N137 Newborn nutrition and feeding
The maternity nurse must be cognizant that cultural practices have significant influence on infant feeding methods. Many regional and ethnic cultures can be found within the United States. One cannot assume generalized observations about any cultural group will hold for all members of the group. Which statement related to cultural practices influencing infant feeding practice is correct? 1 A common practice among Mexican women is known as las dos cosas. 2 Muslim cultures do not encourage breastfeeding due to modesty concerns. 3 Latino women born in the United States are more likely to breastfeed. 4 East Indian and Arab women believe that cold foods are best for a new mother.
1 A common practice among Mexican women is las dos cosas. This refers to combining breastfeeding and commercial infant formula. It is based on the belief that by combining the two feeding methods, the mother and infant receive the benefits of breastfeeding along with the additional vitamins from formula. Among Muslim women, breastfeeding for 24 months is customary. Muslim women may choose to bottle-feed formula or expressed breast milk while in the hospital. Latino women born in the United States are less likely to breastfeed. East Indian and Arab women believe that hot foods, such as chicken and broccoli, are best for the new mother. The descriptor hot has nothing to do with the temperature or spiciness of the food. Test-Taking Tip: What happens if you find yourself in a slump over the examination? Take a time-out to refocus and reenergize! Talk to friends and family who support your efforts in achieving one of your major accomplishments in life. This effort will help you regain confidence in yourself and get you back on track toward the realization of your long-anticipated goal.
Which nursing intervention helps promote early passage of meconium in the infant? 1 Encouraging the mother to feed the infant colostrum 2 Administering a vitamin K injection (Mephyton) to the infant 3 Providing kangaroo care to the infant immediately after birth 4 Feeding unmodified cow's milk to the infant immediately after birth
1 Colostrum is a clear yellowish fluid, which is rich in antibiotics and high in proteins. The fluid also has laxative traits. Therefore, feeding the infant colostrum promotes early passage of meconium. A vitamin K (Mephyton) injection prevents hemorrhagic problems, but does not promote early passage of meconium. Kangaroo care prevents hypothermia and enhances milk production. The nurse should instruct the mother to feed the infant colostrums immediately after birth rather than feeding the infant unmodified cow's milk.
On reviewing the laboratory reports of a newborn, the nurse finds that the infant has galactosemia. What does the nurse advise the parents to ensure safety? 1 Avoid breastfeeding the infant. 2 Feed the infant with expressed human milk. 3 Avoid giving soy-rich formula to the infant. 4 Start giving fruit juice to the infant.
1 Consumption of human milk is contraindicated in infants with galactosemia. Therefore, a newborn with galactosemia should not be breastfed. Any type of human milk is contraindicated in infants with galactosemia. Expressed milk refers to breast milk that is stored in bottles. Therefore, the infant should not be fed with expressed milk either. The infant can be given soy-rich formula, because it does not affect metabolism and is not contraindicated in infants with galactosemia. Fruit juice is not given to infants until 6 months of age. Test-Taking Tip: Have confidence in your initial response to an item because it more than likely is the correct answer.
While caring for a postpartum client, the nurse finds that she is unable to feed her newborn as often as she needs to because the baby spends most of the time sleeping. What should the nurse suggest to the client in this situation? 1 "You can wake the baby up by gently massaging his back." 2 "Do not allow the baby to suck his thumb because it promotes sleep." 3 "Avoid swaddling the baby with a blanket because it prevents deep sleep in the baby." 4 "Store the expressed breast milk in a bottle and feed the baby when it wakes up."
1 Feeding the baby as often as the mother needs to is difficult if the baby spends most of the time sleeping. The mother can wake the baby by gently massaging the back. Preventing thumb sucking will not help wake the baby. The baby should be properly covered with a blanket to prevent cold stress. The nurse should encourage the client to feed the baby on time because it helps promote growth and development in the newborn. Therefore, the nurse should not advise the client to give stored milk to the baby. Test-Taking Tip: Do not worry if you select the same numbered answer repeatedly, because there usually is no pattern to the answers.
