Deck 29: Newborn Nutrition

Question 1

Which of the following functions primarily to provide low-income women and children who are at risk for medical or nutritional problems with nutritious foods to supplement their diets, nutrition education and counseling, and screening and referrals to other health, welfare, and social programs?

A) A B M
B) W I C
C) I L C A
D) L L L I

Answer 1

B

Question 2

The community nurse is working with poor women who are formula-feeding their infants. Which statement indicates that the nurse's education session was effective?

A) "I should use only soy-based formula for the first year."
B) "I should follow the instructions for mixing the powdered formula exactly."
C) "It is okay to add more water to the formula to make it last longer."
D) "The mixed formula can be left on the counter for a day."

Answer 2

B

Question 3

What should the healthcare provider consider when prescribing a medication to a woman who is breastfeeding?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.

A) Drug's potential effect on hormone production
B) Amount of drug excreted into the mother's blood
C) Drug's potential adverse effects to the infant
D) Infant's age and health
E) Mother's need for the medication

Answer 3

C, D, E

Question 4

The nurse is working with a new mother who delivered yesterday. The mother has chosen to breastfeed her infant. Which demonstration of skill is the best indicator that the client understands breastfeeding?

A) She puts the infant to breast when he is asleep to help wake him up.
B) She takes off her gown to achieve skin-to-skin contact.
C) She leans toward the infant so that he turns his head to access the nipple.
D) The infant is crying when he is brought to the breast.

Question 5

Which of the following is a sign of dehydration in the newborn?

A) Slow, weak pulse
B) Soft, loose stools
C) Light colored, concentrated urine
D) Depressed fontanelles

Question 6

Which statements by a breastfeeding class participant indicate that teaching by the nurse was effective?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.

A) "Breastfed infants get more skin-to-skin contact and sleep better."
B) "Breastfeeding raises the level of a hormone that makes me feel good."
C) "Breastfeeding is complex and difficult, and I probably won't succeed."
D) "Breastfeeding is worthwhile, even if it costs more overall."
E) "Breastfed infants have fewer digestive and respiratory illnesses."

Question 7

The nurse is teaching a new mother how to encourage a sleepy baby to breastfeed. Which of the following instructions would not be included in that teaching?

A) Providing skin-to-skin contact
B) Swaddling the newborn in a blanket
C) Unwrapping the newborn
D) Allowing the newborn to feel and smell the mother's breast

Question 8

The nurse is assisting a mother to bottle-feed her newborn, who has been crying. The nurse suggests that prior to feeding, the mother should do which of the following?

A) Offer a pacifier
B) Burp the newborn
C) Unwrap the newborn
D) Stroke the newborn's spine and feet

Question 9

The nurse is performing an assessment on an infant whose mother states that she feeds the infant in a supine position by propping the bottle. Based on this information, what would the nurse include in the assessment?

A) Otoscopic exam of the eardrum
B) Bowel sounds
C) Vital signs
D) Skin assessment

Question 10

When is breastfeeding contraindicated?

A) Infant has hypertension
B) Mother has a history of treated tuberculosis
C) Mother is H I V positive or has A I D S
D) Mother has a history of treated herpes

Question 11

A mother states that her breasts leak between feedings. Which of the following can contribute to the letdown reflex in breastfeeding mothers?

A) Pain with breastfeeding
B) Number of hours passed since last feeding
C) The newborn's cry
D) Maternal fluid intake

Question 12

Which of the following are potential disadvantages to breastfeeding?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.

A) Pain with breastfeeding
B) Leaking milk
C) Equal feeding responsibilities with fathers
D) Vaginal wetness
E) Embarrassment

Question 13

What is the primary carbohydrate in mammalian milk that plays a crucial role in the nourishment of the newborn?

A) Colostrum
B) Lactose
C) Lactoferrin
D) Secretory I g A

Question 14

The nurse knows that in some cases, breastfeeding is not advisable. Which mother should be counseled against breastfeeding?

A) A mother with a poorly balanced diet
B) A mother who is overweight
C) A mother who is H I V positive
D) A mother who has twins

Question 15

A client at 20 weeks' gestation has not decided on a feeding method for her infant. She asks the nurse for advice. The nurse presents information about the advantages and disadvantages of formula-feeding and breastfeeding. Which statements by the client indicate that the teaching was successful?

