Prior to discharge, a new mother who is breastfeeding wonders the best way to know her newborn is getting enough milk.
Which information should the practical nurse (PN) provide?
Use an on-demand feeding schedule.
Count the number of wet diapers per day.
Initiate feeding on the same breast each time.
Supplement with formula between feedings.
The Correct Answer is B
Choice A rationale
Using an on-demand feeding schedule allows the newborn to feed when hungry, which is important for establishing milk supply and meeting the infant's needs. However, it does not directly provide a quantitative measure of milk intake, as duration and frequency can vary.
Choice B rationale
Counting the number of wet diapers per day is an objective and reliable indicator of adequate hydration and milk intake in a breastfed newborn. Typically, a newborn should have at least 6-8 wet diapers per 24 hours by the end of the first week of life, indicating sufficient milk consumption.
Choice C rationale
Initiating feeding on the same breast each time is incorrect. It is generally recommended to alternate breasts with each feeding or offer both breasts at each feeding to ensure equal stimulation and drainage, which helps maintain milk supply in both breasts and prevents engorgement.
Choice D rationale
Supplementing with formula between feedings is not recommended as a primary method to assess milk intake and can interfere with the establishment of a robust breastfeeding relationship. It can decrease the infant's demand for breast milk, potentially reducing the mother's milk supply and introducing allergens.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Consumption of whole milk as a toddler is generally appropriate for growth and development, providing essential fats and nutrients. Unless consumed in excessive quantities or as part of an overall diet high in calories without sufficient physical activity, it is not typically identified as a primary singular contributor to early obesity.
Choice B rationale
Dedicated breastfeeding for 6 months is protective against childhood obesity. Breast milk provides optimal nutrition and growth-promoting factors, and breastfeeding is associated with better self-regulation of caloric intake by infants, potentially reducing the risk of later obesity compared to formula feeding.
Choice C rationale
Exclusive soy-based formula for the first year, while an alternative for specific dietary needs, does not inherently contribute to early obesity more than other formulas. The caloric density and nutritional composition of standard infant formulas are regulated and designed to support healthy growth, making it unlikely to be a primary cause of obesity.
Choice D rationale
Introducing solid foods, such as fortified cereal, before 4 months of age is associated with an increased risk of obesity. Infants lack the necessary gastrointestinal and renal maturity to process solids effectively before this age, and early introduction can lead to excessive caloric intake, disruption of feeding cues, and altered gut microbiome development, predisposing to weight gain.
Correct Answer is D
Explanation
Choice A rationale
This schedule is incorrect for pertussis (whooping cough) immunization. Pertussis vaccination, usually as part of the DTaP vaccine, is initiated in infancy and requires multiple doses to build adequate immunity, not just a single dose at 1 year or 6 years of age.
Choice B rationale
This schedule is incorrect and deviates from the standard recommendations for pertussis vaccination. The typical primary series of DTaP vaccination begins earlier in infancy and includes specific booster doses at later ages to maintain protection against the disease.
Choice C rationale
This schedule is incorrect for pertussis immunization. While some vaccinations begin at birth, and boosters are given periodically, the specific timing and frequency for pertussis in this option do not align with the established guidelines for the DTaP or Tdap vaccines.
Choice D rationale
This is the recommended immunization schedule for pertussis, typically administered as part of the DTaP vaccine. The primary series at 2, 4, and 6 months establishes foundational immunity, and boosters at 15-18 months and 4-6 years of age are crucial for maintaining long-term protection against the disease.
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