A patient asks the nurse why there is corn syrup added to infant formulas. What is the nurse's best response? 1 "To provide sufficient carbohydrates to the baby." 2 "To provide sufficient vitamins to the baby." 3 "To provide sufficient proteins to the baby." 4 "To provide sufficient minerals to the baby."
1 Glucose polymers and corn syrup are added to infant formulas to provide sufficient carbohydrates for the infants. Corn syrup is not rich in vitamins, protein, or minerals. Therefore, it does not prevent deficiency of these nutrients in the infant. Moreover, formula provides adequate amounts of vitamins, proteins, and minerals.
How are the oligosaccharides that are present in breast milk beneficial to the breastfed infant? 1 They prevent bacterial growth. 2 They improve blood circulation. 3 They increase calcium absorption. 4 They promote neurologic development.
1 Oligosaccharides promote an acidic environment in the intestines. They prevent the growth of gram-negative and other pathogenic bacteria while increasing the infant's resistance to gastrointestinal (GI) illness. Oligosaccharides do not affect blood circulation. Oligosaccharides do not affect calcium levels, so they do not increase calcium absorption. Fatty acids, rather than oligosaccharides, promote neurologic development.
What does the nurse instruct a postpartum client to do before initiating breastfeeding? 1 "Spread a few drops of milk on the nipple." 2 "Insert only the nipple into the infant's mouth." 3 "First give milk in the feeding bottle to the infant." 4 "Do not give any additional support to your breasts."
1 Spreading a few drops of expressed milk on the nipple facilitates lubrication and enables the baby to open his or her mouth easily. The nurse should instruct the client to insert the nipple and areola of the breast into the baby's mouth. This practice ensures good latching and less pain and discomfort in the mother. The mother need not start giving bottle milk until breastfeeding is established. The breasts should be supported sufficiently to promote effective latching and positioning of the infant. Test-Taking Tip: Avoid selecting answers that state hospital rules or regulations as a reason or rationale for action.
The birth weight of a breastfed newborn was 8 lb, 4 oz. On the third day the newborn's weight was 7 lb, 12 oz. On the basis of this finding, the nurse should do what? 1 Encourage the mother to continue breastfeeding because it is effective in meeting the newborn's nutrient and fluid needs 2 Suggest that the mother switch to bottle feeding because breastfeeding is ineffective in meeting newborn needs for fluid and nutrients 3 Notify the physician because the newborn is being poorly nourished 4 Refer the mother to a lactation consultant to improve her breastfeeding technique
1 Weight loss of 8 oz falls within the 5% to 10% expected weight loss from birth weight during the first few days of life, which for this newborn would be 6.6 to 13.2 oz. Breastfeeding is effective, and bottle feeding does not need to be initiated at this time. The infant is not undernourished, and the physician does not need to be notified. Test-Taking Tip: Practicing a few relaxation techniques may prove helpful on the day of an examination. Relaxation techniques such as deep breathing, imagery, head rolling, shoulder shrugging, rotating and stretching of the neck, leg lifts, and heel lifts with feet flat on the floor can effectively reduce tension while causing little or no distraction to those around you. It is recommended that you practice one or two of these techniques intermittently to avoid becoming tense. The more anxious and tense you become, the longer it will take you to relax.
Which statement is accurate regarding the effect of breastfeeding on the family or society at large? Select all that apply. 1 Breastfeeding requires fewer supplies and less cumbersome equipment 2 Breastfeeding saves families money 3 Breastfeeding costs employers in terms of time lost from work 4 Breastfeeding benefits the environment 5 Breastfeeding is convenient
1,2,4,5 Breastfeeding is convenient because it does not require cleaning or transporting bottles and other equipment. Breastfeeding saves families money because the cost of formula far exceeds the cost of extra food for the lactating mother. Breastfeeding uses a renewable resource; it does not need fossil fuels, advertising, shipping, or disposal. Less time is lost from work by breastfeeding mothers, in part because infants are healthier. Test-Taking Tip: Come to your test prep with a positive attitude about yourself, your nursing knowledge, and your test-taking abilities. A positive attitude is achieved through self-confidence gained by effective study. This means (a) answering questions (assessment), (b) organizing study time (planning), (c) reading and further study (implementation), and (d) answering questions (evaluation).
