Nokea
How many kilocalories per kilogram (kcal/kg) of body weight does a full-term formula-fed infant need each day?
- A. 50 to 75
- B. 100 to 110
- C. 120 to 140
- D. 150 to 200
Correct Answer: B
Rationale: The correct answer is B (100 to 110 kcal/kg). Full-term formula-fed infants need around 100 to 110 kcal/kg per day for optimal growth and development. This amount is tailored to meet their energy requirements and support proper weight gain. Choices A, C, and D are incorrect because they either fall below or exceed the recommended range for infants. Option A (50 to 75 kcal/kg) is too low, which may lead to inadequate energy intake. Option C (120 to 140 kcal/kg) and Option D (150 to 200 kcal/kg) are too high, potentially causing excessive weight gain or metabolic issues. Therefore, option B is the most suitable and balanced choice for meeting the energy needs of formula-fed infants.
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Which technique should the nurse recommend to the postpartum patient in order to prevent nipple trauma?
- A. Assess the nipples before each feeding.
- B. Limit the feeding time to less than 5 minutes.
- C. Wash the nipples daily with mild soap and water.
- D. Position the infant so the nipple is far back in the mouth.
Correct Answer: D
Rationale: The correct answer is D: Position the infant so the nipple is far back in the mouth. This technique helps prevent nipple trauma by ensuring that the baby latches onto the breast correctly, with a deep latch that prevents excessive pressure and friction on the nipple. By positioning the nipple far back in the baby's mouth, the baby can effectively suckle and draw milk without causing damage to the nipple.
Choice A is incorrect because simply assessing the nipples before each feeding does not actively prevent trauma. Choice B is incorrect as limiting feeding time to less than 5 minutes can lead to inadequate milk transfer and potential nipple trauma due to improper latch. Choice C is incorrect as washing the nipples daily with soap and water can actually strip the skin of natural oils and increase the risk of dryness and cracking, leading to trauma.
Transient tachypnea of the neonate develops due to what pathophysiologic phenomenon?
- A. failure to clear lung fluid by the usual mechanism
- B. failure of the patent ductus arteriosus to close
- C. insufficient surfactant production
- D. aspiration of meconium during vaginal or cesarean birth that interferes with surfactant activity
Correct Answer: A
Rationale: TTN occurs when there is delayed reabsorption of fetal lung fluid after birth.
The labor and delivery nurse understands that some neonates spontaneously take a breath once the head and chest is delivered. Which understanding does the nurse have for the neonate that requires chemical stimuli to breathe?
- A. Oxygen is applied immediately to start respirations.
- B. Carbon dioxide is administered in small doses.
- C. Mild hypoxia and decreased pH stimulates the brain.
- D. Suctioning is used to stimulate breathing efforts.
Correct Answer: C
Rationale: Step 1: Mild hypoxia and decreased pH stimulate the brain to initiate breathing in neonates.
Step 2: This chemical stimuli trigger the respiratory centers in the brainstem.
Step 3: Oxygen administration may not be necessary as the neonate's own respiratory drive is initiated by chemical stimuli.
Step 4: Carbon dioxide administration is not needed as high levels can be harmful.
Step 5: Suctioning is not used to stimulate breathing but to clear airways if necessary.
Summary: Choice C is correct as it aligns with the physiological response of neonates to chemical stimuli for breathing, while the other choices are not relevant or could be potentially harmful.
The nurse must administer erythromycin ophthalmic ointment to a newborn after birth. The nurse should:
- A. instill within 15 minutes of birth for maximum effectiveness
- B. cleanse eyes from inner to outer canthus before administration
- C. apply directly over the cornea.
- D. flush eyes 10 minutes after instillation to reduce irritation
Correct Answer: B
Rationale: Cleansing the eyes from inner to outer canthus ensures that any debris or contaminants are removed before administration, which helps prevent infection and ensures the medication's effectiveness.
At birth, a newborn weighed 6 pounds, 12 ounces. Three days later, the newborn weighs 5 pounds, 10 ounces. What conclusion should the nurse draw regarding this newborn's weight?
- A. This weight loss is within normal limits.
- B. This weight gain is within normal limits.
- C. This weight loss is excessive.
- D. This weight gain is excessive.
Correct Answer: C
Rationale: The correct answer is C: This weight loss is excessive. The newborn's weight decreased from 6 lbs 12 oz to 5 lbs 10 oz in just three days, indicating a significant loss. A newborn typically loses around 5-10% of their birth weight in the first few days. This weight loss exceeds the expected range, suggesting potential issues like inadequate feeding or dehydration. Choices A and B are incorrect because the weight loss is not within normal limits, and weight gain is not observed. Choice D is incorrect as there is no weight gain, let alone excessive weight gain.