Deck 22: Infant Feeding

Question 1

In which condition is breastfeeding contraindicated?

A) Triplet birth
B) Flat or inverted nipples
C) Human immunodeficiency virus infection
D) Inactive, previously treated tuberculosis

Answer 1

Human immunodeficiency virus infection

Question 2

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

Answer 2

100 to 110

Question 3

Which type of formula should not be diluted before being administered to an infant?

A) Powdered
B) Concentrated
C) Ready to use
D) Modified cow's milk

Answer 3

Ready to use

Question 4

Which woman is most likely to continue breastfeeding beyond 6 months?

A) A woman who avoids using bottles
B) A woman who uses formula for every other feeding
C) A woman who offers water or formula after breastfeeding
D) A woman whose infant is satisfied for 4 hours after the feeding

Question 5

Which is an important consideration about the storage of breast milk?

A) Can be thawed and refrozen
B) Can be frozen for up to 2 months
C) Should be stored only in glass bottles
D) Can be kept refrigerated for 48 hours

Question 6

How many milliliters per kilogram (mL/kg) of fluids does a newborn need daily for the first 3 to 5 days of life?

A) 20 to 30
B) 40 to 60
C) 60 to 100
D) 120 to 150

Question 7

How many ounces will an infant who is on a 4-hour feeding schedule need to consume at each feeding to meet daily caloric needs?

A) 1
B) 1.5
C) 3.5
D) 5

Question 8

Which is an important consideration in positioning a newborn for breastfeeding?

A) Placing the infant at nipple level facing the breast
B) Keeping the infant's head slightly lower than the body
C) Using the forefinger and middle finger to support the breast
D) Limiting the amount of areola the infant takes into the mouth

Question 9

The client should be taught that when her infant falls asleep after feeding for only a few minutes, she should do which of the following?

A) Unwrap and gently arouse the infant.
B) Wait an hour and attempt to feed again.
C) Try offering a bottle at the next feeding.
D) Put the infant in the crib and try again later.

Question 10

Which should the nurse recommend to the postpartum client 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.

Question 11

To prevent breast engorgement, what should the new breastfeeding mother be instructed to do?

A) Feed her infant no more than every 4 hours.
B) Limit her intake of fluids for the first few days.
C) Apply cold packs to the breast prior to feeding.
D) Breast-feed frequently and for adequate lengths of time.

Question 12

The breastfeeding client should be taught a safe method to remove her breast from the baby's mouth. Which suggestion by the nurse is most appropriate?

A) Break the suction by inserting your finger into the corner of the infant's mouth.
B) A popping sound occurs when the breast is correctly removed from the infant's mouth.
C) Slowly remove the breast from the baby's mouth when the infant has fallen asleep and the jaws are relaxed.
D) Elicit the Moro reflex in the baby to wake the baby up, and remove the breast when the baby cries.

Question 13

What is the difference between the aseptic and terminal methods of sterilization?

A) The aseptic method requires a longer preparation time.
B) The aseptic method does not require boiling of the bottles.
C) The terminal method requires boiling water to be added to the formula.
D) The terminal method sterilizes the prepared formula at the same time it sterilizes the equipment.

Question 14

What should the nurse explain when responding to the question, "Will I produce enough milk for my baby as she grows and needs more milk at each feeding?"

A) Early addition of baby food will meet the infant's needs.
B) The breast milk will gradually become richer to supply additional calories.
C) As the infant requires more milk, feedings can be supplemented with cow's milk.
D) The mother's milk supply will increase as the infant demands more at each feeding.

Question 15

Which recommendation should the nurse make to a client to initiate the milk ejection reflex?

A) Wear a well-fitting firm bra.
B) Drink plenty of fluids.
C) Place the infant to the breast.
D) Apply cool packs to the breast.

Question 16

A new mother is concerned because her 1-day-old newborn is taking only 1 oz at each feeding. What should the nurse explain?

A) The infant is probably having difficulty adjusting to the formula.
B) An infant does not require as much formula in the first few days of life.
C) The infant's stomach capacity is small at birth but will expand within a few days.
D) The infant tires easily during the first few days but will gradually take more formula.

Question 17

Which is the first step in assisting the breastfeeding mother?

A) Assess the woman's knowledge of breastfeeding.
B) Provide instruction on the composition of breast milk.
C) Discuss the hormonal changes that trigger the milk ejection reflex.
D) Help her obtain a comfortable position and place the infant to the breast.

Question 18

As the nurse assists a new mother with breastfeeding, the mother asks, "If formula is prepared to meet the nutritional needs of the newborn, what is in breast milk that makes it better?" The nurse's best response is that it contains:

A) more calcium.
B) more calories.
C) essential amino acids.
D) important immunoglobulins.

Question 19

Which is the hormone necessary for milk production?

A) Estrogen
B) Prolactin
C) Progesterone
D) Lactogen

Question 20

A breastfeeding client who was discharged yesterday calls to ask about a tender hard area on her right breast. What should be the nurse's first response?

A) "This is a normal response in breastfeeding mothers."
B) "Notify your doctor so he can start you on antibiotics."
C) "Stop breastfeeding because you probably have an infection."
D) "Try massaging the area and apply heat; it is probably a plugged duct."

Question 21

Late in pregnancy, the client's breasts should be assessed by the nurse to identify any potential concerns related to breastfeeding. Which of the following nipple conditions make it necessary to intervene before birth. (Select all that apply.)

