RNC-NIC Nutrition Management 5

Question 1

An infant with galactosemia is identified on newborn screening. Which immediate dietary change is required?

Accepted Answer

Eliminate all galactose by using a soy-based or elemental formula

Answer

Galactosemia requires complete elimination of galactose (found in lactose in breast milk and standard formulas); soy-based formulas are galactose-free and are the standard treatment.

Question 2

A VLBW infant on full enteral feeds is noted to have low serum zinc levels. Which clinical finding is consistent with zinc deficiency?

Accepted Answer

Perioral and perianal dermatitis with poor wound healing

Answer

Zinc deficiency classically presents with acrodermatitis enteropathica-like findings including perioral, perianal, and acral dermatitis along with poor wound healing and growth failure.

Question 3

What is the most appropriate caloric density to initiate when concentrating formula for a cardiac neonate with fluid restriction?

Accepted Answer

24 kcal/oz

Answer

24 kcal/oz is the typical starting point for concentrated formula in fluid-restricted cardiac neonates, with further increases based on tolerance and growth.

Question 4

A nurse is reviewing a preterm infant's growth chart. Which parameter best reflects chronic nutritional status over weeks rather than days?

Accepted Answer

Head circumference growth velocity

Answer

Head circumference growth velocity is a reliable indicator of chronic nutritional adequacy and brain growth over weeks, as it reflects sustained protein and energy status.

Question 5

During kangaroo mother care, a 29-week infant begins rooting and showing feeding cues at the breast. What is the safest initial feeding approach?

Accepted Answer

Offer non-nutritive sucking at the breast only, then supplement by tube

Answer

Non-nutritive sucking at the breast promotes oral motor development and milk supply, with gavage supplementation ensuring adequate intake until the infant can coordinate suck-swallow-breathe.

(RNC-NIC) Registered Nurse Certified in Neonatal Intensive Care Practice Test

(RNC-NIC) Registered Nurse Certified in Neonatal Intensive Care Practice Test

RNC-NIC Nutrition Management 5