A postpartum client tells the nurse, "My baby does not pass soft stools every day." Which instruction should the nurse give the client? 1 "Feed the infant formula." 2 "Provide only breast milk for the infant." 3 "Give vitamin B12 supplements to the infant." 4 "Add corn syrup solids to the infant formula."
2 If the infant does not pass soft stool, it implies that the newborn is being fed formula. The whey/casein ratio of formula is less (20:80) than that of human milk (70:30). The high whey/casein ratio in human milk facilitates easy digestion and produces soft stools in breastfed infants. Therefore, the infant should be given only expressed milk to produce soft stools. Formula contains a lower whey/casein ratio that does not facilitate the formation of soft stools. Vitamin B12 supplements are given to infants who develop symptoms of anemia. Corn syrup is added to infant formula to increase carbohydrate levels.
The nurse advises the client to use a hospital-grade electric pump for effective feeding of a preterm infant. What does the nurse tell the client about using this pump? 1 Hospital-grade electric pumps can be used at any time after childbirth. 2 Pumping should be done 8 to 10 times a day to maintain milk supply. 3 Milk obtained by pumping should be microwaved immediately. 4 Honey should be added to the milk obtained by pumping.
2 Pumping by a hospital-grade electric pump is recommended 8 to 10 times a day to maintain milk supply. A lower rate of pumping will not maintain an adequate quantity of breast milk. Hospital-grade electric pumps should be used as soon as the baby is born to obtain the colostrum, which is important for growth. Milk obtained by pumping should be refrigerated immediately. Heating the milk may decrease its nutritional value. Breast milk is the best food for a preterm infant. It contains all necessary nutrients for the infant, so the client should not add anything to the breast milk. Moreover, honey is known to cause botulism in infants and therefore should be avoided.
Following a vaginal delivery, the client tells the nurse that she intends to breastfeed her infant but she is very concerned about returning to her prepregnancy weight. Based on this interaction, how would the nurse advise the client? Select all that apply. 1 She should join Weight Watchers as soon as possible to ensure adequate weight loss. 2 Even though more calories are needed for lactation, typically women who breastfeed lose weight more rapidly than women who bottle feed in the postpartum period. 3 Weight loss diets are not recommended for women who breastfeed. 4 If breastfeeding, she should regulate her fluid consumption in response to her thirst level. 5 If she decreases her calorie intake by 100 to 200 calories a day she will lose weight more quickly.
2,3,4 "Even though more calories are needed for lactation, typically women who breastfeed lose weight more rapidly than women who bottle feed in the postpartum period" is an accurate statement related to lactation and weight loss. "Weight loss diets are not recommended for women who breastfeed" is an accurate statement relative to women who breastfeed so as to provide adequate nutrient stores and milk production. "If breastfeeding, she should regulate her fluid consumption in response to her thirst level" is an accurate statement that will ensure adequate hydration without overhydration. Weight loss diet plans are not recommended for women who are breastfeeding, because they can lead to depletion of reserves and decreased milk production. Breastfeeding mothers need to increase their caloric intake by 400 to 500 calories per day to ensure provide adequate nutritional stores and milk production.
