Deck 16: Breastfeeding

Question 1

The primary care pediatric nurse practitioner is counseling the mother of a newborn about breastfeeding her infant. Which supplements will the nurse practitioner recommend?

A) Fat-soluble vitamins
B) Iron
C) Multivitamins with iron
D) Vitamin D

Answer 1

D

Question 2

The primary care pediatric nurse practitioner performs an initial well baby exam on a 1-week-old infant who is breastfeeding and who is at birth weight. The mother tells the nurse practitioner that her baby is already sleeping 5 or 6 hours at night. What will the nurse practitioner recommend?

A) Consultation with a lactation specialist to assess intake
B) Pumping her breast during the night to maintain milk supply
C) Supplementing the last feeding of the day with formula
D) Waking the infant up at least every 3 hours to nurse

Answer 2

D

Question 3

The mother of a 15-month-old infant tells the primary care pediatric nurse practitioner that she wishes to continue nursing her child for another year, if possible. What will the nurse practitioner recommend?

A) Breastfeed only at bedtime to establish meal patterns.
B) Clean the toddler's teeth after each breastfeeding.
C) Offer the breast just prior to meals to maintain milk supply.
D) The toddler should continue to be breastfed "on demand."

Answer 3

B

Question 4

The mother of a nursing infant expresses concern about whether high-cholesterol foods will increase her infant's risk of hyperlipidemia. What will the primary care pediatric nurse practitioner tell her?

A) Breastfed infants have lower serum cholesterol levels than those who are not breastfed.
B) Maternal cholesterol levels affect the cardiovascular risk of breastfed babies.
C) Maternal dietary cholesterol intake does not affect the infant's serum cholesterol values.
D) She should limit her dietary cholesterol to prevent hyperlipidemia in her infant.

Question 5

The primary care pediatric nurse practitioner performs a well child assessment on a 6-month-old infant whose mother reports having less breast milk because of stressors associated with pumping and returning to work. The nurse practitioner will provide resources to promote pumping and what other intervention?

A) Discussing adding other foods to the baby's diet.
B) Encouraging the mother to increase her fluid intake.
C) Prescribing a multivitamin containing iron.
D) Suggesting offering only breast milk to the infant.

Question 6

The mother of a newborn infant asks the primary care pediatric nurse practitioner about pumping her breasts when she returns to work in 2 months. What will the nurse practitioner include in teaching this mother?

A) Frozen breast milk may be stored up to 3 months in a 0° F freezer.
B) Once she begins pumping the infant should drink only pumped breast milk.
C) Pumped breast milk must be discarded after 3 days when stored in the refrigerator.
D) Unused defrosted breast milk may be stored in the refrigerator for 48 hours.

Question 7

The mother of a 2-month-old infant tells the primary care pediatric nurse practitioner that she is afraid her breast milk is "drying up" because her baby never seems satisfied and wants to nurse all the time. Which action is correct?

A) Recommend pumping her breasts after feedings.
B) Refer the mother to a lactation consultant.
C) Suggest supplementation with formula.
D) Weigh the infant to assess for a growth spurt.

Question 8

The primary care pediatric nurse practitioner is examining a newborn who is breastfeeding and notes the presence of an ankyloglossia. What will the nurse practitioner do next?

A) Ask the mother if the infant has any feeding difficulties.
B) Refer the infant for a possible frenulectomy.
C) Schedule an appointment with a lactation consultant.
D) Suggest that the mother feed breast milk by bottle.

Question 9

The mother of a newborn asks the primary care pediatric nurse practitioner about the benefits of breastfeeding. What will the nurse practitioner tell her?

A) Breastfeeding for 9 months or longer will reduce the incidence of food allergies.
B) Breast milk is an excellent source of vitamin D, iron, and other essential nutrients for the baby.
C) Nursing her baby exclusively for at least 4 months will help her infant to resist infections.
D) There is a decreased risk of atopic dermatitis in babies who nurse for 12 months or longer.

Question 10

The primary care pediatric nurse practitioner is performing an assessment on a 1-week-old newborn with a slightly elevated bilirubin who is breastfeeding well and who has gained 30 grams in the past 24 hours. The infant is stooling and voiding well. The nurse practitioner suspects breast milk jaundice. Which action is correct?

A) Order home phototherapy and closely monitor bilirubin levels.
B) Reassure the mother that the bilirubin level will drop in a few days.
C) Recheck the serum bilirubin and infant's weight in 24 hours.
D) Recommend that the mother pump her breast milk for a couple of days.

Question 11

The primary care pediatric nurse practitioner learns that the mother of a newborn infant is being tested for tuberculosis after a positive TB skin test. What will the nurse practitioner tell the mother who states a desire to breastfeed her baby?

A) Breast milk is contraindicated if the mother has tuberculosis.
B) She may continue to nurse her baby since the risk of transmission is low.
C) That she can express breast milk and feed that to her infant.
D) To give formula until results of tuberculosis testing are known.

Question 12

The primary care pediatric nurse practitioner sees a 3-day-old nursing infant whose newborn metabolic screen is positive for galactosemia. The nurse practitioner refers the newborn to a specialist for immediate evaluation and will tell the mother to do what?

A) Continue to breastfeed her infant.
B) Give the infant a cow's milk formula.
C) Supplement breast milk with formula.
D) Stop breastfeeding immediately.