Module 1 – Pediatric
Growth And
Development,
Immunizations 2025
1. Which Of The Following Is Appropriate Advice To Give To A Mother Who Is
Breastfeeding Her 10day-Old Infant?
a. “Your Milk Will Come In Today.”
b. “To Minimize Breast Tenderness, The Baby Should Not Be Kept On Either Breast For
More Than Five To Ten Minutes.
c. “A Clicking Sound Made By The Baby During Feedings Signified A Good Latch And Suck.”
d. “The Baby’s Urine Should Be Light Or Colorless.”
2. Which Of The Following Is Appropriate Advice To Give To A Mother Who Is
Breastfeeding Her 12hour-Old Infant?
a. “You Will Likely Have Enough Milk To Feed The Baby Within A Few Hours Of Birth.”
b. “The Baby Might Need To Be Awakened To Be Fed.”
c. “Supplemental Feeding Is Needed Unless The Baby Has At Least Four Wet Diapers In The
First Day Of Life.”
d. “The Baby Will Likely Have A Seedy, Yellow Bowel Movement Today.”
3. Compared With The Use Of Infant Formula, Advantages For The Breastfed Baby Include
All Of The Following Except:
a. Lower Incidence Of Diarrheal Illness
b. Greater Weight Gain In The First Few Weeks Of Life
c. Reduced Risk Of Allergic Disorders
d. Lower Occurrence Of Constipation
4. At Three Weeks Of Age, The Average-Weight, Formula-Fed Infant Should Be Expected
To Take:
a. 2-3 Oz, Or 60-90ml, Q2-3hr
b. 2-3 Oz, Or 60-0-Ml, Q3-4hr
c. 3-4 Oz, Or 90-118ml, Q2-3hr
d. 3-4 Oz, Or 90-118ml, Q3-4hr
5. In Infants, Solid Foods Are Best Introduced No Earlier Than:
a. 1-3 Mth
, b. 3-5 Mth
c. 4-6 Mth
d. 6-8 Mth
6. Nursing Infants Generally Maximally Receive About Which Percentage Of The Maternal
Dose Of A Drug?
a. 1 %
b. 3 %
c. 5 %
d. 10 %
7. Most Drugs Pass Into Breast Milk Through:
a. Active Transport
b. Facilitated Transfer
c. Simple Diffusion
d. Creation Of A Ph Gradient
8. To Remove A Drug From Breast Milk Through “Pump And Dump,” The Nursing Mother
Should Refrain From Taking The Offending Medication And The Process Must Be
Continued For:
a. Two Infant Feeding Cycles
b. Approximately Eight Hours
c. Three To Five Drug-Free Half-Lives Of The Medication
d. A Period Of Time That Is Highly Unpredictable
9. When Counseling A Breastfeeding Woman About Alcohol Use During Lactation, You
Relate That:
a. Drinking A Glass Of Wine Or Beer Will Enhance The Let-Down Reflex.
b. Because Of Its High Molecular Weight, Relatively Little Alcohol Is Passed Into Breast
Milk.
c. Maternal Alcohol Use Causes A Reduction In The Amount Of Milk Ingested By The
Infant.
d. Infant Intoxication Can Be Seen With The Mother Having As Few As One To Two
Alcoholic Drinks.
10. The Anticipated Average Daily Weight Gain During The First Three Months Of Life Is
Approximately: A. 15 G Or 0.53oz
b. 20 G Or 0.7oz
c. 25 G Or 0.88oz
d. 30 G Or 1oz
11. The Average Required Caloric Intake In An Infant From Age Zero To Three Months Is
Usually:
a. 40-60 Kcal/Kg/Day
b. 60-80 Kcal/Kg/Day
c. 80-100 Kcal/Kg/Day
, d. 100-120 Kcal/Kg/Day
12. Regarding Physiological Jaundice In The Newborn, Select All That Are Correct:
a. It Occurs Between The First 12 And 24 Hours Of Life.
b. It Progresses From The Abdomen Toward The Head Of The Infant.
c. Unconjugated Bilirubin Is Elevated.
d. Risk Of Development Of Hyperbilirubinemia Can Be Reduced In A Breastfed Infant With
Frequent Breastfeeding Every Two To Three Hours Per 24 Hours.
e. It Can Be Avoided By Supplemental Water And Dextrose Feedings Between
Breastfeeding In The First Three To Four Days Of Life To Increase Infant Hydration While
Awaiting Mother’s Milk To Come In.