The nurse is caring for a postpartum client who is Muslim. Which cultural practice does the nurse observe in the client? 1 Feeding honey to the infant 2 Feeding clarified butter to the infant 3 Rubbing softened dates on the infant's palate 4 Combining breastfeeding and commercial formula
3 In Muslim culture, before initiating the first feeding, a small piece of softened date is rubbed on the newborn's palate. Cultures in southern Asia, the Pacific Islands, and parts of sub-Saharan African often feed newborns honey or clarified butter before the initiation of breastfeeding. Mexican women feed infants both commercial formula and breast milk in order to provide the infant with the benefits of breastfeeding as well as additional vitamins from formula. Test-Taking Tip: Practicing a few relaxation techniques may prove helpful on the day of an examination. Relaxation techniques such as deep breathing, imagery, head rolling, shoulder shrugging, rotating and stretching of the neck, leg lifts, and heel lifts with feet flat on the floor can effectively reduce tension while causing little or no distraction to those around you. It is recommended that you practice one or two of these techniques intermittently to avoid becoming tense. The more anxious and tense you become, the longer it will take you to relax.
The nurse assesses a Mexican client who gave birth to an infant. What might the nurse expect the client to do before feeding the infant for the first time? 1 Eat seaweed soup and rice. 2 Restrict breastfeeding for some time after birth. 3 Give both expressed milk and infant formula. 4 Rub a piece of soft date on the newborn's palate.
3 Mexican mothers believe that infants will receive benefits of breastfeeding and vitamins from infant formula. Therefore, the nurse expects the client to give both expressed milk and infant formula, regardless of client teaching about problems with milk supply, latch and early termination. Eating seaweed soup and rice to improve milk production is practiced by Korean mothers. Restricting breastfeeding for some time after birth is practiced by Southern Asian mothers because of beliefs about the harmful nature or inadequacy of colostrum. Muslim women would rub a small piece of soft date on the newborn's palate as a ritual.
The concept of tandem feeding is defined as what? 1 Adequate nutritional stores for the mother and infant 2 Using both breasts to nurse the baby 3 Breastfeeding an infant and an older sibling during the same period of time. 4 Supplementing breast feeding with bottle feeding to maintain adequate weight gain.
3 Tandem feeding involves a mother who nurses both an infant and an older child. Nutritional stores, using both breasts to nurse the baby, and supplementation are not concepts of tandem feeding. Test-Taking Tip: Being prepared reduces your stress or tension level and helps you maintain a positive attitude.
In helping the breastfeeding mother position the baby, nurses should keep in mind what important information? 1 The cradle position is usually preferred by mothers who had a cesarean birth 2 Women with perineal pain and swelling prefer the modified cradle position 3 Whatever the position used, the infant is "belly to belly" with the mother 4 While supporting the head, the mother should push gently on the occiput
3 The infant inevitably faces the mother, belly to belly. The football position usually is preferred after cesarean birth. Women with perineal pain and swelling prefer the side-lying position because they can rest while breastfeeding. The mother should never push on the back of the head. It may cause the baby to bite, hyperextend the neck, or develop an aversion to being brought near the breast. Test-Taking Tip: Being emotionally prepared for an examination is key to your success. Proper use of resources over an extended period of time ensures your understanding and increases your confidence about your nursing knowledge. Your lifelong dream of becoming a nurse is now within your reach! You are excited, yet anxious. This feeling is normal. A little anxiety can be good because it increases awareness of reality; but excessive anxiety has the opposite effect, acting as a barrier and keeping you from reaching your goal. Your attitude about yourself and your goals will help keep you focused, adding to your strength and inner conviction to achieve success.
In helping the breastfeeding mother position the baby, nurses should keep what in mind? 1 The cradle position is usually preferred by mothers who had a cesarean birth. 2 Women with perineal pain and swelling prefer the modified cradle position. 3 Whatever the position used, the infant is "skin to skin" with the mother. 4 While supporting the head, the mother should push gently on the occiput.
3 Whichever position is used, the infant is skin to skin. The football position usually is preferred after cesarean birth. Women with perineal pain and swelling prefer the side-lying position because they can rest while breastfeeding. The infant inevitably faces the mother, belly to belly. The mother should never push on the back of the head. It may cause the baby to bite, hyperextend the neck, or develop an aversion to being brought near the breast. Test-Taking Tip: If the question asks for an immediate action or response, all of the answers may be correct, so base your selection on identified priorities for action.
