Republic of the Philippines

Professional Regulation Commission

Board of Midwifery
Manila City

Infant Care and Feeding 11:00 AM to 1:00 PM

GENERAL INSTRUCTIONS:
1. The test questionnaire contains 100 test questions. Examinees shall manage to
use 2 hours.
2. Read INSTRUCTIONS printed on your answer sheet.
3. Shade only one (1) box for each question on your answer sheets. Two or more
boxes shaded will invalidate your answer.
4. AVOID ERASURES.
5. This material is protected by Copyright Laws. Unauthorized used shall be
prosecuted in the full extent of the Philippine Laws.

1. When instructing parents to prevent irritant diaper dermatitis, which patient

education must be included?
a. use zinc oxide barrier cream to protect the skin
b. use baby wipes with alcohol to keep the skin dry
c. decrease the frequency of diaper changes to prevent irritation
d. avoid using disposable diapers and apply cloth diapers instead

2. When is an appropriate time to bathe the newborn?

A. Immediately after birth
B. After feeding the newborn
C. Before feeding the newborn
D. Upon discharge

3. After a baby is born, what should be the first action performed?

A. Clamp and cut the cord
B. Dry the baby
C. Maintain patent airway
D. Do foot printing

4. During drying and stimulation of the baby, your rapid assessment shows that the baby is
crying. What is your next action?
A.Suction the baby’s mouth and nose
B. Clamp and cut the cord
C. Do skin-to-skin contact
D. Do early latching on

5. When should the cord be clamped after birth?

A. When the cord pulsations stop
B. anytime within first 30 minutes
C. immediately after delivery
D. All of the above are appropriate

6. Which of the following is NOT true about umbilical cord clamping and care:
a. infant should be sponge bathed until the stump is healed
b. rubbing alcohol can be swabbed on the cord stump to help it dry up
c. how you care for the cord stump will determine if you have an inny or an outy
d. the stump will dry up and fall off within 7 to 10 days

7. What is the late sign of hunger for the babies?

A. mouthing, licking, tonguing movements
B. rooting
C. changes in facial expressions
D. Crying

8. On her second day of life, baby James was observed to regurgitate after feeding. Which
two factors probably caused her regurgitation?
1. Imperfect control of the cardiac sphincter 3. Immaturity of the nervous system
2. Infant is not active 4. Pyloric sphincter is not well developed
a. 1 and 2 b. 1 and 3 c. 2 and 4 d. 1 and 4

9. A communicable disease that affects the growth and development among children
a. Primary complex b. asthma c. leprosy d. diabetes

10. There are __ steps to a successful breastfeeding which is criteria in the accreditation of a
mother-friendly hospital:
a. 20 b. 10 c. 5 d. 15

11. The normal cry of the newborn is:

a. Lusty, frequent b. Cried with a cause c. Trembling d. Loud continuous

12. A new parent asks the midwife, "How can diaper rash be prevented?" The midwife
should recommend which of the following?

A. Wash with soap before applying a thin layer of oil.

B. When changing the diaper, wipe the buttocks with oil and powder the creases.
C. Wash with a mild cleanser such as Dove and water and dry thoroughly
whenever stooling has occurred.
 D. Wash with soap and water every time diaper is changed

13. Gracie, the mother of a 3-month-old infant calls the clinic and states that her child
has a diaper rash. What should the midwife advice?

A. “Switch to cloth diapers until the rash is gone”

B. “Use baby wipes with each diaper change.”
C. “Leave the diaper off while the infant sleeps.”
D. “Offer extra fluids to the infant until the rash improves.”

14. What's the best way to prevent diaper rash?

a. Change your baby's diaper every one to three hours and at least once a night
b. Carefully clean his skin and apply a barrier cream with petroleum jelly or
zinc-oxide after each change
c. Let your baby have plenty of 'bare-bum' time
d. All of the above

15. If the baby suffers from diaper rash, you should advised mother to
a. Keep his bottom damp at all times
b. Change his diaper less frequently
c. Give his bottom some "air time"
d. Apply ointment or petrolleum

16. What is the most common cause of diaper rash?

a. Skin exposure to the pee and poo in a diaper
b. Wet skin
c. Diarrhea
d. Skin reaction to a chemical