13. The Most Likely Consequence Of Inadequate Feeding During The First Few Weeks Of A
Newborn Is:
a. Hypercalcemia
b. Hypernatremia
c. Hypokalemia
d. Hyperkalemia
14. Which Of The Following Would Be A Concern Regarding Weight Change In A Newborn?
a. Weight Loss Of 2% By Day Two Of Life
b. No Weight Gain After Three Days Of Life
c. Weight Gain Of Less Than 3% After One Week Of Life
d. Weight Loss Of Greater Than 7% At Any Time After The First Week Of Life
15. A Mother Who Has Been Breastfeeding Her Newborn Is Planning On Returning To Work
And Asks About The Use Of Breast Pumps. The Np Counsels On All Of The Following
Except:
a. Some Insurance Companies Will Cover The Costs Of Breast Pumps.
b. Breast Pumps Can Allow Flexibility In Allowing Mothers To Return To Work Or School.
c. Double Pumps Are Not Recommended As They Express About Half The Amount Of Milk
As Single Pumps.
d. Federal Law Requires The Employer To Provide Adequate Breaks And A Location For
Breast Pumping.
Indicate (Yes Or No) Whether Each Of The Following Is Expected With A Good Latch By A Newborn.
16. __________ Areola Easily Visible
17. __________ Dimpling Of The Baby’s Cheeks
18. __________ Clicking Noise Made By Baby
19. __________ Baby’s Mouth Widely Open With Lips Flanged Outward
20. Expected Stool Findings For A Two-Week-Old Baby Who Is Breastfeeding Would Most
Likely Include:
a. Loose, Seedy Stools Multiple Times Per Day
, b. Black, Tar-Like Stool About Once Per Day
c. Thick, Blood-Tinged Stool After Each Feeding
d. Watery Stool About Once Every Two To Three Days
21. A 26-Year-Old Mother Who Is Breastfeeding Her Four-Month-Old Son Reports A
Problematic Cough And Intermittent Wheeze. She Has A History Of Asthma That Was
Well-Controlled With A Mediumpotency Inhaled Corticosteroid (Ics) And Sporadic Use
Of A Short-Acting Beta-2 Agonist (Ie, Albuterol), But She Stopped Taking Her Medication
During Her Pregnancy. The Np Advises That:
a. She Should Return To Using The Ics On A Set Schedule With As-Needed Albuterol And
Continue Breastfeeding.
b. She Should Continue With The Ics On A Set Schedule With As-Needed Albuterol And
Discontinue Breastfeeding.
c. A Long-Acting Beta-2 Agonist (Laba) Is Recommended While Breastfeeding.
d. Theophylline Should Be Used While Breastfeeding Until The Baby Is Six Months Old,
Then Switch To An Ics.
22. The Use Of Homemade Infant Formula Versus Commercially Prepared Infant Formula Is
Discouraged Due To:
a. Increased Risk Of Contaminations
b. Increased Risk Of An Allergic Reaction
c. Excessive Amount Of Calcium
d. Higher Cost
Indicate (Yes Or No) Whether The Following Infant Formulas Should Be Discarded.
23. __________ Reconstituted (Unused) Formula Left At Room Temperature For One Hour.
24. __________ Reconstituted (Unused) Formula Stored In The Refrigerator For Two Hours.
25. __________ Leftover Formula Following A Feeding Left At Room Temperature For 20
Minutes.
Indicate (Yes Or No) Whether Each Would Support A Decision To Start Solid Foods In An Infant.
26. __________ At Least Three Months Old
27. __________ Is Able To Sit Upright Without Any Support
28. __________ Has More Than Doubled The Birth Weight
29. __________ Consumes More Than 32oz Of Formula Each Day
30. Which Of The Following Is Most Accurate Regarding Fluoride Supplementation In
Infants?
a. Supplementation Is Not Needed For Any Infant Younger Than 12 Months Of Age.
b. Supplementation Is Advised In Infants Six Months And Older Who Are Exclusively
Breastfed.
c. Supplementation Is Not Needed For Any Formula-Fed Infant.
d. All Infants Should Receive Supplementation At Four Months Of Age Until They Begin
Solid Foods.
