Low Risk Neonatal Nurse Exam Low Risk Neonatal Nurse Exam Newborn Nutrition & Breastfeeding Support 1 — Questions and Answers
Question 1: Which is the most reliable indicator that a breastfeeding newborn is receiving adequate milk intake?
- 6–8 wet diapers per day after day 4 (Correct answer)
- Infant sleeps more than 4 hours between feedings
- Mother reports no breast engorgement
- Infant's skin remains slightly jaundiced
Correct answer: 6–8 wet diapers per day after day 4
Six to eight wet diapers daily after the fourth day of life indicates adequate hydration and milk transfer in a breastfed newborn.
Question 2: What is the recommended feeding frequency for a healthy term breastfed newborn in the first weeks of life?
- Every 4–5 hours on a strict schedule
- 8–12 times per 24 hours on demand (Correct answer)
- Every 6 hours to allow full digestion
- Only when the infant cries persistently
Correct answer: 8–12 times per 24 hours on demand
Healthy term newborns should breastfeed 8–12 times in 24 hours on demand to establish milk supply and meet caloric needs.
Question 3: A nurse observes a newborn with a shallow latch during breastfeeding. Which action is the priority?
- Supplement immediately with formula
- Assist the mother to reposition and achieve a deeper latch (Correct answer)
- Apply nipple shield without instruction
- Document and reassess in 4 hours
Correct answer: Assist the mother to reposition and achieve a deeper latch
Correcting latch depth is the priority because a shallow latch causes nipple pain and ineffective milk transfer.
Question 4: Which finding in a 3-day-old newborn requires further evaluation before attributing weight loss to normal physiologic changes?
- Weight loss of 4% of birth weight
- Transitional stool present
- Weight loss greater than 10% of birth weight (Correct answer)
- Mild jaundice at 48 hours
Correct answer: Weight loss greater than 10% of birth weight
Weight loss exceeding 10% of birth weight warrants evaluation for inadequate feeding, dehydration, or an underlying pathology.
Question 5: When is iron-fortified infant formula the appropriate choice for a newborn?
- When the mother chooses not to breastfeed or cannot breastfeed (Correct answer)
- Only if the infant is premature
- As a supplement to every breastfeeding session
- When the infant has hyperbilirubinemia
Correct answer: When the mother chooses not to breastfeed or cannot breastfeed
Iron-fortified formula is the appropriate alternative when breastfeeding is not possible or not chosen by the mother.
Question 6: Which maternal condition is a contraindication to breastfeeding in the United States?
- Gestational diabetes resolved postpartum
- HIV-positive status (Correct answer)
- History of mastitis in a prior pregnancy
- Mild postpartum depression on SSRIs
Correct answer: HIV-positive status
In the US, HIV-positive mothers are advised not to breastfeed because HIV can be transmitted through breast milk.
Low Risk Neonatal Nurse Exam Low Risk Neonatal Nurse Exam Newborn Nutrition & Breastfeeding Support 1
Which is the most reliable indicator that a breastfeeding newborn is receiving adequate milk intake?