A) "Formula-feeding gives the baby protection from infections."
B) "Breast milk cannot be stored; it has to be thrown away after pumping."
C) "Breastfeeding is more expensive than formula-feeding."
D) "My baby will have a lower risk of food allergies if I breastfeed."

Question 16

When a breastfeeding mother complains that her breasts are leaking milk, the nurse can offer which effective intervention?

A) Decrease the number of minutes the newborn is at the breast per feeding.
B) Decrease the mother's fluid intake.
C) Place absorbent pads in the bra.
D) Administer oxytocin.

Question 17

A nurse is evaluating the diet plan of a breastfeeding mother. Which beverage is most likely to cause intolerance in the infant?

A) Orange juice
B) Milk
C) Decaffeinated tea
D) Water

Question 18

A new mother who is breastfeeding tells the nurse that her infant is spitting up frequently, has very loose stools and copious gas, and feeds for only short periods of time. The nurse suspects a feeding intolerance and, after questioning the mother about her diet, suggests that she do which of the following?

A) Stop breastfeeding and switch to formula.
B) Eliminate dairy products from her diet.
C) Supplement breastfeeding with a soy-based formula.
D) Offer the baby water between feedings.

Question 19

The nurse is caring for a premature infant in the N I C U, and is going to attempt a bottle feeding with thawed breast milk. How long can thawed breast milk be stored in the refrigerator before the nurse must discard it?

A) 4 hours
B) 8 hours
C) 12 hours
D) 24 hours

Question 20

The nurse is teaching a prenatal class about feeding methods. A father-to-be asks the nurse which method, breast or formula, leads to the fastest infant growth and weight gain. Which response by the nurse is best?

A) "In the first 3 to 4 months breastfed babies tend to gain weight faster."
B) "In the first 3 to 4 months there is no difference in weight gain."
C) "In the first 3 to 4 months bottle-fed babies grow faster."
D) "In the first 3 to 4 months growth isn't as important as your comfort with the method."

Question 21

The nurse encourages a new mother to feed the newborn as soon as the newborn shows interest. The nurse bases this recommendation on which benefits of early feedings?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.

A) Early feedings stimulate peristalsis.
B) Colostrum is thinner than mature milk.
C) Early feedings enhance maternal-infant bonding.
D) Early feedings promote the passage of meconium.
E) Colostrum contains a high number of calories.

Question 22

The nurse is caring for a new breastfeeding mother who is from Pakistan. The nurse plans her care so that the newborn is offered the breast on which of the following?

A) Day of birth
B) First day after birth
C) Second day after birth
D) Third to fourth day after birth

Question 23

The nurse is reviewing the process of pumping the breasts with a new mother. In which order should the nurse provide this information?
1. Fill glass or bottles 3/4 full
2. Massage the breasts and relax
3. Sit up straight or lean forward
4. Wash hands with soap and water
5. Pump each breast for 10 to 20 minutes

Question 24

The nurse is reviewing the contents of breastmilk with a new mother. What amount of water should the nurse explain is in 8 ounces of breastmilk? Record your answer rounding to the nearest whole number.

Question 25

The nurse is preparing a class on breastfeeding for pregnant women in their first trimester. The women are from a variety of cultural backgrounds, and all speak English well. Which statement should the nurse include in this presentation?

A) "Although some cultures believe colostrum is not good for the baby, it provides protection from infections and helps the digestive system to function."
B) "Some women are uncomfortable with exposing their breasts to nurse their infant, but it really isn't a big deal. You will get used to it."
C) "No religion prescribes a feeding method, so you all can choose whatever method makes the most sense to you."
D) "In most cultures, it is culturally acceptable to speak about intimate matters in front of their families."

Question 26

A newborn weighs 7 l b s. 10 ounces at birth. What is the maximum number of calories that the nurse should instruct the mother that the baby needs to consume each day? (Calculate to the nearest whole number.)

Question 27

The nurse is instructing a new mother on the type of stool to expect a breast-fed newborn to produce. In which order should the nurse explain the stool changes?
1.

2.

3.

4.

5.