Growth And
Development,
Immunizations 2025
1. Which Of The Following Is Appropriate Advice To Give To A Mother Who Is
Breastfeeding Her 10day-Old Infant?
a. “Your Milk Will Come In Today.”
b. “To Minimize Breast Tenderness, The Baby Should Not Be Kept On Either Breast For
More Than Five To Ten Minutes.
c. “A Clicking Sound Made By The Baby During Feedings Signified A Good Latch And Suck.”
d. “The Baby’s Urine Should Be Light Or Colorless.”
2. Which Of The Following Is Appropriate Advice To Give To A Mother Who Is
Breastfeeding Her 12hour-Old Infant?
a. “You Will Likely Have Enough Milk To Feed The Baby Within A Few Hours Of Birth.”
b. “The Baby Might Need To Be Awakened To Be Fed.”
c. “Supplemental Feeding Is Needed Unless The Baby Has At Least Four Wet Diapers In The
First Day Of Life.”
d. “The Baby Will Likely Have A Seedy, Yellow Bowel Movement Today.”
3. Compared With The Use Of Infant Formula, Advantages For The Breastfed Baby Include
All Of The Following Except:
a. Lower Incidence Of Diarrheal Illness
b. Greater Weight Gain In The First Few Weeks Of Life
c. Reduced Risk Of Allergic Disorders
d. Lower Occurrence Of Constipation
4. At Three Weeks Of Age, The Average-Weight, Formula-Fed Infant Should Be Expected
To Take:
a. 2-3 Oz, Or 60-90ml, Q2-3hr
b. 2-3 Oz, Or 60-0-Ml, Q3-4hr
c. 3-4 Oz, Or 90-118ml, Q2-3hr
d. 3-4 Oz, Or 90-118ml, Q3-4hr
5. In Infants, Solid Foods Are Best Introduced No Earlier Than:
a. 1-3 Mth
, b. 3-5 Mth
c. 4-6 Mth
d. 6-8 Mth
6. Nursing Infants Generally Maximally Receive About Which Percentage Of The Maternal
Dose Of A Drug?
a. 1 %
b. 3 %
c. 5 %
d. 10 %
7. Most Drugs Pass Into Breast Milk Through:
a. Active Transport
b. Facilitated Transfer
c. Simple Diffusion
d. Creation Of A Ph Gradient
8. To Remove A Drug From Breast Milk Through “Pump And Dump,” The Nursing Mother
Should Refrain From Taking The Offending Medication And The Process Must Be
Continued For:
a. Two Infant Feeding Cycles
b. Approximately Eight Hours
c. Three To Five Drug-Free Half-Lives Of The Medication
d. A Period Of Time That Is Highly Unpredictable
9. When Counseling A Breastfeeding Woman About Alcohol Use During Lactation, You
Relate That:
a. Drinking A Glass Of Wine Or Beer Will Enhance The Let-Down Reflex.
b. Because Of Its High Molecular Weight, Relatively Little Alcohol Is Passed Into Breast
Milk.
c. Maternal Alcohol Use Causes A Reduction In The Amount Of Milk Ingested By The
Infant.
d. Infant Intoxication Can Be Seen With The Mother Having As Few As One To Two
Alcoholic Drinks.
10. The Anticipated Average Daily Weight Gain During The First Three Months Of Life Is
Approximately: A. 15 G Or 0.53oz
b. 20 G Or 0.7oz
c. 25 G Or 0.88oz
d. 30 G Or 1oz
11. The Average Required Caloric Intake In An Infant From Age Zero To Three Months Is
Usually:
a. 40-60 Kcal/Kg/Day
b. 60-80 Kcal/Kg/Day
c. 80-100 Kcal/Kg/Day
, d. 100-120 Kcal/Kg/Day
12. Regarding Physiological Jaundice In The Newborn, Select All That Are Correct:
a. It Occurs Between The First 12 And 24 Hours Of Life.
b. It Progresses From The Abdomen Toward The Head Of The Infant.
c. Unconjugated Bilirubin Is Elevated.
d. Risk Of Development Of Hyperbilirubinemia Can Be Reduced In A Breastfed Infant With
Frequent Breastfeeding Every Two To Three Hours Per 24 Hours.
e. It Can Be Avoided By Supplemental Water And Dextrose Feedings Between
Breastfeeding In The First Three To Four Days Of Life To Increase Infant Hydration While
Awaiting Mother’s Milk To Come In.
