Neonatal Nurse Practitioner Exam Nutrition, Fluids, and Metabolic Disorders 1

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

Stable premature neonates require 110-130 kcal/kg/day to achieve intrauterine growth rates of approximately 15-20 g/kg/day.

Question 2

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

Accepted Answer

Lactose

Answer

Lactose is the primary carbohydrate in human milk and most standard infant formulas, providing approximately 40% of total caloric intake.

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

Excess free water (hypotonic fluids) in premature neonates with high insensible losses creates dilutional hyponatremia; urine output reflects appropriate fluid response.

Question 4

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

Accepted Answer

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

Answer

NEC primarily affects premature infants with immature gut immunity, motility, and mucosal barrier function, with greatest risk in those <32 weeks or <1500g.

Question 5

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

Accepted Answer

Pneumatosis intestinalis (gas in the bowel wall)

Answer

Pneumatosis intestinalis—gas produced by bacteria within the bowel wall—is the pathognomonic radiologic sign of NEC.

Neonatal Nurse Practitioner Exam Practice Test

Neonatal Nurse Practitioner Exam Practice Test

Neonatal Nurse Practitioner Exam Nutrition, Fluids, and Metabolic Disorders 1