17. Which of the following is the most appropriate food to be given early to baby during
its supplementary feeding
1. Mashed potato 3. Squash 5. Egg
2. Fish fillet 4. Chicken breast 6. Yellow camote

a. 1, 2, 3 b. 1,2,3,6 c. 1 , 2, 4 d.1, 3, 6

18. All of the ff are components of APGAR score, except:

a. BP b. muscle tone c. skin color d. heart rate

19. Measles infection is caused by a virus. Measles is considered highly contagious and
infectious when
a. When Rashes Appears
b. Rashes disappearance
c. Before rashes appears
 d. If scar appears

20. The primary critical observation for Apgar scoring is the:

A. Heart rate
B. Respiratory rate
C. Presence of meconium
D. Evaluation of the Moro reflex

21. Marie brought her 10 month old infant for consultation because of fever, started 4
days prior to consultation. The medical term epistaxis is commonly known as
a. nose bleeding.
b. vaginal bleeding.
c. vomiting of blood.
d. spitting of blood.

22. When using the otoscope to examine the ears of a 2 year-old child, the midwife
should
a. Pull the pinna up and back
b. Pull the pinna down and back
c. Hold the pinna gently but firmly in its normal position
d. Hold the pinna against the skull

23. Breastmilk which stands in a room temperature can be used up to how many hours
a. 6 -8 hours b. 24 hours c. 3-5 days d. 1 week

24. In Integrated Management of Childhood Illness, severe conditions generally require

urgent referral to a hospital. Which of the following severe conditions DOES NOT
always require urgent referral to a hospital?
A. Mastoiditis
B. Severe dehydration
C. Severe pneumonia
D. Severe febrile disease

25. These vaccines are given 3 doses at one month intervals:

A. DPT, BCG, TT
B. DPT, TT, OPV
C. OPV, Hep. B, DPT
D. Measles, OPV, DPT

26. Which of the four signs of good attachment is true in this statement?

A. the chin should touch the breast while the mouth is wide open and while the lower lip
is turned inward more areola is visible above than below
B. the chin should touch the breast while the mouth is wide open and the lower lip turned
inward, more areola is visible above than below
 C. the chin should touch the breast while the mouth is wide open while the lower lip
turned outward and more areola visible below than above
D. the chin should touch the breast, the mouth is wide open while the lower lip
turned outward and more areola visible above than below

27. Which is the following is an expected activity of a 8 month old with a normal
growth
a. stand alone b. eat alone c. sit alone d. crawl

28. Flat, red localized areas of capillary dilatation of the eyelid, between eyebrows and
on the nose is called:
a. stork bites b. birth mark c. forceps mark d. strawberry marks

29. A baby born with the head elongated and slightly swollen. This appearance of the
baby’s head is considered as:
a. caput succedaneum b. cephalhematoma c. brain damage d. tumor

30. How long or within what period does the body temperature of an infant stabilized?
a. 48 hrs. b. 8 hrs. c. 24hrs. d. 12 hrs.

31. You’re assessing a neonate who has blackish blue marks around his buttocks.
What are these marks called?
a. Milia
b. VernixCaseosa
c. Mongolian Spots
d. Nevus Flammeus

32. When teaching the mother of a child with eczema, which of the following
instructions should be included in the midwife’s teaching?
a) Dress the infant warmly to prevent undue chilling
b) Cut the infant’s fingernails and toenails regularly
c) Use bubble bath instead of soap for bathing
d) Wash the infant’s clothes with the mild detergent and fabric softener

33. During drying and stimulation of the baby, your rapid assessment shows that the
baby is crying. What is your next action?
a) Suction baby’s mouth and nose
b) Clamp and cut the cord
c) Do skin-to-skin contact
d) Do early latching on

34. Calcium and phosphorus are important nutrients in the diet of pregnant women
for a proper development of the baby
a. muscles b. veins and arteries
 c. bones and teeth d. kidney and lungs

35. The milk ejection reflex influence by which of the following hormone
a) Prolactin
b) Oxytocic
c) Progesterone
d) Estrogen

36. Which of the following is NOT TRUE regarding the treatment of breast
engorgement?
a) After a fed, apply cold compress on the breast to reduce edema
b) If the baby is able to suck, feed less frequently
c) Before a feed, to stimulate oxytocin reflex, stimulate the nipple skin and give
massage
d) If the baby is not able to suck , express milk by hand or with a pump