After assessing the stools of a newborn, the nurse plans to evaluate the infant's breastfeeding effectiveness. Which possible finding in the stools prompted such an evaluation? 1 Greenish yellow, loose stools on third day. 2 Yellow, soft, and seedy stools on seventh day. 3 Greener, thinner, and less sticky stools on second day. 4 Greenish black, thick, and sticky meconium stools on third day.
4 Breastfeeding effectiveness and milk transfer should be assessed if the infant passes greenish black, thick, and sticky meconium stools on third or fourth day. Greenish yellow, loose stools are usually observed in a 3-day-old newborn. Yellow, soft, and seedy stools are usually observed in a week-old newborn. Green, thin, and less sticky stools are the usual stool patterns of 2-day-old infant.
The parents of an infant are feeding their child formula milk that is too concentrated. The nurse instructs the parents to mix only one scoop of powdered formula in 60 ml of water. What is the rationale behind this? 1 The infant has hypoglycemia. 2 The infant has galactosemia. 3 The infant has difficulty swallowing. 4 The infant has immature kidneys.
4 One scoop of powdered formula in 60 ml of water is the proper concentration to feed an infant. Overly concentrated powdered formula will provide excess amounts of protein and minerals. Because infants have immature kidneys, overly concentrated powdered formula would impede the infant's filtration ability. Therefore, the nurse instructs the infant's mother to prepare the proper concentration. Overly concentrated powdered formula would not result in hypoglycemia in the infant. Infants with galactosemia should not be fed milk, and should be administered protein supplements. Overly concentrated powdered formula would not cause difficulty swallowing, but would increase the amount of nutrients supplied to the infant.
The nurse is preparing a diet plan for a Korean postpartum patient. What food should the nurse include in the client's diet plan to possibly increase the production of breast milk? 1 Clarified butter 2 Corn syrup 3 Boiled chicken 4 Seaweed soup
4 Seaweed soup is preferred by Korean clients after delivery to increase milk production. Some cultures believe that clarified butter will clear out meconium. Corn syrup solids are added to infant formula to increase carbohydrate levels. Hmong patients prefer boiled chicken as part of their diet in the first month after birth. Test-Taking Tip: Watch for grammatical inconsistencies. If one or more of the options is not grammatically consistent with the stem, the alert test taker can identify it as a probable incorrect option. When the stem is in the form of an incomplete sentence, each option should complete the sentence in a grammatically correct way.
The nurse advises a postpartum client to feed her newborn with expressed milk. While teaching about breast milk storage, which instruction should the nurse include? 1 The milk can be stored in the refrigerator in plastic bags for 4 days. 2 Always fill the container to the brim before placing it in the freezer. 3 Avoid placing the milk container in the middle rack of the refrigerator. 4 Milk can be stored along with other food in the refrigerator.
4 The breast milk container can be stored along with other food items in the refrigerator without contamination. Breast milk can be stored in plastic bags for up to 3 days; after 3 days it begins to deteriorate. When milk is to be frozen, the container should be only three quarters full to allow space for expansion. If the container is filled to the brim, the milk will expand and break the container. The milk container should be stored in the middle of the refrigerator rather than in the door. This keeps the milk colder and helps prevent accidental spillage and breakage of the container. Test-Taking Tip: Do not select answers that contain exceptions to the general rule, controversial material, or degrading responses.
The nurse finds that an infant has tremors and decreased serum calcium levels. Which finding from the child's medical history may be responsible for these symptoms? 1 The infant's mother gives fluoride supplements to the infant. 2 The infant's mother feeds unmodified cow's milk to the infant. 3 The infant's mother underwent bariatric surgery before the infant was 1 year old. 4 The infant's mother fed the infant concentrated formula before the infant was 15 days old.
