Neonatal Nurse Practitioner Exam Nutrition, Fluids, and Metabolic Disorders

Question 1

What is the recommended caloric intake to support adequate growth in a stable premature neonate?

Accepted Answer

110-130 kcal/kg/day

Answer

60-80 kcal/kg/day

Answer

80-100 kcal/kg/day

Answer

150-180 kcal/kg/day

Question 2

Which carbohydrate is the primary energy source in human breast milk and most neonatal formulas?

Accepted Answer

Lactose

Answer

Fructose

Answer

Maltodextrin

Answer

Sucrose

Question 3

A VLBW neonate has a serum sodium of 128 mEq/L on day 3 of life with urine output of 6 mL/kg/hr. What is the most likely cause?

Accepted Answer

Excessive free water administration (dilutional hyponatremia)

Answer

Syndrome of inappropriate ADH (SIADH)

Answer

Pseudohyponatremia from hyperglycemia

Answer

Salt-wasting nephropathy

Question 4

Necrotizing enterocolitis (NEC) is most common in which neonatal population?

Accepted Answer

Premature infants, especially those <32 weeks or <1500g

Answer

Term infants born by cesarean section

Answer

Post-term infants with meconium aspiration

Answer

Large for gestational age (LGA) infants

Question 5

Which finding on abdominal X-ray is pathognomonic for necrotizing enterocolitis?

Accepted Answer

Pneumatosis intestinalis (gas in the bowel wall)

Answer

Dilated bowel loops

Answer

Absence of bowel gas

Answer

Calcified meconium

Question 6

Total parenteral nutrition (TPN) in neonates typically starts with which amino acid concentration to promote anabolism?

Accepted Answer

3-4 g/kg/day starting on day 1

Answer

0.5 g/kg/day

Answer

1 g/kg/day increasing slowly

Answer

5 g/kg/day from birth