37. Symptoms manifested by night blindness and white spots among infants and
children is deficiency in:
a) Vitamin C
b) Iron
c) Vitamin K
d) Vitamin A

38. Deficiency disease cause by inadequate vitamin C in the diet of infants is

a. kwashiorkor
b. infantile eczema
c. iron deficiency
d. scurvy

39. First social smile is seen at

a. 4 months
b. 3 months
c. 2months
d. 5 months

40. Infants can LOL or laugh out loud can be heard at

a. 7 months
b. 3 months
c. 1 months
d. 5 months

41. Which of the following hormones influences milk let down reflex?
A. Prolactin c. Progesterone
B. Oxytocin d. Estrogen
42. Solid foods are not given until this reflex disappears:
A. Gagging c. Extrusion
B. Swallowing d. Rooting

43. Lucy was 7 lbs at birth. By one year of the newborn, she should weigh:
A. 14 lbs b. 21 lbs c. 24 lbs. d. 28 lbs

44. Whitish lesions appearing like milk curds on the tongue and mucus membrane of
the mouth of the infant is:
A. Thrush c. Furunculosis
B. Impetigo d. Scurvy

45. Which of the following is suggestive of Vitamin A deficiency in children

characterized by a white foamy lesion occurring on the conjunctiva or sclera of the eye?
a. Xeropthalmia
b. Bitots Spot
c. Keratomalacia
d. Corneal Xerosis

46. When assessing the newborn’s heart rate, which of the following ranges would be
considered normal if the newborn were sleeping?
A. 80 beats per minute
B. 100 beats per minute
C. 120 beats per minute
D. 140 beats per minute

47. At about what age does an infant start to recognize familiar faces and objects, such as
own hand?
a. 1 month
b. 2 months
c. 3 months
d. 4 months

48. In terms of gross motor development, what would the midwife expect an infant age 5
months to do?
a. Sit erect without support.
b. Roll from back to abdomen.
c. Turn from abdomen to back.
d. Move from prone to sitting position.

49. At what age can most infants sit steadily unsupported?

a. 4 months
b. 6 months
 c. 8 months
d. 12 months

50. At what age do most infants begin to fear strangers?

a. 2 months
b. 4 months
c. 6 months
d. 12 months

51. At what age would the midwife expect an infant to be able to say "mama" and "dada"
with meaning?
a. 4 months
b. 6 months
c. 10 months
d. 14 months

52. At what age should the midwife expect an infant to begin smiling in response to
pleasurable stimuli?
a. 1 month
b. 2 months
c. 3 months
d. 4 months

53. What clinical manifestations suggest hydrocephalus in an infant?

a. Closed fontanel, high-pitched cry
b. Bulging fontanel, dilated scalp veins
c. Constant low-pitched cry, restlessness
d. Depressed fontanel, decreased blood pressure

54. A 4-month-old child is discharged home after surgery for the repair of a cleft lip.
Instructions to the parents include:
a. provide crib toys for distraction.
b. breast- or bottle-feeding can begin immediately.
c. give pain medication to infant to minimize crying.
d. leave infant in crib at all times to prevent suture strain.

55. The midwife must assess 10-month-old infant. He is sitting on his mother's lap and
appears to be afraid of the midwife and of what might happen next. Which of the
 following initial actions by the midwife would be most appropriate?
a. Initiate a game of peek-a-boo.
b. Ask father to place the baby on the examination table.
c. Talk softly to the baby while taking him from his father.
d. Undress baby while he is still sitting on his father's lap.

56. Which condition results from deposition bilirubin in the neonates brain, specialy in the
brain stem and ganglia
a. Keratosis
b. Kernicterus
c. Ptosis
d. Hydrops fetalis

57. Which of the following diseases where in you can find Koplik Spot
a. Tetanus
b. Poliomyelitis
c. Diphtheria
d. Measles

58. Vitamin K is given to neonate in order to prevent

a. infection
b. bleeding
c. rickets
d. jaundice

59. The safest and most economical way for the mother to prevent anemia in the 0-6 months
old infant is by:
a. giving iron preparation
b. breast feeding
c. giving early supplementation
d. artificial feeding

60. A discussion starts among several mothers concerning whether to use reusable or
dispensable diapers for their babies. Most mother are of the opinion that:
a. Reusable and disposable diapers have both been found satisfactory and the choice is
personal.
b. Reusable diapers are better for daytime use, and disposable diapers are better
for night time use.
c. Reusable diapers are better since they are most absorbent.
d. Disposable diapers are better since they are less irritating to an infant's skin

61. Which of the following scope proper for prenatal care that prevents diaper rash?
a. Remove the soiled diaper, pat the perineum, and replace with dry one.
b. Wash the perineum with water, pat it, and dry.
 c. Remove the soiled diaper and replace it with a dry on.
d. Dry the perineum with the used diaper and apply powder.