2 Cow's milk is rich in calcium. However, unmodified cow's milk has a low calcium to phosphorus ratio and results in decreased calcium absorption. It causes hypocalcemia and tremors in the infant. Therefore, the nurse should check whether the infant's mother is feeding the infant unmodified cow's milk. Fluoride supplements cause spotting of the permanent teeth (fluorosis). If the infant's mother underwent bariatric surgery, then the risk of vitamin B12 deficiency is increased in the infant. Because infants have immature kidneys, concentrated formula may impede the filtration ability of the infant's kidneys.
The nurse tells a postpartum client to gently massage her breasts before performing hand expression. Why the nurse did give such an instruction? 1 Prevent nipple trauma 2 Reduce body temperature 3 Stimulate the let-down reflex 4 Reduce pain during expression
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While teaching breastfeeding techniques to a postpartum patient, the nurse advises the patient to check whether the infant's cheeks are rounded or dimpled during feeding. What is the reason for giving such advice to the patient? 1 It prevents nipple trauma. 2 Possible prevention of trauma to the infant's jaws. 3 To indicate the effectiveness of breastfeeding. 4 It helps the infant latch onto the nipples.
3 Usually during sucking, the infant's cheeks become rounded and are not dimpled, so the shape of the baby's cheeks indicates the effectiveness of feeding. Nipple trauma can be prevented by inserting a finger in the side of baby's mouth to break the suction. Trauma to the infant's jaw is not associated with rounded cheeks. Placing the nipple on the infant's lips helps the infant latch.
A lactating client with tuberculosis (TB) has completely recovered from the infection and has stopped taking TB medication for 2 weeks. Which advice given by the nurse would be beneficial for the client's 4-month-old baby? 1 "Breastfeed your baby." 2 "Give your baby expressed milk." 3 "Give your baby concentrated formula." 4 "Give your baby fluoride supplements."
1 The client is completely cured and has stopped taking antitubercular medications. Because the client has recovered, breastfeeding would not cause infection in the fetus; therefore, the nurse should advise the client to start breastfeeding the infant to help in growth and development. Because breastfeeding is safe if the client is noninfectious, the nurse should not advise the client to feed the infant with expressed milk. The nurse should instruct the client to avoid giving the infant concentrated formula because the infant's kidneys are immature. Giving the infant concentrated formula may impair the excretory ability of the kidneys. Fluoride supplements should not be given to infants younger than 6 months.
A postpartum client has been advised to give formula to the infant. The client reports that her breasts are firm, hot, and shiny. What treatment does the nurse recommend to reduce the milk supply? 1 Cold compression 2 Breast massage 3 Placing cabbage leaves over the breast 4 Antiinflammatory drugs
3 When the client does not breastfeed, milk accumulates and causes breast engorgement, which is characterized by firm, hot, and shiny breasts. The phytoconstituents present in cabbage leaves help dry up the milk supply in the client who cannot breastfeed. Therefore, the nurse should place the crushed cabbage leaves over the client's breasts. Accumulation of milk in the breasts causes pain and inflammation. Cold compressors are used to treat engorgement. Breast massage will increase milk flow. Antiinflammatory drugs are prescribed to relieve pain and inflammation in the breasts; they do not decrease the milk supply. Test-Taking Tip: Reread the question if the answers do not seem to make sense, because you may have missed words such as not or except in the statement.
The nurse is caring for a lactating client. On reviewing the client's medical history, the nurse finds that the client has undergone bariatric surgery. Which nutritional supplement would be beneficial to prevent a deficiency state in the mother and the infant? 1 Folic acid supplement 2 Fluoride supplement 3 Vitamin C supplement 4 Vitamin B12 supplement
4 Bariatric surgery refers to weight loss surgery, which includes various procedures performed on obese clients . A client who has undergone bariatric surgery is at increased risk of a vitamin B12 deficiency because of lower food intake, and because the client is lactating, the breastfeeding infant is also at increased risk of a vitamin B12 deficiency. Therefore, the primary health care provider would prescribe vitamin B12 supplements for the newborn. Folic acid supplements are usually required during the perinatal period to prevent neural tube defect in the baby. Folic acids supplements would not be required for the client. Fluoride supplements are given to prevent dental caries, but a client with a history of bariatric surgery would not require additional fluoride supplements. Breast milk contains high levels of vitamin C. Vitamin C levels are not altered due to bariatric surgery. Therefore, vitamin C supplements would not be required.
