? O. Ask about the types of practices used and when they are applied.Correct P. Provide a list of harmful herbs and ask the family to avoid those. Q. Suggest that the family avoid using these remedies in their children. R. Tell the parents to use the herbs in conjunction with modern medications.
4. The primary care pediatric nurse practitioner works with families from avariety of cultures and socioeconomic classes. Which is an example of cultural humility in practice? M. Giving health care advice that takes cultural differences into account N. Identification of other cultures that may be superior to one’s own culture C. Receptivity to learning about the perspectives of other culturesCorrect D. Respecting other cultures while maintaining the views of one’s own
5. A Somalian immigrant mother is concerned that her 8yearold

child is underweight. The primary care pediatric nurse practitioner notes thatthe child’s weight is at the 25th percentile. After realizing that the mother is comparing her child to a group of Americanborn children who are overweight, the pediatric nurse practitioner isable to convince the mother that this is a normal weight. Which domain of cultural competence does this represent? A. Global B. Interpersonal Correct N. Intrapersonal O. Organizational

6. The primary care pediatric nurse practitioner in a community health centermeets a family who has recently immigrated to the United States who speak only Karon. They arrive in the clinic with a church sponsor, who translates for them. The pediatric nurse practitioner notices that the sponsor answers for the family without giving them time tospeak. The pediatric nurse practitioner will H. ask the sponsor to allow the family to respond. I. develop the plan of care and ask the sponsor to make sure it is followed. J. request that the sponsor translate written instructions for the family. K. use the telephone interpreter service to communicate with thefamily. Correct
7. The primary care pediatric nurse practitioner prescribes a twice dailyinhaled corticosteroid for a 12yearold child. At a well child visit, the child reports not using the medication on a regular basis. Which response by the pediatric nurse

practitioner demonstrates an understanding of clientcenteredcare? A. Asking the child to describe usual daily routines and schedules Correct I. Referring the family to a social worker to help with medication compliance J. Reviewing the asthma action plan with the parent and the child K. Teaching the child how the medication will help to control asthmaSymptoms

8. A primary care pediatric nurse practitioner working in a community healthcenter wishes to develop a program to assist impoverished children and families to have access to healthy foods. Which strategy will the pediatric nurse practitioner employto ensure the success of such a program? G. Asking community members to assist in researching andimplementing a program Correct H. Designing a community garden approach that involves children and theirparents I. Gaining support from the corporate community to provide neededresources J. Providing evidencebased information about the importance of a healthydiet
9. The parents of a special needs child tell the primary care pediatric nursepractitioner that they are planning a 3month

visit to their home country in Africa. The pediatric nurse practitioner assists the family to obtain a sufficient supply of medications and formula and to make sure that the child’s equipment canbe transported and used during the trip and at the destination. This is an example of E. global application. Correct F. global awareness. G. system application. H. system awareness.

10. The primary care pediatric nurse practitioner is examining a child whoseparents recently emigrated from a wartorn country in the Middle East. Which is a priority assessment when performing the patient history? A. Asking about physical, psychological, and emotional trauma Correct E. Determining the parents’ English language competency and literacy level F. Learning about cultural preferences and complementary medicinepractices G. Reviewing the child’s previous health and illness records Chapter 7. Children with Special Health Care Needs
11. A child born with Dandy Walker malformation is receiving palliative care inthe pediatric unit. A nurse should:
12. Provide the parents, patient, and family members with supportive careduring this time.
13. Ask the parents to be part of the plan of care as much as possible.
14. Attempt to provide a primary nurse for this particular patient on each shift.
15. All of the above are