Question 1

A new mother wants to be sure that she is meeting her daughter's needs while feeding the baby commercially prepared infant formula.The nurse should evaluate the mother's knowledge about appropriate infant feeding techniques.Which statement by the client reassures the nurse that correct learning has taken place?

Accepted Answer

Most infants swallow air when fed from a bottle and should be given a chance to burp several times during and after the feeding.Solid food should not be introduced to the infant for at least 4 to 6 months after birth.A microwave should never be used to warm any food to be given to an infant.The heat is not distributed evenly,which may pose a risk of burning the infant.Any formula left in the bottle after the feeding should be discarded because the infant's saliva has mixed with it.

Question 2

A breastfeeding woman develops engorged breasts at 3 days postpartum.What action will help this client achieve her goal of reducing the engorgement?

Accepted Answer

The mother should be instructed to attempt feeding her infant every 2 hours while massaging the breasts as the infant is feeding.Skipping feedings may cause further swelling and discomfort.If the infant does not adequately feed and empty the breast,then the mother may pump to extract the milk and relieve some of the discomfort.Dehydration further irritates swollen breast tissue.

Question 3

A pregnant woman wants to breastfeed her infant; however,her husband is not convinced that there are any scientific reasons to do so.The nurse can give the couple printed information comparing breastfeeding and bottle feeding.Which statement regarding bottle feeding using commercially prepared infant formulas might influence their choice?

Accepted Answer

Exposure to cow's milk poses a risk of developing allergies,eczema,and asthma.Newborns should be fed during the night,regardless of the feeding method.Iron is better absorbed from breast milk than from formula.Commercial formulas are designed to meet the nutritional needs of the infant and to resemble breast milk.No supplements are necessary.

Question 4

A new father is ready to take his wife and newborn son home.He proudly tells the nurse who is discharging them that within the next week he plans to start feeding the infant cereal between breastfeeding sessions.Which information should the nurse provide regarding this feeding plan?

Accepted Answer

The introduction of solid foods before the infant is 4 to 6 months of age may result in overfeeding and decreased intake of breast milk.The belief that feeding solid foods helps infants sleep through the night is untrue.The proper balance of carbohydrate,protein,and fat for an infant to grow properly is in the breast milk or formula.

Question 5

A postpartum woman telephones the provider regarding her 5-day-old infant.The client is not scheduled for another weight check until the infant is 14 days old.The new mother is worried about whether breastfeeding is going well.Which statement indicates that breastfeeding is effective for meeting the infant's nutritional needs?

Accepted Answer

After day 4,when the mother's milk comes in,the infant should have six to eight wet diapers every 24 hours.Typically,infants sleep 2 to 4 hours between feedings,depending on whether they are being fed on a 2- to 3-hour schedule or cluster-fed.The infant's sleep pattern is not an indication whether the infant is breastfeeding well.The infant should have a minimum of three bowel movements in a 24-hour period.Breastfed infants typically gain 15 to 30 g/day.

Question 6

Which statement regarding the nutrient needs of breastfed infants is correct?

Accepted Answer

Human milk contains only small amounts of vitamin D.All infants who are breastfed should receive 400 International Units of vitamin D each day.Neither breastfed nor formula-fed infants need to be fed water,not even in very hot climates.During the first 3 months,formula-fed infants consume more energy than breastfed infants and therefore tend to grow more rapidly.Vitamin K shots are required for all infants because the bacteria that produce it are absent from the baby's stomach at birth.

Question 7

Parents have been asked by the neonatologist to provide breast milk for their newborn son,who was born prematurely at 32 weeks of gestation.The nurse who instructs them regarding pumping,storing,and transporting the milk needs to assess their knowledge of lactation.Which statement is valid?

Accepted Answer

Human milk is the ideal food for preterm infants,with benefits that are unique,in addition to those benefits received by full-term,healthy infants.Greater physiologic stability occurs with breastfeeding,compared with formula feeding.Consumption of alcohol during lactation is approached with caution.Excessive amounts can have serious effects on the infant and can adversely affect the mother's milk ejection reflex.To establish an optimal milk supply,the most appropriate instruction for the mother should be to pump 8 to 10 times a day for 10 to 15 minutes on each breast.

Question 8

The nurse is explaining the benefits associated with breastfeeding to a new mother.Which statement by the nurse would provide conflicting information to the client?

Accepted Answer

Although breastfeeding delays the return of fertility,it is not an effective birth control method.Women who breastfeed have a decreased risk of breast cancer,an increase in bone density,and a possibility of faster postpartum weight loss.

Question 9

A new mother asks the nurse what the "experts say" about the best way to feed her infant.Which recommendation of the American Academy of Pediatrics (AAP)regarding infant nutrition should be shared with this client?

Accepted Answer

Breastfeeding and human milk should also be the sole source of milk for the first 12 months,not for only the first 6 months.Infants should be started on solids when they are ready,usually at 6 months,whether they start on formula or breast milk.If infants are weaned from breast milk before 12 months,then they should receive iron-fortified formula,not cow's milk.

Question 10

According to demographic research,which woman is least likely to breastfeed and therefore most likely to need education regarding the benefits and proper techniques of breastfeeding?

Accepted Answer

Women least likely to breastfeed are typically younger than 25 years of age,have a lower income,are less educated,are employed full time outside the home,and are African-American.

Question 11

At a 2-month well-baby examination,it was discovered that an exclusively breastfed infant had only gained 10 ounces in the past 4 weeks.The mother and the nurse develop a feeding plan for the infant to increase his weight gain.Which change in dietary management will assist the client in meeting this goal?