On interacting with a lactating client, the nurse finds that the patient consumes alcohol. Which advice should the nurse give in order to prevent potential risks to the infant? 1 "Avoid consuming grape juice while breastfeeding." 2 "Pump and discard the first 10 drops of breast milk." 3 "Avoid breastfeeding for 2 hours after consuming alcohol." 4 "Feed the infant cow's milk rather than breast milk."
6 If a breastfeeding mother consumes alcohol, she is advised to avoid breastfeeding for at least 2 hours after consuming alcohol. This will avoid potential risks to the infant. Consuming grape juice is beneficial during breastfeeding, but it does not reduce risks in the infant. Pumping and discarding the first 10 drops of milk is not sufficient to remove alcohol. Breast milk is nutritionally superior to cow's milk. Therefore, the nurse should advise the patient to feed the infant breast milk rather than cow's milk.
With regard to the long-term consequences of infant feeding practices, the nurse should instruct the obese client that the best strategy to decrease the risk for childhood obesity for her infant is what? 1 An on-demand feeding schedule 2 Breastfeeding 3 Lower-calorie infant formula 4 Smaller, more frequent feedings
Breastfeeding is the best prevention strategy for decreasing childhood and adolescent obesity. Breastfeeding also assists the woman to return to her prepregnant weight sooner. All breastfed infants should be fed on demand. Lower-calorie formula is an inappropriate strategy that does not meet the infant's nutritional needs. Breastfeeding is the most appropriate choice for infant feeding. Smaller feedings are not necessary. Infants should continue to be fed every 2 to 3 hours in the newborn period. Test-Taking Tip: The night before the examination you may wish to review some key concepts that you believe need additional time, but then relax and get a good night's sleep. Remember to set your alarm, allowing yourself plenty of time to dress comfortably (preferably in layers, depending on the weather), have a good breakfast, and arrive at the testing site at least 15 to 30 minutes early.2
The nurse taught new parents the guidelines to follow regarding the bottle-feeding of their newborn. They will be using formula from a can of concentrate. The parents would demonstrate an understanding of the nurse's instructions if they did what? 1 Wash the top of the can and can opener with soap and water before opening the can. 2 Adjust the amount of water added according to the weight gain pattern of the newborn. 3 Add some honey to sweeten the formula and make it more appealing to a fussy newborn. 4 Warm formula in a microwave oven for a couple of minutes before feeding.
1 Washing the top of the can and can opener with soap and water before opening the can of formula is a good habit for a parent to get into to prevent contamination. Directions on the can for dilution should be followed exactly and not adjusted according to weight gain to prevent nutritional and fluid imbalances. Honey is not necessary and could contain botulism spores. The formula should be warmed in a container of hot water because a microwave can easily overheat it.
The nurse assesses a postpartum client who is breastfeeding her infant. The client states that she does not consume eggs or meat. The nurse is aware that the infant may have which deficiency? 1 Vitamin D deficiency 2 Vitamin E deficiency 3 Vitamin K deficiency 4 Vitamin B12 deficiency
4 The client does not consume eggs and meat, which are rich sources of vitamin B12. Therefore, the infant should receive supplemental vitamin B12 from birth to decrease the risk associated with vitamin B12 deficiency. Vitamin D is absent in human milk. It is produced in the infants when they are exposed to sunlight. Vitamin E deficiency is not observed in clients who do not consume eggs and meat. Deficiency of vitamin K may occur in the infant if the client does not consume green leafy vegetables. Test-Taking Tip: Attempt to select the answer that is most complete and includes the other answers within it. For example, a stem might read, "A child's intelligence is influenced by:" and three options might be genetic inheritance, environmental factors, and past experiences. The fourth option might be multiple factors, which is a more inclusive choice and therefore the correct answer.
