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Chapter 01: Health Status of Children: Global and National Perspectives
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Primary Care, 7th Edition
MULTIPLE CHOICE abirb.com/test
1. Which region globally has the highest infant mortality rate?
a. Indonesia
b. Southern Asia abirb.com/test
c. Sub-Saharan Africa
d. Syria
ANS: B abirb.com/test
Although Sub-Saharan Africa and Southern Asia together account for 77% of the infant
mortality rate globally, Southern Asia has the highest infant mortality rate (39%) in the world
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followed closely by Sub-Saharan Africa (38%).
2. The primary care pediatric nurse practitioner understands that, to achieve the greatest
world-wide reduction in child mortality from pneumonia and diarrhea, which intervention is
most effective? abirb.com/test
a. Antibiotics
b. Optimal nutrition
c. Vaccinations
d. Water purification
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ANS: C
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Rotavirus is the most common cause of diarrhea globally and Strep pneumonia is the leading
cause of pneumonia, and together these are the leading infectious causes of childhood
morbidity and mortality globally. Both are vaccine-preventable diseases. Antibiotics to treat
pneumonia, optimal nutrition, and clean water all help to reduce morbidity and mortality, but
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vaccination prevents the diseases from occurring.
3. Which statement correctly reflects the health status of children in the United States?
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a. Globalism has relatively little impact on child health measures in the U.S.
b. Obesity rates among 2- to 5-year-olds have stabilized below Health People 2020
goal of 9.4%.
c. The rate of household poverty is lower than in other economically developed
nations. abirb.com/test
d. Young children who attend preschool or day care have higher food insecurity.
ANS: B
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Obesity rates are a major concern for child health in the U.S. but recently have stabilized at
8.9%. Globalism has an increasing effect on child health in the U.S. The rate of household
poverty in the U.S. is higher than in other economically developed nations. Young children
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who attend preschool or day care have lower food insecurity.
4. The primary care pediatric nurse practitioner understands that what major child health
outcome is dramatically associated with worldwide climate change?
a. Housing abirb.com/test
b. Education
c. Nutrition
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d. Pollution
ANS: C
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There is growing evidence that climate change is having a dramatic effect on food crops that
leads to food distribution issues and food insecurity among families.
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5. When providing well child care for an infant in the first year of life, the primary care pediatric
nurse practitioner demonstrates an understanding of current guidelines when taking what
action? abirb.com/test
a. Focusing less on development and more on illness prevention and nutrition.
b. Following guidelines established by the Bright Futures publication.
c. Scheduling well-baby visits to coincide with key developmental milestones.
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d. Seeing the infant at ages 2, 4, 6, and 12 months when immunizations are due.
ANS: C
In the most recent AAP Recommendations for Preventive Pediatric Health Care, there is a
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greater emphasis on behavioral and developmental issues and a recommendation that well
child care be based on child and family development rather than the periodicity of
immunization schedules.
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Chapter 02: Unique Issues in Pediatrics
Garzon Maaks: Burns’ Pediatricabirb.com/test
Primary Care, 7th Edition
MULTIPLE CHOICE abirb.com/test
1. What is the foundational basis of patient-and-family centered care (PFCC)?
a. The family is to be considered when patient care is being planned
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b. The patient has ultimate control over health care decisions
c. A family member acts as the patient’s surrogate decision makes
d. The patient is the focus of the primary care provider’s attention
ANS: B abirb.com/test
While all options are correct statements, the foundational basis of PFCC is the patient has
ultimate control over health care decisions.
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2. Which assessment question best demonstrates the primary care provider’s understanding of
effectively dealing with the greatest challenge to providing dual patient care?
a. To the parent: “Do you feel comfortable providing in-home care for your child?”
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b. To the child: “When would you like your physical therapy sessions to be
scheduled?”
c. To the parent: “What are your feelings about going to family therapy to help with
this transition?” abirb.com/test
d. To the child: “When did you first notice the pain in your knees?”
ANS: B
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One of the greatest challenges is how to access, acknowledge, and include the child’s voice,
which is often lost and/or overridden in health care. By directly asking the child their opinion
or feelings, the PCP is providing for the child’s voice to be heard and acknowledged. None of
the other options addresses that need.
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3. Which intervention best demonstrates a pediatric nurse primary care pediatric nurse
practitioner’s understanding of effective pain assessment?
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a. Providing instructions regarding the Faces pain assessment tool to parents of all
newly admitted children
b. Assisting in the development of a child-centered pain assessment scale
c. Reviewing the documentation regarding the child’s pain assessment 30 minutes
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after analgesic medication was administered
d. Explaining to both the child and the parents why pain medication will be delivered
intravenously
ANS: B abirb.com/test
In the past, clinicians and researchers have relied on adult-developed and adult-centered tools
and approaches, which have been “adapted” for use with children by adding pictures and/or
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simpler language. There is increasing realization that data from adapted, adult-centered
models have has not adequately captured the voices and/or experiences of children. Engaging
in the development of an assessment tool that is child focused is the best demonstration of
understanding. All other options rely on adaptation of adult-centered tools or focus on
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standard pain management related interventions.
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4. Which theorist is responsible for presenting an alternative theory to those established theories
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that focus on how the pediatric patient thinks?
a. Piaget
b. Vygotsky
c. Skinner
d. Bandura
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ANS: B
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Vygotsky and Siegler both provide pediatric primary care with a new understanding or
alternative lens through which to view children and childhood regarding how they think and
process information. The other options represent traditional theorists: Piaget does focus on
how children think while Skinner and Bandura are concerned with how children’s learning
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and behavior is affected by experiences.
5. What is the strongest predictor of health regarding the pediatric patient?
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a. The early identification of existing health problems
b. Health literacy of the parent(s) and/or caregiver(s)
c. Assess to specialized healthcare professionals
d. Past experience with same of similar health issues
ANS: B
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The health literacy possessed by parents/caregivers is one of the strongest predictors of the
health of a pediatric patient. While the other options enhance good health outcomes, they are
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all influenced by appropriate health literacy.
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