62. The goal of the initial assessment for the newbom is to determine:
a. deformities and handicaps
b. the state of oxygenation and ventilation
c. the level of hemoglobin
d. the heart rate

63. Before the infant takes its first breath after birth the midwife’s concern is to:
a. perform APGAR score
b. clear the airway
c. clamp and cut the umbilical cord
d. stimulate to cry

64. The midwife dries the infant after birth in order to:
a. remove organisms acquired during delivery
b. stimulate the circulating system
c. avoid excess heat loss
d. remove the skin’s white substance

65. An APGAR score of 0-3 is:

a. inconclusive
b. guarded
c. depressed
d. serious

66. Which of the following signs of the infant should the midwife report promptly to the
doctor?
a. pulse rate is 140 per minute
b. blood pressure is 84/50
c. sternum moves inward with inspirations
d. regurgitates after his last feeding

67. Which of the following is NOT considered as basic life support?

a. airway intervention
b. therapeutic intervention
c. ventilation
d. circulation

68. Which of the following injury at birth the midwife need not to refer immediately?
a. facial palsy
b. cephalhematoma
c. hemorrhage
d. brain damage
69. Vitamin K is given to newborn after birth primarily to help:
a. increased calcium absorption
b. stimulate respirations
c. improved blood coagulation
d. increase peristalsis movement

70. In the immediate assessment of the newborn the priority is the:

a. respiration
b. weight
c. temperature
d. blood pressure

71. The purpose of placing the baby in the crib with the head lower than the trunk is to:
a. improve respiration
b. facilitate the drainage of secretion
c. avoid tympanism
d. prevent hiccups

72. Indication of pulmonary function in young infants: The most reliable and reproducible
rate can be achieved when the infant is:
a. sleeping
b. sitting
c. awake
d. standing

73. Silver nitrate solution is placed in infant’s eye to prevent:

a. retrolental fibroplasia
b. herpes simplex
c. myopia
d. gonorrhea opthalmia neonatorum

74. Which of the following is the neonate that a midwife must refer and work about?
a. absence of meconium within 24 hours
b. excessive mucus secretion
c. Jaundiced skin five days after birth
d. none of these

75. Failure to administer Vitamin K most often leads to:

a. bleeding within 24 hours of delivery.
b. prolonged prothrombin time.
c. early blood clotting
d. anemia.

76. The correct dose of Vit. K to be given to a neonate is:

a. 1 mg b. 1 ampule c. 1cc d. 0.5 cc
77. The stool of a breastfeed baby will appear to be:
a. mushy and golden yellow c. well formed and light yellow
b. well formed and watery yellow d. hard and dark yellow

78. Measles vaccine is given by what route?

a. oral b. intramuscular c. subscutaneous d. Intradermal

79. The bilirubin of term babies peaks on the 3rd day of life in pre term it is on the:
a. beyond 10 days b. 6th- 10th days c. 3rd-7th days d. 5th-7th days

80. Physiological jaundice of the newborn appears definitely between the third and seventh
days after birth. How many days will it disappear?
A. 1-2
B. 2-3
C. 4-5
D. 7-10

81. BCG and measles has the same doses?

a. 3
b. 1
c. 4
d. 2

82. An infant can be able to pick up small objects using pincer grasp at which age
A. 10 mos.
B. 5 mos.
C. 7 mos.
D. 8 mos.

