Parents have been asked to provide breast milk for their premature infant who is hospitalized.
Which of the following is an appropriate part of the education a nurse will provide?
A premature infant can digest breast milk more easily than formula milk.
A glass of wine just before pumping will help reduce stress and anxiety.
The mother should only pump as much as the infant can drink.
The mother should pump every 2 to 3 hours, including during the night.
The Correct Answer is A
Choice A rationale
Breast milk is specifically tailored to the nutritional and immunological needs of the human infant. It contains lipase, which assists the immature neonatal gut in breaking down fats, making it significantly easier to digest than cow milk-based formulas. For premature infants, who have sensitive gastrointestinal tracts, breast milk reduces the incidence of necrotizing enterocolitis. It also provides essential antibodies like secretory IgA that protect the fragile intestinal mucosa from pathogenic invasion and systemic infection.
Choice B rationale
Alcohol consumption is contraindicated during lactation, especially when providing milk for a premature infant with an underdeveloped liver. Ethanol easily passes into breast milk and can impair the infant's neurological development and growth patterns. While stress management is important for the let-down reflex, pharmacological or substance-based relaxation methods are unsafe. The nurse should instead recommend deep breathing, warm compresses, or gentle massage to stimulate oxytocin release and facilitate the pumping process without chemical risks.
Choice C rationale
Limiting pumping to only what the infant currently consumes can lead to a decrease in milk supply over time. Milk production is a supply and demand process governed by the hormone prolactin. Premature infants often consume very small volumes initially, but their needs will increase rapidly as they grow. Encouraging the mother to pump frequently and empty the breasts completely ensures that her supply is established and maintained for the long-term nutritional requirements of the developing child.
Choice D rationale
Frequent pumping every 2 to 3 hours mimics the natural feeding patterns of a newborn and is critical for stimulating the breasts to produce adequate milk. Nighttime pumping is particularly important because prolactin levels are naturally higher during the late night and early morning hours. Consistent stimulation prevents engorgement and mastitis while ensuring the mammary glands receive the hormonal signals necessary to sustain lactation. This rigorous schedule is vital for mothers of hospitalized infants to maintain productivity.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Neonatal weight loss is a physiological expectation during the first week of life. Newborns typically lose 5 percent to 10 percent of their birth weight due to the loss of extracellular fluid, meconium passage, and limited initial caloric intake before the mother's mature milk comes in. A 7 percent weight loss at 4 days postpartum is within the normal range. Providing reassurance helps alleviate parental anxiety while documenting the trend ensures proper clinical tracking of growth.
Choice B rationale
Introducing supplemental feedings like formula or water for a 7 percent weight loss is unnecessary and can interfere with the establishment of a successful breastfeeding relationship. Supplementation reduces the infant's demand at the breast, which can lead to a decrease in maternal milk production through the feedback inhibition of lactation. Unless weight loss exceeds 10 percent or there are signs of dehydration, the nurse should encourage frequent, exclusive breastfeeding sessions to ensure adequate intake.
Choice C rationale
While lactation consultants are valuable resources, a 7 percent weight loss on day 4 is a standard physiological occurrence that does not automatically indicate a breastfeeding problem. If the infant is latching well, has audible swallows, and has appropriate voiding and stooling patterns (typically 4 or more voids and 3 or more stools by day 4), a specialist referral is not yet indicated. The primary nurse can provide sufficient guidance on positioning and latch techniques.
Choice D rationale
Reporting this finding to a provider as abnormal would be clinically inaccurate since it falls within the expected 5 percent to 10 percent range for a 4-day-old infant. Healthcare providers monitor weight trends, but 7 percent does not trigger an immediate medical intervention or diagnostic workup for failure to thrive. Over-reporting normal physiological processes can lead to unnecessary medicalization of the postpartum period and cause undue stress for the new parents regarding their infant's health.
Correct Answer is A
Explanation
Choice A rationale
Cigarette smoking introduces systemic toxins such as nicotine, cadmium, and lead, which induce oxidative stress within the reproductive system. This oxidative damage can impair sperm morphology, reduce motility, and cause DNA fragmentation within the sperm cells. By acknowledging that smoking reduces sperm quality, the nurse provide accurate scientific information regarding how lifestyle factors directly contribute to subfertility by decreasing the likelihood of successful fertilization of the oocyte.
Choice B rationale
This response is inappropriate because a single semen analysis is often insufficient to provide a definitive clinical picture, and it dismisses the patient's valid concern. Furthermore, even if the total sperm count appears within the normal range of 15 million to 200 million per milliliter, the quality, motility, and genetic integrity of those sperm may still be severely compromised by chronic tobacco use, which would still hinder the couple's ability to conceive.
Choice C rationale
While it is true that smoking is a primary risk factor for lung cancer due to carcinogen exposure, the statement that it has no effect on sperm is scientifically incorrect. Tobacco use is known to cause a decrease in seminal volume and sperm concentration. Providing false information regarding the impact of smoking on reproductive health misses a critical opportunity for patient education and health promotion specifically related to the couple's current fertility struggles.
Choice D rationale
This statement is factually inaccurate and medically misleading. While marijuana use can indeed negatively impact reproductive hormones and sperm function, tobacco is equally or more detrimental to male fertility. Claiming only marijuana affects sperm count ignores the well-documented negative effects of nicotine and other chemicals in cigarettes on spermatogenesis and sperm transit. The nurse must provide evidence-based information covering all substances that contribute to the couple's difficulty in conceiving.
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