Neonatal Intensive Care Nurse Exam Neonatal Nutrition and Feeding 1 — Questions and Answers
Question 1: The preferred enteral nutrition for preterm infants in the NICU is:
- Human breast milk (mother's own milk or pasteurized donor milk) (Correct answer)
- Standard term infant formula
- Soy-based formula
- Glucose water initially for all preterm infants
Correct answer: Human breast milk (mother's own milk or pasteurized donor milk)
Human milk reduces NEC risk, improves immune function, and supports neurodevelopment; it is the gold standard for preterm nutrition.
Question 2: Necrotizing enterocolitis (NEC) is most commonly seen in:
- Preterm infants under 32 weeks gestation (Correct answer)
- Term infants only
- Infants exclusively receiving breast milk
- Post-term infants over 42 weeks
Correct answer: Preterm infants under 32 weeks gestation
NEC primarily affects preterm infants whose immature gut mucosa is susceptible to ischemia and bacterial overgrowth.
Question 3: Which sign is an early indicator of feeding intolerance in a tube-fed neonate?
- Increasing gastric residuals, abdominal distension, or emesis (Correct answer)
- Increased urine output
- Weight gain greater than 30 g/day
- Improving SpO2 after feedings
Correct answer: Increasing gastric residuals, abdominal distension, or emesis
Increasing gastric residuals, abdominal distension, and vomiting are early signs of feeding intolerance requiring reassessment of feeding plan.
Question 4: Kangaroo mother care (skin-to-skin) has been shown to:
- Improve breastfeeding rates, stabilize vital signs, and improve neurodevelopmental outcomes (Correct answer)
- Increase risk of hypothermia in preterm infants
- Reduce breast milk production
- Be contraindicated for infants on respiratory support
Correct answer: Improve breastfeeding rates, stabilize vital signs, and improve neurodevelopmental outcomes
Kangaroo care provides warmth, promotes bonding, increases milk production, and improves cardiovascular stability in NICU infants.
Question 5: Human milk fortifier (HMF) is added to breast milk for preterm infants because:
- Breast milk alone does not meet the elevated protein, calcium, and phosphorus needs of preterm infants (Correct answer)
- Breast milk contains too many calories for preterm infants
- Formula is not available in most NICUs
- HMF reduces NEC risk by adding probiotics
Correct answer: Breast milk alone does not meet the elevated protein, calcium, and phosphorus needs of preterm infants
Preterm infants have higher nutrient requirements for growth; HMF supplements protein, minerals, and vitamins to optimize preterm bone and growth outcomes.
Question 6: The sucking-swallowing-breathing coordination necessary for safe oral feeding typically matures at approximately:
- 33–35 weeks postmenstrual age (Correct answer)
- 24–28 weeks gestational age
- Term (40 weeks) and not before
- 6 weeks postnatal age regardless of gestation
Correct answer: 33–35 weeks postmenstrual age
Coordinated sucking, swallowing, and breathing for safe oral feeding develops between 33–35 weeks PMA in most preterm infants.
Neonatal Intensive Care Nurse Exam Neonatal Nutrition and Feeding 1
The preferred enteral nutrition for preterm infants in the NICU is: