Roth 10e NCLEX



Roth 10e NCLEX

Chapter 12

MULTIPLE CHOICE

1. The mother of an infant child asks the nurse what the right feeding schedule is for an infant. Of the following responses, which would be the best response for the nurse to make?

|a. |Feed the infant every 2 hours. |c. |Feed the infant every 4 hours |

|b. |Feed the infant every 3 hours |d. |Feed the infant when the infant is hungry. |

ANS: D

Although babies have been fed according to prescribed time schedules in the past, it is preferable to feed babies on demand. Feeding on demand prevents the frustrations that hunger can bring and helps the child develop trust in people. The newborn may require more frequent feedings, but normally by the time the baby is 2 or 3 months old, the demand schedule averages approximately every 4 hours.

PTS: 1 REF: Introduction

2. The parents of an infant tell the nurse that they are concerned that their healthy breastfed infant is not getting enough fluid from breast milk alone. What could the nurse say about the infants’ need for fluids?

|a. |Babies require 2 ml of water per calorie consumed. |c. |Offer the baby water in a bottle frequently and let the |

| | | |baby drink ad libitum. |

|b. |Give the baby a bottle with 10 ml of water 4 times a day.|d. |The ratio of water to calories in breast milk is ideal |

| | | |for the infant. |

ANS: D

Infants have more water per pound of body weight than do adults. Thus, infants usually need 1.5 ml of water per calorie. This is the same ratio of water to calories found in human milk and in most infant formulas.

PTS: 1 REF: Nutritional Requirements

3. The parents bring a two month infant in who has had frequent ear infections. The baby is being fed formula from a bottle. The nurse knows that feeding position may affect development of ear infections. How should the nurse say the infant should be positioned for feeding?

|a. |in a semi upright position |c. |on its side |

|b. |lying flat |d. |propped up in a chair |

ANS: A

It appears that babies held in a semi-upright position during bottle feeding are less inclined to develop middle ear infections than those fed lying down.

PTS: 1 REF: Bottle Feeding

4. A client tells the nurse that formula is very expensive and wants to know when the infant can be given regular cow’s milk. What is the best response for the nurse to make?

|a. |at 6 months of age |c. |at 18 months of age |

|b. |at 12 months of age |d. |at 24 months of age |

ANS: B

Infants under 1 year of age should not be given regular cow’s milk.

PTS: 1 REF: Bottle Feeding

5. The client tells the nurse she is going to begin giving a 3 month old infant rice cereal at bedtime so the infant will sleep through the night. What will the nurse tell the client?

|a. |Introducing solid food before 4 to 6 months will reduce |c. |That is a good way to get the baby to sleep through the |

| |the likelihood that the infant will develop allergies. | |night. |

|b. |Make sure the cereal is iron fortified. |d. |The introduction of solid foods before the age of 4 to 6 |

| | | |months is not recommended. |

ANS: D

The introduction of solid foods before the age of 4 to 6 months is not recommended. It is thought that the early introduction of solid foods may increase the possibility of the development of food allergies.

PTS: 1 REF: Supplementary Foods

6. A client who wanted to breast feed her premature newborn who was born at 33 weeks is told the newborn must be fed by total parenteral nutrition. What reason will the nurse give the distraught mother for this?

|a. |It is easier for the nurses. |c. |The mother’s breast milk is not yet ready. |

|b. |The infant has not yet developed the sucking reflex. |d. |The mother needs to rest. |

ANS: B

Babies sucking reflex is not developed until 34 weeks gestation.

PTS: 1 REF: Premature Infants

MULTIPLE RESPONSE

1. A concerned parent tells the nurse that the infant has not quite doubled its birth weight at 6 months. Which of the following statements could the nurse make? Select all that apply.

|a. |A baby usually doubles its birth weight by 1 year of age.|d. |Growth rates vary from child to child. |

|b. |A baby usually doubles its birth weight by 6 months of |e. |If the baby has not doubled its birth weight by 6 months |

| |age. | |of age, the baby is not receiving sufficient food. |

|c. |A baby triples its birth weight by 6 months of age. |f. |There is probably something wrong with the baby if it |

| | | |hasn’t doubled its birthweight by 6 months of age. |

ANS: B, D

A baby doubles its birth weight by 6 months of age and triples it within the first year. It is important to remember that growth rates vary from child to child.

PTS: 1 REF: Nutritional Requirements

2. The mother of an infant asks the nurse how she can be sure the baby is getting sufficient nutrients and calories from breastfeeding. Which of the following statements could the nurse make to teach the mother how to assess the infants intake of nutrients and calories? Select all that apply.

|a. |If the breast becomes less full during nursing. |d. |If the infant isn’t irritable. |

|b. |If the infant is experiencing normal growth. |e. |If there are one or two mustard-colored bowel movements a|

| | | |day |

|c. |If the infant is feeding at least every four hours. |f. |If there are six or more wet diapers a day. |

ANS: A, B, E, F

One can be quite confident the infant is getting sufficient nutrients and calories from breastfeeding if (1) there are six or more wet diapers a day, (2) there is normal growth, (3) there are one or two mustard-colored bowel movements a day, and (4) the breast becomes less full during nursing.

PTS: 1 REF: Breastfeeding

3. The client asks the nurse why the infant cannot have cow’s milk before 1 year of age. Which of the following are reasons the nurse could give? Select all that apply.

|a. |Cow’s milk doesn’t provide sufficient calories. |d. |The fat is not absorbed as efficiently as that in human |

| | | |milk. |

|b. |Cow’s milk will damage the infants liver. |e. |The kidneys are challenged by its high protein and |

| | | |mineral content. |

|c. |Dehydration can result. |f. |The proteins are more difficult to digest. |

ANS: C, D, E, F

Infants under the age of 1 year should not be given regular cow’s milk. Because its protein is more difficult and slower to digest than that of human milk, it can cause gastrointestinal blood loss. The kidneys are challenged by its high protein and mineral content, and dehydration and even damage to the central nervous system can result. In addition, the fat is not absorbed as efficiently as that in human milk.

PTS: 1 REF: Bottle Feeding

4. The parent of an 8 month old child asks the nurse for advice about how to tell when the child is full. Which of the following could the nurse say are ways the infant will indicate he or she is full? Select all that apply.

|a. |Crying |d. |Looking around and no longer opening his or her mouth to |

| | | |solid food. |

|b. |Eating smaller bites of solid food. |e. |Playing with food and not eating. |

|c. |Falling asleep while eating. |f. |Playing with the nipple on a bottle or breast. |

ANS: C, D, E, F

Babies differ in the amount of food they eat from day to day. An infant will let you know when he or she is full by:

Playing with the nipple on a bottle or breast

Looking around and no longer opening his or her mouth to solid food.

Falling asleep while eating

Playing with food and not eating

PTS: 1 REF: Supplementary Foods

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