Question 28

A client from Mexico has just delivered a son, and the nurse offers to assist in putting the baby to breast. Although the client indicated before the birth that she wanted to breastfeed, she is very hesitant, and says she would like to bottle-feed for the first few days. After talking to her, the nurse understands that her primary reason for wanting to delay breastfeeding is based on what cultural belief?

A) Breast milk causes skin rashes.
B) It is harmful to breastfeed immediately.
C) Colostrum is bad for the baby.
D) Thin milk causes diarrhea.

Question 29

A nurse is evaluating the diet plan of a breastfeeding mother, and determines that her intake of fruits and vegetables is inadequate. The nurse explains that the nutritional composition of the mother's breast milk can be adversely affected by this nutritional inadequacy. Which strategy should the nurse recommend to the mother?

A) Stop breastfeeding
B) Provide newborn supplements to the newborn
C) Offer whole milk
D) Supplement with skim milk

Question 30

During an educational session the nurse learns that legislation was written to support breastfeeding mothers. In which order did the titles of this legislation occur?
1. Establish standards for safe and effective breast pumps
2. Include breastfeeding equipment as medical care for taxes
3. Require businesses with 50 or more employees to give lactating women breaks
4. Give tax incentives to businesses that establish a private place for breastfeeding
5. Protect lactating women from being fired or discriminated against in the workplace

Question 31

The nurse is completing the discharge teaching of a young first-time mother. Which statement by the mother requires immediate intervention?

A) "I will put my baby to bed with his bottle so he doesn't get hungry during the night."
B) "My baby will probably have a bowel movement each breastfeeding, and will wet often."
C) "Nursing every 2 to 3 hours is normal, for a total of 8 to 12 feedings every day."
D) "I will drink fenugreek tea from my grandmother to prevent my milk from coming in."

Question 32

The nurse is explaining the nutritional differences between breast milk and formula to an expectant couple. The mother-to-be asks whether breast milk is nutritionally superior to formula. What should the nurse reply?

A) The vitamins and minerals in formula are more bioavailable to the infant.
B) There is no cholesterol in breast milk.
C) The only carbohydrate in breast milk is lactose.
D) The ratio of whey to casein proteins in breast milk changes to meet the nutritional needs of the growing infant.

Question 33

A premature newborn is unable to suck at the breast. The nurse plans care for the mother, who is going to hand-express milk. Arrange the steps for milk expression in the correct order.
1. Roll the thumb and fingers simultaneously forward.
2. Position the thumb at 12:00 and the forefinger and middle finger at 6:00 around the areola.
3. Repeat the sequence multiple times to completely drain the breasts.
4. Stretch the areola back toward the chest wall without lifting the fingers off the breast.

Question 34

The nurse is working with a client from Southeast Asia. The client tells the nurse that she should not put the baby to breast until her milk comes in and her breasts are warm, because "cold milk" (colostrum) is bad for the baby. After the nurse explains the benefits of colostrum, the client still insists that "cold milk" is bad. Which response by the nurse is best?

A) "What kind of formula would you like to use?"
B) "That idea is folklore. Colostrum is good for the baby."
C) "Now that you are here, you need to feed your baby the right way."
D) "Let's give the baby formula after you breastfeed."

Question 35

A new mother asks the nurse about the football hold to use when breastfeeding. Which picture should the nurse use to explain this position to the new mother?

A)

B)

C)

D)

Question 36

The nurse is demonstrating to a patient the proper steps for breastfeeding a newborn. Put these steps in the logical order that would assist the patient in placing the newborn to her breast.
1. Tickle the newborn's lips with the nipple.
2. Allow the newborn to latch on to the nipple.
3. The newborn opens her mouth wide.
4. Have the newborn face the mother tummy to tummy.
5. Position the newborn so the nose is at the level of the nipple.

Question 37

The nurse has completed a community education session on growth patterns of infants. Which statement by a participant indicates that additional teaching is needed?

A) "Newborns should regain their birth weight by 1 week of age."
B) "Breastfed and formula-fed babies have different growth rates."
C) "Formula-fed infants regain their birth weight earlier than breastfed infants."
D) "Healthcare providers consider breastfeeding to be the 'gold standard' for neonatal nutrition."