Question 1

During an assessment of a 4&#173;week&#173;old infant, the primary care pediatric nurse&#10;practitioner learns that a breastfed infant nurses every 2 hours during the day but is able to sleep for a 4&#173;hour period during the night. The infant has gained 20 grams per day in the interval since last seen in the clinic. What will the nurse practitioner recommend?&#10;A. Continuing to nurse the infant using the current pattern&#10;B. Nursing the infant for longer periods every 4 hours&#10;C. Supplementing with formula at the last nighttime feeding&#10;D. Waking the infant every 2 hours to nurse during the night

Accepted Answer

The infant is gaining weight appropriately and is sleeping for a 4-hour period, indicating that the current feeding pattern is providing adequate nutrition. Additionally, waking the infant every 2 hours during the night may disrupt the baby's sleep and feeding schedule. Therefore, the nurse practitioner should recommend continuing to nurse the infant using the current pattern. Supplementing with formula is not necessary as the infant is gaining weight appropriately. Nursing for longer periods every 4 hours may lead to engorgement or oversupply for the mother and may not necessarily improve weight gain for the infant.

Question 2

The primary care pediatric nurse practitioner is performing a well baby
examination on a 2monthold infant who has gained 25 grams per day in the last interval. The mother is nursing and tells the nurse practitioner that her infant seems fussy and wants to nurse more often. What will the nurse practitioner tell her?
A. She may not be making as much breastmilk as before.
B. She should keep a log of the frequency and duration of each feeding.
C. The infant may be going through an expected growth spurt.
D. The infant should stay on the previously established nursing schedule.

The infant may be going through an expected growth spurt.

Accepted Answer

The infant's increased fussiness and desire for more nursing may be indicative of an expected growth spurt. The infant's weight gain of 25 grams per day is within the expected range for this age, and therefore, the nurse practitioner should reassure the mother that breastfeeding more frequently is likely to support the infant's growth during this time.

Question 3

The parent of a 5&#173;month&#173;old is worried because the infant becomes fussy but&#10;doesn't always seem interested in nursing. What will the nurse practitioner tell this parent?&#10;A. The infant may be expressing a desire to play or to rest.&#10;B. The parent should give ibuprofen for teething pain before nursing.&#10;C. This is an indication that the infant is ready for solid foods.&#10;D. This may indicate gastrointestinal discomfort such as constipation.

Accepted Answer

Fussiness in infants can be caused by a variety of factors, including tiredness or a desire to play. It does not necessarily indicate a problem with feeding or a need for solid foods or pain relief medication. The nurse practitioner should reassure the parent that this behavior is normal and offer tips for soothing or engaging the infant during these periods of fussiness.

Question 4

The primary care pediatric nurse practitioner is examining a 12monthold infant
who was 6 weeks premature and observes that the infant uses a raking motion to pick up small objects. The PEDS questionnaire completed by the parent did not show significant developmental delays. What will the nurse practitioner do first?
A. Perform an indepth developmental assessment.
B. Reassure the parent that this is normal for a premature infant.
C. Refer the infant to a developmental specialist.
D. Suggest activities to improve fine motor skills.

Accepted Answer

The infant has lost weight since birth and discharge, which is normal. However, the weight gain at this visit is not adequate, and there may be concerns regarding the infant's feeding. Therefore, scheduling a weight check in 1 week is the appropriate action to ensure that the infant's weight gain is on track. Supplementing with formula may not be necessary, and referral to a lactation consultant can be considered, but a weight check in 1 week should be done first to assess the need for further intervention. Follow up at the 2-month checkup may be too late to address any potential feeding issues.

Question 5

The primary care pediatric nurse practitioner is performing a well baby
examination on a 2monthold infant who has gained 25 grams per day in the last interval. The mother is nursing and tells the nurse practitioner that her infant seems fussy and wants to nurse more often. What will the nurse practitioner tell her?
A. She may not be making as much breastmilk as before.
B. She should keep a log of the frequency and duration of each feeding.
C. The infant may be going through an expected growth spurt.
D. The infant should stay on the previously established nursing schedule.