Which statement regarding infant weaning is correct? 1 Weaning should proceed from breast to bottle to cup. 2 The feeding of most interest should be eliminated first. 3 Abrupt weaning is easier than gradual weaning. 4 Weaning can be mother or infant initiated.
4 Weaning is initiated by the mother or the infant. With infant-led weaning the infant moves at his or her own pace in omitting feedings, which leads to a gradual decrease in the mother's milk supply. Mother-led weaning means that the mother decides which feedings to drop. Infants can be weaned directly from the breast to a cup. Bottles are usually offered to infants less than 6 months old. If the infant is weaned prior to 1 year of age, iron-fortified formula rather than cow's milk should be offered. The feeding of least interest to the baby or the one through which the infant is likely to sleep should be eliminated first. Every few days thereafter the mother drops another feeding. Gradual weaning over a period of weeks or months is easier for both the mother and the infant than an abrupt weaning. Test-Taking Tip: Do not panic while taking an exam! Panic will only increase your anxiety. Stop for a moment, close your eyes, take a few deep breaths, and resume review of the question.
The nurse is assessing a postpartum client who is breastfeeding her infant. Which sign indicates that the infant is latched on to the mother's breast and is receiving the mother's milk? 1 The infant's cheeks are dimpled during sucking. 2 The infant's sucking is not audible. 3 The client feels strong tugging on the nipple. 4 The client feels pinching and pain in the nipple.
3 A strong tugging sensation on the nipple is a sign that the infant is latching and feeding well. During sucking, the infant's cheeks should be rounded. Dimpled cheeks indicate improper latching. Audible sucking indicates that the infant is swallowing milk properly. If the infant has latched well, the client should not feel pain or pinching in nipple during breastfeeding.
Which assessment by the nurse indicates problems with latch? 1 The infant's cheeks are rounded while sucking 2 The infant's jaw glides smoothly while sucking 3 The mother reports pain in her nipples while breastfeeding 4 The mother reports that the infant swallows audibly
3 If the mother feels severe pain in her nipple, it indicates the infant is unable to properly suck the milk and the infant would have difficulty feeding. If the infant's cheeks are rounded but not dimpled while feeding, then it indicates effective latching. If the infant's jaw glides smoothly while sucking, it indicates that the infant is able to properly latch on to the nipples. It is usually audible when a breastfeeding infant swallows, because sucking creates a vacuum in the intraoral cavity as the breast is compressed. Audible swallowing indicates effective feeding.
During the assessment of a postpartum client, the nurse finds that the client has a low-grade fever, sore throat, and skin rashes. On reviewing the laboratory report, the nurse finds that the client has varicella infection. What is the best nursing intervention in this situation? 1 Asking the mother to provide kangaroo care to the infant 2 Advising the client to avoid protein-rich foods 3 Advising the client not to feed the infant with expressed milk 4 Temporary isolation of the infant and the client
4 Because the client has varicella infection, the mother and the infant should be temporarily isolated to prevent the spread of infection. Kangaroo care should be avoided to prevent the spread of the infection. The client can consume protein-rich food, because it does not cause any complication during varicella infection. When the client is infected with varicella, it is safe to feed the infant expressed milk, because the virus does not infect the breast milk. Breastfeeding should be avoided, because the infection may spread through skin-to-skin contact. Test-Taking Tip: What happens if you find yourself in a slump over the examination? Take a time-out to refocus and reenergize! Talk to friends and family who support your efforts in achieving one of your major accomplishments in life. This effort will help you regain confidence in yourself and get you back on track toward the realization of your long-anticipated goal.