83. At 28 weeks of age, a normal baby should be able:

a. Roll over
b. Reach for and grasp l objects
c. Sit with support
d. Utter repetitive vowel sounds

e. 1 and 2 c. 2 and 4
f. 3 and 4 d. all of the above

84. The midwife documents which of the following reflexes as being responsible for an
infant incurving the toes with uncurling and fanning out of the toes when the
lateral plantar surface is stroked.
A. Moro Reflex
B. Gallant reflex
C. Rooting reflex
D. Babinski reflex
85. In giving partial bath, it should proceed from the cleanest to the soiled areas of the
body.
The correct sequence should be:
a. Face and eyes, hair, trunk diaper area
b. hair, face and eyes, trunk, diaper area
c. extremities, trunk, face and eyes, hair
d. trunk, extremities, face and eyes, diaper area

86. After teaching the mother about the neonate’s positive Babinski reflex, the midwife
determines that the mother understands the instructions when she says that a positive
Babinski reflex indicates?
a) Immature muscle coordination.
b) Immature central nervous system.
c) Possible lower spinal cord defect.
d) Possible injury to nerves that innervate the feet.

87. The distance of the bililight therapy into the newborns body should be
g. 6-8 inches c. 12-30 inches
h. 2-3 inches d. 10-15 inches

88. Andria is a new mother. She notices that when she strokes her baby's cheek, the baby
turns his head in the direction it was touched. What is this called?
a. Moro reflex c. Babinski reflex
b. Sucking reflex d. Rooting reflex

89. In teaching the mother of a young infant to treat oral thrush, which of the following
actions reflect an inappropriate teaching of the community health midwife?
a. Wash her hands.
b. Wipe the infant’s mouth with a clean, soft cloth wrapped around her finger
and dipped in tap water.
c. Paint the infant’s mouth with half-strength Gentian Violet.
d. Wash her hands again.

90. The most common organism causing mastitis is:

a. Gardenella vaginalis c. Escherichia coli

b. Streptococcus d. Staphylococcus aureus

91. If after 30 seconds of thorough drying, newborn is breathing or crying which of the
following is an immediate nursing action?

A. Do footprinting

B. Place newborn prone on the mother’s abdomen or chest skin-to-skin

C. Wipe off vernixcaseosa if present

D. Place newborn supine on the mother’s abdomen or chest skin-to-skin

92. After 1-3 minutes of life, Midwife PsyWalkvendor is about to cut and clamp the cord.
Which of the following should be included in her plan of care?

I. Cut and clamp the cord immediately

II. Wait for cord pulsation to stop

III. Apply sterile clamp or tie 2 cm and the second clamp 5 cm from the base

IV. Cut close to the first clamp with a clean scissor

V. Observe for oozing blood from the umbilical cord

VI. Milk the cord towards the newborn

A. I, II, III, V

B. I, II, III, IV, VI

C. II, III, IV, V,

D. II, III, V

93. After the baby is delivered, the cord was cut between two clamps using a sterile
scissors and blade, then the baby is placed at the:

A. Mother’s breast
B Mother’s side
C. Give it to the grandmother
D. Baby’s own mat or bed

94. The midwife is preparing to administer erythromycin ophthalmic ointment to a

neonate soon after delivery. This should explain to the parents that this medication,
in addition to preventing blindness caused by gonococcal organisms, also prevents
neonatal blindness caused by which of the following?

A. beta-hemolytic streptococcus.
B. Chlamydia trachomatis.
C. Escherichia coli.
D. Staphylococcus aureus

95. A midwife prepares to administer a vitamin K injection to a newborn and

the mother asks the midwife why her newborn infant needs the injection. The best
response by the midwife would be:
A. “Your infant needs vitamin K to develop immunity.”
B. “The vitamin K will protect your infant from being jaundiced.”
C. “Newborn infants have sterile bowels, and vitamin K promotes the growth of bacteria
in the bowel.”
D. “Newborn infants are deficient in vitamin K, and this injection prevents
your infant from abnormal bleeding.”

96. Which of the following is the most appropriate food to be given early to baby during
its supplementary feeding
3. Mashed potato 3. Squash 5. Egg
4. Fish fillet 4. Chicken breast

b. 1, 2, 3 b. 1 and 3 c. 1 and 4 d. all of these

97. All of the ff are components of APGAR score, except:

a. BP b. muscle tone c. skin color d. heart rate
98. When using the otoscope to examine the ears of a 2 year-old child, the midwife
should
a. Pull the pinna up and back
b. Pull the pinna down and back
c. Hold the pinna gently but firmly in its normal position
d. Hold the pinna against the skull

99. Breastmilk which stands in a room temperature can be used up to how many hours
a. 6 -8 hours b. 24 hours c. 3-5 days d. 1 week

100. Which of the following is expected to be done by a normal 7 mos. old infant?
a. crawl b. sit alone c. stand alone d. eat alone