(COMPLETE) NR 602 QUESTIONS 2023
The primary care pediatric nurse practitioner is examining a newborn that is breastfeeding and notes the presence of an
... [Show More] ankyloglossia. What will the nurse practitioner do next?
a. Ask the mother if the infant has any feeding difficulties.
b. Refer the infant for a possible frenulectomy.
c. Schedule an appointment with a lactation consultant.
d. Suggest that the mother feed breast milk by bottle.
{{Correct Ans- ANS: A
Infants with ankyloglossia may have difficulty feeding if the tongue does not extend well. The PNP should first assess feeding difficulties and then may refer for a lactation consultant or consider a frenulectomy.
The mother of a 2-month-old infant tells the primary care pediatric nurse practitioner that she is afraid her breast milk is "drying up" because her baby never seems satisfied and wants to nurse all the time. Which action is correct?
a. Recommend pumping her breasts after feedings.
b. Refer the mother to a lactation consultant.
c. Suggest supplementation with formula.
d. Weigh the infant to assess for a growth spurt.
{{Correct Ans- ANS: D
Infants have growth spurts about every 3 to 4 weeks that increase their breast milk needs. Until the mother's milk supply catches up, the infant will act hungry and want to nurse more frequently. The PNP should evaluate for this growth spurt and then instruct the mother to feed her baby more often to increase her milk supply. Since the infant is hungry, the infant should nurse. It is not necessary to refer for a lactation consultation or to supplement with formula.
The primary care pediatric nurse practitioner is performing an assessment on a 1-week-old newborn with a slightly elevated bilirubin who is breastfeeding well and who has gained 30 grams in the past 24 hours. The infant is stooling and voiding well. The nurse practitioner suspects breast milk jaundice. Which action is correct?
a. Order home phototherapy and closely monitor bilirubin levels.
b. Reassure the mother that the bilirubin level will drop in a few days.
c. Recheck the serum bilirubin and infant's weight in 24 hours.
d. Recommend that the mother pump her breast milk for a couple of days.
{{Correct Ans- ANS: C
Infants with breast milk jaundice who are gaining weight and thriving should continue to breastfeed and be monitored for the development of pathologic jaundice. It is not necessary to order phototherapy or discontinue breastfeeding unless pathologic jaundice is present. The bilirubin may remain elevated up to 3 months.
The mother of a newborn asks the primary care pediatric nurse practitioner about the benefits of breastfeeding. What will the nurse practitioner tell her?
a. Breastfeeding for 9 months or longer will reduce the incidence of food allergies.
b. Breast milk is an excellent source of vitamin D, iron, and other essential nutrients for the baby.
c. Nursing her baby exclusively for at least 4 months will help her infant to resist infections.
d. There is a decreased risk of atopic dermatitis in babies who nurse for 12 months or longer.
{{Correct Ans- ANS: C
There is evidence that infants who exclusively breastfeed for at least 4 months have less risk for infection than infants breastfed for less time. However, infants who breastfeed exclusively for 9 months or for longer than 12 months may have increased risks for food hypersensitivities and atopic dermatitis. Breast milk is a poor source of vitamin D and iron.
The primary care pediatric nurse practitioner sees a 3-day-old nursing infant whose newborn metabolic screen is positive for galactosemia. The nurse practitioner refers the newborn to a specialist for immediate evaluation and will tell the mother
a. to continue to breastfeed her infant.
b. to give the infant a cow's milk formula.
c. to supplement breast milk with formula.
d. to stop breastfeeding immediately.
{{Correct Ans- ANS: D
Infants with galactosemia cannot consume galactose, which is in both cow's milk and breast milk. Since there is a potential for a life-threatening response, the mother should be instructed to stop nursing immediately. [Show Less]