NSNE 7200 Final Exam UPDATED ACTUAL
QUESTIONS AND CORRECT ANSWERS
Health challenges that affect PREMATURE infants - CORRECT ANSWER - F&E
imbalance
- RDS
- hyperoxia
- poor suck & swallow reflex
- BPD
- PDA
- NEC
- AOP
- IVH
- PVL
- pneumonia
Health challenges that affect TERM/POST-TERM infants - CORRECT ANSWER -
intrapartum asphyxia
- MAS
- PPHN
- HIE
Lactogenesis vs. Galactopoeisis - CORRECT ANSWER lactogensis = initiation of
milk production triggered by drop in estrogen, lactogen, progesterone which allows prolactin
levels to rise
Galactopoeisis = ongoing milk production
What affects galactopoeisis? - CORRECT ANSWER - sensory stimulation, i.e., infant
suckling
,- breast emptying
- supply & demand
- milk-ejection reflex
Common health challenges that increase vulnerability associated with early discharge of
TERM infants - CORRECT ANSWER - difficulty with BF
- jaundice
- dehydration
CCHD screening (3 points) - CORRECT ANSWER - pulse ox measurement of R hand
+ either foot
- O2 sats must be above 95% and difference b/w hand & foot should be 3% or less
- infant immediately fails if O2 sats <90% or after 3 tries
Whey in breast milk - CORRECT ANSWER - smooth & easily digestible
- higher in content in early lactation (90%)
Casein in breast milk - CORRECT ANSWER - less digestible; requires more enr to
breakdown
- enhances absorption of iron to prevent iron-dependent bacteria from proliferating in GI
Important factors in milk transfer (3 points) - CORRECT ANSWER - compression
- suction
- tongue action
Feeding cues (3 points) - CORRECT ANSWER - bringing hands to mouth
- rooting
- mouthing & sucking motions
,Preparing for a feed (3 points) - CORRECT ANSWER - help mom get into a
comfortable position with back, head, and arms supported
- position baby belly-to-belly, STS
- prop baby up so body is aligned with breasts
- infant's head & body aligned
Basic BF positions (3 points) - CORRECT ANSWER - cradle
- side-lying
- football
Promoting good latch when breasts are large & soft (4 points) - CORRECT
ANSWER - support breast by using C-hold
- wait until baby's mouth is wide-open; jaw to be as far back as possible
- lead latch with chin
- draw baby firmly towards breast with nipple centred b/w tongue & baby's upper lip; bodies
close
Signs of good latch (6 points) - CORRECT ANSWER - tugging sensation on nipple
(not pain)
- mouth wide open
- lips flanged outward
- tongue cupped beneath breast
- tip of nose & chin are touching breast
- cheeks are rounded (not sucked in or dimpled)
Signs of good suck (6 points) - CORRECT ANSWER - begins with quick sucking to
stimulate let down, then becomes deep & rhythmical
- regular audible swallowing
- observable "wiggle" at junction of ear & temple
- no audible smacking or clicking
, - BF is comfortable for mom
- baby ends feed on own
How often & long to BF? (4 points) - CORRECT ANSWER - feed as often & as long
as baby wants
- q2-3h during day, q3-4 during night
- at least 8x in 24h
- feeds apprx 20-30 min
Signs that baby is getting enough milk (3 points) - CORRECT ANSWER - looks
content after feeds
- feeding at least 8x in 24h + at least 15-20 min per breast
- 6-8 wet diapers + 3 stools q24h by day 4
Nature of milk relating to frequency & duration of feeds (4 points) - CORRECT
ANSWER - always exist in a state of change
- fat content changes from feed-to-feed
- the longer the feed & the effectiveness of milk removal = the higher the fat content
- longer interval b/w feeds = lower fat concentration for next feed
Supporting the BF experience (8 points) - CORRECT ANSWER - aware of factors that
influence feeding choices
- ongoing education, esp. During antenatal period - feeding cues, positioning, good latch
- providing support for common BF challenges = unpreparedness, lack of confidence
- encourage frequent feedings & assure cluster feeding is normal - not a sign of inadequate
milk supply
- provide family with support resources
- provide positive feedback
- promote fully-informed infant feeding decisions