13. The Most Likely Consequence Of Inadequate Feeding During The First Few Weeks Of A
Newborn Is:
a. Hypercalcemia
b. Hypernatremia
c. Hypokalemia
d. Hyperkalemia
14. Which Of The Following Would Be A Concern Regarding Weight Change In A Newborn?
a. Weight Loss Of 2% By Day Two Of Life
b. No Weight Gain After Three Days Of Life
c. Weight Gain Of Less Than 3% After One Week Of Life
d. Weight Loss Of Greater Than 7% At Any Time After The First Week Of Life
15. A Mother Who Has Been Breastfeeding Her Newborn Is Planning On Returning To Work
And Asks About The Use Of Breast Pumps. The Np Counsels On All Of The Following
Except:
a. Some Insurance Companies Will Cover The Costs Of Breast Pumps.
b. Breast Pumps Can Allow Flexibility In Allowing Mothers To Return To Work Or School.
c. Double Pumps Are Not Recommended As They Express About Half The Amount Of Milk
As Single Pumps.
d. Federal Law Requires The Employer To Provide Adequate Breaks And A Location For
Breast Pumping.
Indicate (Yes Or No) Whether Each Of The Following Is Expected With A Good Latch By A Newborn.
16. __________ Areola Easily Visible
17. __________ Dimpling Of The Baby’s Cheeks
18. __________ Clicking Noise Made By Baby
19. __________ Baby’s Mouth Widely Open With Lips Flanged Outward
20. Expected Stool Findings For A Two-Week-Old Baby Who Is Breastfeeding Would Most
Likely Include:
a. Loose, Seedy Stools Multiple Times Per Day
, b. Black, Tar-Like Stool About Once Per Day
c. Thick, Blood-Tinged Stool After Each Feeding
d. Watery Stool About Once Every Two To Three Days
21. A 26-Year-Old Mother Who Is Breastfeeding Her Four-Month-Old Son Reports A
Problematic Cough And Intermittent Wheeze. She Has A History Of Asthma That Was
Well-Controlled With A Mediumpotency Inhaled Corticosteroid (Ics) And Sporadic Use
Of A Short-Acting Beta-2 Agonist (Ie, Albuterol), But She Stopped Taking Her Medication
During Her Pregnancy. The Np Advises That:
a. She Should Return To Using The Ics On A Set Schedule With As-Needed Albuterol And
Continue Breastfeeding.
b. She Should Continue With The Ics On A Set Schedule With As-Needed Albuterol And
Discontinue Breastfeeding.
c. A Long-Acting Beta-2 Agonist (Laba) Is Recommended While Breastfeeding.
d. Theophylline Should Be Used While Breastfeeding Until The Baby Is Six Months Old,
Then Switch To An Ics.
22. The Use Of Homemade Infant Formula Versus Commercially Prepared Infant Formula Is
Discouraged Due To:
a. Increased Risk Of Contaminations
b. Increased Risk Of An Allergic Reaction
c. Excessive Amount Of Calcium
d. Higher Cost
Indicate (Yes Or No) Whether The Following Infant Formulas Should Be Discarded.
23. __________ Reconstituted (Unused) Formula Left At Room Temperature For One Hour.
24. __________ Reconstituted (Unused) Formula Stored In The Refrigerator For Two Hours.
25. __________ Leftover Formula Following A Feeding Left At Room Temperature For 20
Minutes.
Indicate (Yes Or No) Whether Each Would Support A Decision To Start Solid Foods In An Infant.
26. __________ At Least Three Months Old
27. __________ Is Able To Sit Upright Without Any Support
28. __________ Has More Than Doubled The Birth Weight
29. __________ Consumes More Than 32oz Of Formula Each Day
30. Which Of The Following Is Most Accurate Regarding Fluoride Supplementation In
Infants?
a. Supplementation Is Not Needed For Any Infant Younger Than 12 Months Of Age.
b. Supplementation Is Advised In Infants Six Months And Older Who Are Exclusively
Breastfed.
c. Supplementation Is Not Needed For Any Formula-Fed Infant.
d. All Infants Should Receive Supplementation At Four Months Of Age Until They Begin
Solid Foods.
