Compared with the use of infant formula, advantages for the baby of breastfeeding include all of the following except:
lower incidence of diarrheal illness
greater weight gain in the first few weeks of life
reduced risk of allergic disorders
lower occurrence of constipation
In infants, solid foods are best introduced no earlier than:
When counseling a breastfeeding woman about alcohol use during lactation, you relate that:
drinking a class of wine ore beer will enhance the let-down reflex
because of its high molecular wright, relatively little alcohol is passed into the breast milk
maternal alcohol use causes a reduction int he amount of milk ingested by the infant
infant intoxication can be seen with mother's having as few as one to two alcoholic drinks
Regarding physiologic jaundice in the newborn, select all that are correct:
It occurs between the first 12-24 hours of life
It progresses from the abdomen toward the head of the infant
Unconjugated bilirubin is elevated
Risk of development of hyperbilirubinemia can be reduced if the breastfed infant with frequent breastfeeding every 2-3 hours per 24 hours
It can be avoided by supplemental water and dextrose feedings between breastfeeding in the first 3-4 days of life to increase the infant hydration while awaiting the mother's milk to come in
A faun tail nevus is a sign of which of the following
Congenital heart disease
Cafe-au-lait spots look like tan-to-light brown stains that have irregular borders. They can be located anywhere on the body. Which of the following is a correct statement?
They are associated with neurofibromatosis or von Recklinghausen's disease
They may be considered as precancerous after biopsy
They are more common in darker-skinned children
They are associated with Wilson's disease
The red reflex is elicited by shining a light in the eyes of the infat at an angle with the light about 15 in. away. What is the NP is screening for?
the blinking response
You are reviewing the bilirubin level on a 3-day old term-infant neonate. You note that is is 10 mg/dL. The infant has a slight yellow color to his skin, mucous membranes, and sclera. The infnat is feeding well, is not irritable, and has 8-10 wet diapers ped day. Which of the following is a true statement?
Keep on monitoring the infant's bilirubin level until it returns back to normal in about 1 week
Recommend that the infant be treated with phototherapy 10 minutes a day until the bilirubin level is back down to a normal range
Refer the infant to a neonatologist as soon as possible
Refer the infant to the neonatal intensive care unit
Which of the following statements is false regarding jaundice in breastfed infants?
Breastfed infants have a higher incidence of hyperbilirubinemia compare with formula-fed infants
The mechanisms of breast milk jaundice is still not known
Phototherapy is usually not indicated for these infants
It usually starts in the first week of life
Which of the following is appropraite advice to give to a mother who is breastfeeding her 10-day old infant?
Your milk will come in today
To minimize breast tenderness, the baby should not be kept on either breast for more than 5-10 minutes
A clicking sound made by the baby during feedings signifies a good latch and suck
The baby's urine should be light or colorless
All of the following statements about phototherapy are correct except:
Light from the blue to white spectrum is used
It is not always necessary to use a shield for the infant's eyes
Unconjugated bilirubin in the skin is converted to a water-soluble nontoxic substance that is excreted in the bile
The infant's eyes should be shielded
What is the primary carbohydrate found in breast milk and commercial infant formulas?
During a well child visit, a new father wants to know if he can give fresh whole milk to his 6-month olf son. The NP would recommend that:
He can start giving whole milk, but not skim milk by 6 months of age
He should not give whole milk until the boy is at least 12 months of age
He can give whole milk to his son at anytime
He should not give whole milk to his son without diluting it with water
Which of the following foods would you advise a new mother to introduce to her 6-month old infant first
Iron-fortified rice cereal
Plain rice cereal
Iron-fortified pureed chicken meat
Plain pureed carrots
A new mother who is on her 4th day of breastfeeding complains to the NP that her breast are very sore. The NP would:
recommend a decrease in the number of times she breastfeeds her infant per day
recommend that she stop breastfeeding and use infant formula for the next 48 hours
educate the mother that this is a normal for the first weed or 2 of breastfeeding and the soreness will eventually go away
recommend that she purchase plastic nipple pads for her nursing bra and use them daily
All of the following statements reflect inadequate breast milk production except:
full-term infant is at birth weight by the second week of life
less than 6 wet diapers per day or less than 4 stools a per day
infant is nursing fewer than 8 times per 24-hour period
weight loss of >10% of birth weight
The NP examines a 4-week old boy whose mother reports that he has cried for at least 3 hours a day at the same time of the day since birth, What is the main goal in the clinical evaluation of this infant?