- involve partners
QUESTIONS AND CORRECT ANSWERS
Health challenges that affect PREMATURE infants - CORRECT ANSWER - F&E
imbalance
- RDS
- hyperoxia
- poor suck & swallow reflex
- BPD
- PDA
- NEC
- AOP
- IVH
- PVL
- pneumonia
Health challenges that affect TERM/POST-TERM infants - CORRECT ANSWER -
intrapartum asphyxia
- MAS
- PPHN
- HIE
Lactogenesis vs. Galactopoeisis - CORRECT ANSWER lactogensis = initiation of
milk production triggered by drop in estrogen, lactogen, progesterone which allows prolactin
levels to rise
Galactopoeisis = ongoing milk production
What affects galactopoeisis? - CORRECT ANSWER - sensory stimulation, i.e., infant
suckling
,- breast emptying
- supply & demand
- milk-ejection reflex
Common health challenges that increase vulnerability associated with early discharge of
TERM infants - CORRECT ANSWER - difficulty with BF
- jaundice
- dehydration
CCHD screening (3 points) - CORRECT ANSWER - pulse ox measurement of R hand
+ either foot
- O2 sats must be above 95% and difference b/w hand & foot should be 3% or less
- infant immediately fails if O2 sats <90% or after 3 tries
Whey in breast milk - CORRECT ANSWER - smooth & easily digestible
- higher in content in early lactation (90%)
Casein in breast milk - CORRECT ANSWER - less digestible; requires more enr to
breakdown
- enhances absorption of iron to prevent iron-dependent bacteria from proliferating in GI
Important factors in milk transfer (3 points) - CORRECT ANSWER - compression
- suction
- tongue action
Feeding cues (3 points) - CORRECT ANSWER - bringing hands to mouth
- rooting
- mouthing & sucking motions
,Preparing for a feed (3 points) - CORRECT ANSWER - help mom get into a
comfortable position with back, head, and arms supported
- position baby belly-to-belly, STS
- prop baby up so body is aligned with breasts
- infant's head & body aligned
Basic BF positions (3 points) - CORRECT ANSWER - cradle
- side-lying
- football
Promoting good latch when breasts are large & soft (4 points) - CORRECT
ANSWER - support breast by using C-hold
- wait until baby's mouth is wide-open; jaw to be as far back as possible
- lead latch with chin
- draw baby firmly towards breast with nipple centred b/w tongue & baby's upper lip; bodies
close
Signs of good latch (6 points) - CORRECT ANSWER - tugging sensation on nipple
(not pain)
- mouth wide open
- lips flanged outward
- tongue cupped beneath breast
- tip of nose & chin are touching breast
- cheeks are rounded (not sucked in or dimpled)
Signs of good suck (6 points) - CORRECT ANSWER - begins with quick sucking to
stimulate let down, then becomes deep & rhythmical
- regular audible swallowing
- observable "wiggle" at junction of ear & temple
- no audible smacking or clicking
, - BF is comfortable for mom
- baby ends feed on own
How often & long to BF? (4 points) - CORRECT ANSWER - feed as often & as long
as baby wants
- q2-3h during day, q3-4 during night
- at least 8x in 24h
- feeds apprx 20-30 min
Signs that baby is getting enough milk (3 points) - CORRECT ANSWER - looks
content after feeds
- feeding at least 8x in 24h + at least 15-20 min per breast
- 6-8 wet diapers + 3 stools q24h by day 4
Nature of milk relating to frequency & duration of feeds (4 points) - CORRECT
ANSWER - always exist in a state of change
- fat content changes from feed-to-feed
- the longer the feed & the effectiveness of milk removal = the higher the fat content
- longer interval b/w feeds = lower fat concentration for next feed
Supporting the BF experience (8 points) - CORRECT ANSWER - aware of factors that
influence feeding choices
- ongoing education, esp. During antenatal period - feeding cues, positioning, good latch
- providing support for common BF challenges = unpreparedness, lack of confidence
- encourage frequent feedings & assure cluster feeding is normal - not a sign of inadequate
milk supply
- provide family with support resources
- provide positive feedback
- promote fully-informed infant feeding decisions
- involve partners