Accepted Answer

Usually the solution to slow weight gain is to improve the feeding technique.Position and the latch-on technique are evaluated,and adjustments are made.Adding a feeding or two within a 24-hour period might help.Solid foods should not be introduced to an infant for at least 4 to 6 months.Bottle feeding may cause nipple confusion and may limit the supply of milk.Iron supplements have no bearing on weight gain.

Question 12

While discussing the societal impacts of breastfeeding,the nurse should be cognizant of the benefits and educate the client accordingly.Which statement as part of this discussion would be incorrect?

Accepted Answer

Actually,less time is lost to work by breastfeeding mothers,in part because infants are healthier.Breastfeeding is convenient because it does not require cleaning or transporting bottles and other equipment.It 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.

Question 13

A newly delivered mother who intends to breastfeed tells her nurse,"I am so relieved that this pregnancy is over so that I can start smoking again." The nurse encourages the client to refrain from smoking.However,this new mother is insistent that she will resume smoking.How will the nurse adapt her health teaching with this new information?

Accepted Answer

The new mother should be encouraged not to smoke.If she continues to smoke,she should be encouraged to always smoke in another room,removed from the baby.Smoking may impair milk production.When the products of tobacco are broken down,they cross over into the breast milk.Tobacco also results in a reduction of the antiinfective properties of breast milk.Research supports the conclusion that mothers should not smoke within 2 hours before a feeding (AAP Committee on Drugs,2001).The effects of secondhand smoke on infants include excessive crying,colic,upper respiratory infections,and an increased risk of sudden infant death syndrome (SIDS).

Question 14

A new mother recalls from prenatal class that she should try to feed her newborn daughter when she exhibits feeding readiness cues rather than waiting until the baby is frantically crying.Which feeding cue would indicate that the baby is ready to eat?

Accepted Answer

Sucking motions,rooting,mouthing,and hand-to-mouth motions are examples of feeding readiness cues.Waving her arms in the air,having the hiccups,and stretching out her extremities are not typical feeding readiness cues.

Question 15

The nurse should be cognizant of which statement regarding the unique qualities of human breast milk?

Accepted Answer

Growth spurts (at 10 days,3 weeks,6 weeks,and 3 months)usually last 24 to 48 hours,after which the infants resume normal feeding.The milk of mothers of preterm infants is different from that of mothers of full-term infants to meet the needs of these newborns.Milk changes composition during feeding.The fat content of the milk increases as the infant feeds.Colostrum precedes mature milk and is more concentrated and richer in proteins and minerals (but not fat).

Question 16

A nurse providing couplet care should understand the issue of nipple confusion.In which situation might this condition occur?

Accepted Answer

Nipple confusion can result when babies go back and forth between bottles and breasts,especially before breastfeeding is established in 3 to 4 weeks; bottle feeding and breastfeeding require different skills.Abrupt weaning can be distressing to the mother and/or baby but should not lead to nipple confusion.Pacifiers used before breastfeeding is established can be disruptive but do not lead to nipple confusion.Breastfeeding twins require some logistical adaptations but should not lead to nipple confusion.

Question 17

A primiparous woman is delighted with her newborn son and wants to begin breastfeeding as soon as possible.How should the client be instructed to position the infant to facilitate correct latch-on?

Accepted Answer

The infant's head and body should be in correct alignment with the mother and the breast during latch-on and feeding.The infant should be facing the mother with his arms hugging the breast.The baby's body should be held in correct alignment (i.e.,ears,shoulder,and hips in a straight line)during feedings.The mother should support the baby's neck and shoulders with her hand and not push on the occiput.

Question 18

A nurse is discussing the storage of breast milk with a mother whose infant is preterm and in the special care nursery.Which statement indicates that the mother requires additional teaching?

Accepted Answer

Breast milk for the hospitalized infant can be stored in the refrigerator for only 8 days,not for 3 months.Breast milk can be stored in the freezer for 3 months,in a deep freezer for 6 months,or at room temperature for 4 hours.Human milk for the healthy or preterm hospitalized infant can be kept in the refrigerator for up to 8 days or in the freezer for up to 3 months,but only for 4 hours or less at room temperature.

Question 19

Which statement is the best rationale for recommending formula over breastfeeding?

Accepted Answer

Breastfeeding is contraindicated when mothers have certain viruses,tuberculosis,are undergoing chemotherapy,or are using or abusing drugs.Some women lack confidence in their ability to produce breast milk of adequate quantity or quality.The key to encouraging these mothers to breastfeed is anticipatory guidance beginning as early as possible during the pregnancy.A major barrier for many women is the influence of family and friends.She may view formula feeding as a way to ensure that the father and other family members can participate.Each encounter with the family is an opportunity for the nurse to educate,dispel myths,and clarify information regarding the benefits of breastfeeding.Many women see bottle feeding as more convenient and less embarrassing than breastfeeding.They may also see breastfeeding as incompatible with an active social life.Although modesty issues related to feeding the infant in public may exist,these concerns are not legitimate reasons to formula-feed an infant.Often,the decision to formula feed rather than breastfeed is made without complete information regarding the benefits of breastfeeding.

Question 20

Which information should the nurse provide to a breastfeeding mother regarding optimal self-care?

Accepted Answer

Large weight loss releases fat-stored contaminants into her breast milk,and it also involves eating too little and/or exercising too much.A breastfeeding mother needs to add only 200 to 500 extra calories to her diet to provide the extra nutrients for her infant.However,this is true only if she does not drink alcohol,limits coffee to no more than two cups (including caffeine in chocolate,tea,and some sodas,too),and carefully reads the herbal tea ingredients.Although she needs her rest,moderate exercise is healthy.

Quiz 25: Newborn Nutrition and Feeding