Accepted Answer

Reading simple board books to the infant at bedtime is the best option for improving speech and language skills in the infant. Reading to a child helps to develop language skills, enhance listening and memory skills, and encourage a love of reading. Educational videos may not be as effective, as they do not allow for interaction between the parent and infant. Singing and playing lullabies can also be beneficial, but reading provides more specific opportunities for vocabulary building and language development. Turning on the television is not recommended for infants, as it can be overstimulating and may hinder language development.

Question 6

The mother of a 6&#173;week&#173;old breastfeeding infant tells the primary care pediatric&#10;nurse practitioner that her baby, who previously had bowel movements with each feeding, now has a bowel movement once every third day. What will the nurse practitioner tell her?&#10;A. Her baby is probably constipated.&#10;B. It may be related to her dietary intake.&#10;C. She should consume more water.&#10;D. This may be normal for breastfed babies.

Accepted Answer

Breastfed babies can have varying bowel movements, ranging from multiple per day to once every few days. As long as the infant’s poop is soft and easy to pass, and the baby does not seem to be in discomfort or distress, having fewer bowel movements is not necessarily a cause for concern. This is a normal variation in breastfeeding infants.

Question 7

The primary care pediatric nurse practitioner is performing a well baby
examination on a 2monthold infant who has gained 25 grams per day in the last interval. The mother is nursing and tells the nurse practitioner that her infant seems fussy and wants to nurse more often. What will the nurse practitioner tell her?
A. She may not be making as much breastmilk as before.
B. She should keep a log of the frequency and duration of each feeding.
C. The infant may be going through an expected growth spurt.
D. The infant should stay on the previously established nursing schedule.

Accepted Answer

The nurse practitioner should perform an in-depth developmental assessment to determine if the infant has any other developmental delays.

Question 8

The parent of a newborn infant asks the primary care pediatric nurse practitioner
when to intervene to help the infant's future intellectual growth. What will the nurse practitioner tell the parent?
A. Cognitive learning begins during the toddler years.
B. Intellectual growth begin when speech develops.
C. Language and literacy skills begin at birth.
D. Preschool is an optimal time to begin general learning.

Accepted Answer

Language and literacy skills begin at birth. Research has shown that language acquisition starts at birth and that early exposure to language and literacy skills is critical for intellectual growth. Therefore, it is important for parents to engage in activities such as talking, reading, and singing to their infants from the very beginning.

Question 9

The mother of a 3&#173;month&#173;old child tells the primary care pediatric nurse&#10;practitioner that it is &#34;so much fun&#34; now that her infant coos and smiles and wants to play. What is important for the nurse practitioner to teach this mother?&#10;A. Appropriate ways to stimulate and entertain the infant&#10;B. How to read the infant's cues for overstimulation&#10;C. The importance of scheduling &#34;play dates&#34; with other infants&#10;D. To provide musical toys to engage the infant

Accepted Answer

It is important for the nurse practitioner to teach the mother how to read the infant's cues for overstimulation to ensure the child's comfort and well-being.

Question 10

The mother of a 6&#173;month&#173;old infant is distressed because the infant can say&#10;&#34;dada&#34; but not &#34;mama&#34; and asks the primary care pediatric nurse practitioner why this is when she is the one who spends more time with the infant. How will the nurse practitioner respond?&#10;A. &#34;At this age, your baby does not understand the meaning of sounds.&#34;&#10;B. &#34;Babies at this age cannot make the 'ma' sound.&#34;&#10;C. &#34;Most sounds made by babies at this age are accidental.&#34;&#10;D. &#34;This may mean that your baby doesn't hear well.&#34;

Accepted Answer

The answer of The mother of a 6&#173;month&#173;old infant is...

Deck 5: Developmental Management of Infants