Rule out any physiologic cause for the crying spells
Make sure the infant is well clothed
Evaluate the environment
Order laboratory and diagnostic testing
A newborn infant who is SGA is noted to have a shortenend palpebral fissures and microcephaly with a small jaw. The infant is most likely to be diagnosed with:
Fetal alcohol syndrome
All of the following are true about strawberry hemangiomas found in infatnts except:
Most will involute spontaneously by the age of 18-24 months
Watchful waiting is the most useful strategy
Hemangiomas should be treated with laser therapy if they have not resolved by the age of 12 months
Strawberry hemangiomas are benign
When does the infant triple its birth weight?
Which of the following is appropriate advice to give to a mother who is breastfeeding her 12-hour old infant?
You will likely have enough milk to feed the baby within a few hours after birth
The baby might need to be awakened to be fed
Supplemental feeding is needed unless the baby has at least four wet diapers in the first few days of life
The baby will likely have a seedy yellow bowel movement today
The NP knows that the history component of the newborn visit can be completed prenatally or within the first two weeks of life.
Oxygenated blood is carried from the placenta to the fetus via the...
Inferior Vena Cava
Superior Vena Cava
When assessing the umbilical cord, there should be two veins and one artery
Select all that apply
Right atrium, foramen ovale, left atrium, left ventricle, aorta
Right atrium, right ventricle, pulmonary artery, ductus arteriosus, aorta
Right atrium, right ventricle, pulmonary artery, left atrium, left ventricle, aorta
Right atrium, ductus arteriosis, left atrium, left ventricle, aorta
During your assessment of the 1 hour old newborn, auscultation reveals fine crackles with fast shallow breathing. Respirations are 60 bpm, heart rate is 110 bpm, skin color is normal. abdomen is rounded, and there are bowel sounds. You as the provider know that this should concern you as these are signs of abnormal transition.
Which of the following are considered to be NORMAL findings of the newborn's visit in the office that warrant NO further assessment:
Cafe-au-lait spot >5 mm and more than 6
Petichiae located on the abdomen
The parents of a 3-day-old baby present their child to the emergency department (ED). They state that the newborn has generally been acting well since being discharged from the hospital yesterday. She is breastfeeding every 2-3 hours, moving her bowels multiple times daily, wetting her diapers after each feeding, and consoling appropriately.
However, the parents report that when they placed the baby on her side earlier today, she turned different colors-the side facing down was red, whereas the side facing up was white. On examination, the baby appears normal, but when laid on her right side, her skin changes colors forming a well-demarcated line dividing the body into a left and right side. You as the NP know that this may be...
Transitional milk is secreted from 4-10 days postpartum with mature milk being produced at approximately 10 days.
All of the following medications are administered to the newborn EXCEPT:
While completing a newborn assessment, the practitioner checks for the asymmetric tonic neck reflex (ATNR) by turning the infant's head to one side. During this a NORMAL response would be:
Extension of the contralateral side and flexion of the ipsilateral side
Extension of the ipsilateral side and flexion of the contralateral side
Flexion of the elbow and extension of the knee on the ipsilateral side
Flexion of the elbow and extension of the knee on the contralateral side
A mother comes into the clinic and asks you about breast-milk storage. You as the provider explain that all of the following are proper ways to store breast milk EXCEPT:
In a freezer up to 6 months
In a cooler with ice up to 24 hours
In a warm room up to 1-2 hours
In a refrigerator for up to 3-8 days
Which of the following are NOT contraindications to breastfeeding. Select all that apply:
CMV with a normal weight baby
Illicit drug use
Use of chemotherapy
Use of hormonal contraceptives
A breastfeeding mother presents to the clinic with small lumps on the breast that are red, irritated, and painful to the touch. You diagnose the mother with:
Clogged milk ducts
This is a normal finding
All of the following are major risk factors for the development of sever hyperbilirubinemia except:
Gestational age 35-36
Pre-discharge TSB or TCB in the high-risk zone
Gestational age 37-38 weeks
A phenotype is the internally coded inheritable information.
If a child receives two copies of one chromosome from one parent and non from the other, the child will be homozygous for every gene on that chromosome. This explains which pattern of inheritance?
A father brings in his newborn for a sick visit and states that the baby smells funny even after washing. Upon physical assessment, you find that the baby has fair skin, blue eyes, eczema, and a musty odor. You suspect which of the following genetic disorders?
A 3 month-old infant presents to the clinic with vomiting and diarrhea that is worsened after breastfeeding. The infant is lethargic, has hypotonia, an enlarged liver, and appears to have cataracts upon assessment. You as the provider suspect which genetic disorder?
MCADD (Medium-chain acyl-CoA dehydrogenase deficiency)
The difference between sleep and "shutting down" in the infant is that "shutting down" uses energy to maintain it.