A nurse is providing discharge education to the parents of a formula-fed newborn.
Which statement by the parents indicates a need for further clarification about formula feeding.
The baby's stool should change from black to green/brown color over the next few days.
We'll feed the baby on-demand and watch for hunger cues.
We can use tap water from our kitchen faucet to prepare the formula.
We need to make sure to burp our baby during and after each feeding.
The Correct Answer is A
Choice A rationale
This statement requires further clarification as it contains an inaccuracy about meconium's expected change. Meconium, the black, tarry, sticky stool of a newborn, is normally replaced by 𝐭ransitional 𝐬tools (greenish-brown/yellow and looser) by about 2-3 days of life, regardless of feeding type. Stool color will then progress to a pale yellow or tan, pasty consistency for formula-fed infants; the continued presence of black stool beyond this period suggests inadequate intake or a potential gastrointestinal issue.
Choice B rationale
𝐎n-demand 𝐟eeding, or cue-based feeding, is the appropriate method for both formula-fed and breastfed newborns, ensuring their nutritional and caloric needs are met by recognizing early signs of hunger such as rooting, sucking on hands, or being restless. This method promotes optimal weight gain and satiety, which is the correct understanding of infant feeding practices, indicating no need for further clarification.
Choice C rationale
Using 𝐭ap 𝐰ater for formula preparation is acceptable practice, provided the water supply is clean and safe (e.g., public water). If the tap water is from a private well or is questionable, boiling it is advised, but for most municipal sources, tap water can be used directly. This statement shows a correct understanding of formula preparation, so no further clarification is needed regarding the safety of municipal tap water.
Choice D rationale
Burping is essential for formula-fed infants because they tend to swallow more air during feeding than breastfed infants, leading to discomfort, distension, and reflux. Burping helps expel this swallowed air, which typically requires a break mid-feeding (after every 0.5 to 1 ounce) and at the end. This statement demonstrates a correct understanding of proper formula feeding technique, thus requiring no further teaching. .
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Slipping of the periosteal joint is not a recognized term or common pathology in this context. Developmental (congenital) hip dysplasia (DDH) is the condition associated with the described findings, which relate to the instability or dislocation of the femoral head within the acetabulum and not merely a periosteal issue which is the tough, fibrous sheath covering the bone.
Choice B rationale
Overriding of the pelvic bone is not typically the cause of a positive Ortolani sign or uneven gluteal creases. The physical findings of a 'click' during Ortolani's maneuver indicate dislocation of the hip, where the femoral head is reduced into the acetabulum, and uneven gluteal creases reflect femoral shortening caused by the displacement of the joint.
Choice C rationale
These findings are pathognomonic (highly characteristic) of instability or dislocation of the hip joint, which is Developmental (congenital) hip dysplasia (DDH), and are not considered normal variations in a newborn assessment. Normal findings would include symmetrical skin folds and a negative Ortolani and Barlow maneuver (no clicks or clunks indicating instability).
Choice D rationale
Uneven gluteal creases (a sign of limb shortening) and a positive Ortolani sign (the 'click' representing the reduction of a dislocated hip into the acetabulum) are the classic clinical signs suggestive of Developmental (congenital) hip dysplasia (DDH), indicating a potentially unstable or dislocated hip joint. —.
Correct Answer is A
Explanation
Choice A rationale
Morphine is a common first-line opioid used to manage severe symptoms of NAS, such as tremors, seizures, and autonomic dysfunction, by targeting the same opioid receptors affected by maternal substance use. A decreased environmental stimulation plan of care, including swaddling, quiet, dark spaces, and gentle handling, is vital to minimize CNS irritability and hyperactivity often seen in NAS, promoting neurobehavioral organization and reducing energy expenditure.
Choice B rationale
Phenobarbital, an anticonvulsant and sedative, is often used as a second-line or adjunct therapy for NAS, particularly when seizures are present or if the infant is non-responsive to the primary opioid. Delaying feeding is inappropriate; infants with NAS often have poor suck/swallow coordination and increased caloric needs due to hyperactivity and may require small, frequent feedings or high-calorie formulas to prevent dehydration and ensure adequate growth.
Choice C rationale
Amoxicillin is an antibiotic used to treat bacterial infections and has no role in the pharmacological management of Neonatal Abstinence Syndrome (NAS), which is a neurobehavioral condition caused by in utero exposure to opioids or other substances. Placing the infant on the abdomen is a maneuver sometimes used to relieve respiratory distress or congestion but is not a primary or specific intervention for the CNS irritability and hypertonia characteristic of NAS.
Choice D rationale
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) used for pain and fever relief and is not indicated for the management of the complex neurobehavioral and autonomic symptoms of NAS. Applying barrier cream is routine skin care for all neonates to prevent diaper rash; while helpful for the diarrhea associated with NAS, it is not the most specific or critical component of the overall plan of care for severe symptoms. —.
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