A) Flat nipples
B) Cracked nipples
C) Everted nipples
D) Inverted nipples
E) Nipples that contract when compressed

Question 22

For which infant should the nurse anticipate the use of soy formula? (Select all that apply.)

A) Preterm infant
B) Infant with galactosemia
C) Infant with phenylketonuria
D) Infant with lactase deficiency
E) Infant with a malabsorption disorder

Question 23

Which interventions may relieve symptoms of colic in the infant? (Select all that apply.)

A) Increased stimulation of infant to provide distraction
B) Burping infant frequently during feedings
C) Feeding infant placed in an upright position
D) Providing chamomile tea to infant
E) Feeding infant on an on demand schedule

Question 24

A breastfeeding mother asks the postpartum nurse if any supplementation is necessary once her breast milk comes in. What is the nurse's best response?

A) "Are you concerned about your ability to adequately nurse your baby?"
B) "Do you eat a well-balanced diet, high in protein and carbohydrates?"
C) "Breast milk is low in vitamin D and supplementation with 400 IU is recommended."
D) "Your breast milk has all the vitamins and will adequately meet your baby's needs."

Question 25

A mother conveys concern over the fact that she is not sure if her newborn child is getting enough nutrients from breastfeeding. This is the baby's first clinic visit after birth. What information can you provide that will help alleviate her fears about nutrient status for her newborn?

A) Monitor the infant's output; as long as at least six or more diapers are changed in a 24-hour period, that should be sufficient.
B) Tell the mother that if a baby is satisfied with feeding, she or he will be content and not fussy.
C) Tell the mother that breast milk contains everything required for the infant and not to worry about nutrition.
D) Provide nutrition information in the form of pamphlets for the mother to take home with her so that she uses them as a point of reference.

Question 26

A client who is receiving a pitocin (Oxytocin) infusion for the augmentation of labor is experiencing a contraction pattern of more than eight contractions in a 10-minute period. Which intervention would be a priority?

A) Increase the rate of pitocin infusion to help spread out the contraction pattern.
B) Place oxygen on the client at 8 to 10 L/min via face mask and turn the client to her left side.
C) Stop the pitocin infusion.
D) Call the physician to obtain an order for the initiation of magnesium sulfate.

Question 27

A new mother is preparing for discharge. She plans on bottle feeding her baby. Which statement indicates to the nurse that the mom needs more information about bottle feeding?

A) "I should encourage my baby to consume the entire amount of formula prepared for each feeding."
B) "I can make up a 24-hour supply of formula and refrigerate the bottles so I am ready to feed my baby."
C) "I will hold my baby in a cradle hold and alternate sides from left to right when I feed my baby."
D) "I will generally feed my baby every 3 to 4 hours or more as signs of hunger are displayed."

Question 28

A new mother asks whether she should feed her newborn colostrum because it is not real milk. The nurse's best answer includes which information?

A) Colostrum is unnecessary for newborns.
B) Colostrum is high in antibodies, protein, vitamins, and minerals.
C) Colostrum is lower in calories than milk and should be supplemented by formula.
D) Giving colostrum is important in helping the mother learn how to breast-feed before she goes home.

Question 29

A newborn infant weighs 7 pounds, 2 ounces, on the fifth day of life. How much water should be given to the newborn based on required fluid needs?

A) Fluid replacement should be based on weight and calculated in the range of 60 to 100 mL/kg.
B) Offer additional water to tolerance in between infant feedings to maintain hydration.
C) Give 12 ounces of fluid per feeding.
D) No water is needed because formula and breast milk are adequate to maintain hydration.

Question 30

The nurse is teaching a postpartum client different holds for breastfeeding. Which of the following figures depicts the football hold frequently used for clients who have had a cesarean birth?

A)
B)
C)
D)

Question 31

A new mother asks why she has to open a new bottle of formula for each feeding. What is the nurse's best response?

A) "Formula may turn sour after it is opened."
B) "Bacteria can grow rapidly in warm milk."
C) "Formula loses some nutritional value once it is opened."
D) "This makes it easier to keep track of how much the baby is taking."

Question 32

What is the most serious consequence of propping an infant's bottle?

A) Colic
B) Aspiration
C) Dental caries
D) Ear infections

Question 33

A mother is attempting to breastfeed her infant in the hospital setting. The infant is sleepy and displays some audible swallowing, the maternal nipples are flat, and the breasts are soft. The nurse has attempted to teach the mother positioning on one side, and now the mother wants to place the infant to the breast on the other side. Based on LATCH scores, the nurse would designate a score of:

A) 10 and document findings in the chart.
B) 6 and further teach and assist the mother in feeding activities.
C) 5 and tell the mother to discontinue feeding attempts at this time because the infant is too sleepy.
D) 8 and no further assistance is needed for feeding.

Question 34

A new mother asks the nurse, "How will I know early signs of hunger in my baby?" The nurse's best response is which of the following? (Select all that apply.)

A) Crying
B) Rooting
C) Lip smacking
D) Decrease in activity
E) Sucking on the hands

Question 35

A mother is breastfeeding her newborn infant but is experiencing signs of her breasts feeling tender and full in between infant feedings. She asks if there are any suggestions that you can provide to help alleviate this physical complaint. The best nursing response would be to:

A) tell the client to wear a bra at all times to provide more support to breast tissue.
B) have the client put the infant to her breast more frequently.
C) place ice packs on breast tissue after infant feeding.
D) explain that this is a normal finding and will resolve as her breast tissue becomes more used to nursing.