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Question 1 Type: MCSA The parent of a newborn infant reports that the baby wakes up every 2 hours and only takes about 2 ounces of formula before going back to sleep. What instruction should the nurse give this parent? 1. Make the baby wait at least 3 hours between feedings. 2. Continue to feed the baby with this “on demand†schedule. 3. When the baby gets sleepy during feeding, use techniques such as moving around and tickling to encourage wakefulness. 4. Offer the baby less formula to prevent waste. Correct Answer: 2 Rationale 1: Making the baby wait longer between feedings may result in feeding difficulties later in childhood. Rationale 2: Newborns are often fed following an “on demand†schedule. This might include feedings every 2 hours at first. Rationale 3: Trying to keep the baby awake to feed may result in feeding difficulties later in childhood. Rationale 4: Offering less formula may result in feeding difficulties later in childhood. Global Rationale: Page Reference: 1257 Cognitive Level: Applying Client Need: Physiological Integrity Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Implementation Learning Outcome: 04 Identify nutritional variations throughout the life cycle. Question 2 Type: MCSA What criteria does the nurse use to evaluate to determine if an infant’s regurgitation, or spitting up, should be further investigated? 1. How often the baby spits up 2. How much the baby spits up at a time 3. If the baby is gaining weight adequately 4. The consistency of the regurgitated matter Correct Answer: 3 Rationale 1: Many babies spit up after every meal and some seem to spit up a great deal. Rationale 2: How much the baby spits up at a time is not included in criteria to evaluate if the regurgitation should be further investigated. Rationale 3: As long as the baby is gaining weight adequately, it is not abnormal for regurgitation or spitting up to occur. Rationale 4: The consistency of the regurgitated material may be thin (just consumed) or curdled (has been partially digested) and either case is normal. Global Rationale: Page Reference: 1258 Cognitive Level: Applying Client Need: Physiological Integrity Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome: 04 Identify nutritional variations throughout the life cycle. Question 3 Type: MCSA
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