Chapter 27 Contemporary Maternal Newborn Nursing 7th Edition by Patricia W. Ladewig

Chapter 27 Contemporary Maternal Newborn Nursing 7th Edition by Patricia W. Ladewig

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

Chapter 27_LO01_Q01

The nurse is teaching an early-parenting class to families expecting their first child soon. A client asks the nurse if breast milk is really better than formula. The best response by the nurse is:

1. “Breast milk is the perfect food for human babies.
2. “Formula attempts to imitate the composition of breast milk.
3. “Breastfed babies grow faster because of breast milk.
4. “Formula is harder to digest than is breast milk.

Correct Answer: 2

Rationale:

1. Although this statement is true, it is somewhat vague because it does not describe the nutritional composition of breast milk. In addition, this response is emotionally laden, and judgmental of the use of formula, and therefore not therapeutic.
2. This statement best answers the question about whether breast milk or formula is best. Breast milk is the “gold standard” on which formula is based. Formula attempts to provide nutrition that is similar to breast milk; however, breast milk composition is different in many ways.
3. Although exclusively breastfed infants have the same or slightly higher weight gain than their formula-fed and mixed-fed peers in the first 3–4 months, the client’s question is not about growth, it is about whether breast milk or formula is better.
4. The client’s question is not about digestion of formula and breast milk, the question is about which is better. It is best to answer a client’s question directly.

Cognitive level: Application

Category of Client Need: Health Promotion and Maintenance

Nursing Process: Implementation

Learning Outcome: 27.1 Compare the nutritional values and compositions of breast milk and formula preparations in relation to the nutritional needs of the newborn.

Chapter 27_LO01_Q02

The nurse is teaching a prenatal class about feeding methods. A father-to-be asks the nurse which method, breast or formula, leads to the fastest infant growth and weight gain. Which response by the nurse is best? “In the first 3–4 months:

1. “Breastfed babies gain weight faster.”
2. “There is no difference in weight gain.”
3. “Bottle-fed babies grow faster.”
4. “Growth isn’t as important as your comfort with the method.”

Correct answer: 1

Rationale:

1. Once feeding is established, breastfed babies tend to gain weight faster than do bottle-fed babies, and have a leaner body at the end of the first year.
2. Breastfed babies have a leaner body at the end of the first year.
3. Breastfed babies tend to gain weight faster than do bottle-fed babies.
4. Although comfort with the feeding method is important, the question is specifically about growth and weight gain; it is not therapeutic to change the topic and not answer the question.

Cognitive Level: Implementation

Category of Client Need: Health Promotion and Maintenance

Nursing Process: Application

Learning Outcome: 27.1 Compare the nutritional values and compositions of breast milk and formula preparations in relation to the nutritional needs of the newborn.

Chapter 27_LO01_Q03

The community nurse is working with poor women who are formula-feeding their infants. Which statement indicates that the nurse’s education session was effective?

1. “I should only use soy-based formula for the first year.”
2. “I follow the instructions for mixing the powdered formula exactly.”
3. “I can reuse one bottle for several feedings.”
4. “The mixed formula can be left on the counter for a day.”

Correct answer: 2

Rationale:

1. Soy-based formulas are more expensive than whey-based formulas, and are only needed by infants with milk allergies. No information is provided about milk allergy symptoms. Powdered formula is the cheapest, followed by concentrated formula; ready-to-feed formula is the most expensive.
2. Powdered and concentrated formula must be mixed according to manufacturer’s guidelines. Formula that is too concentrated can lead to excess sodium intake, which creates increased thirst and overfeeding.
3. Each bottle should contain only enough formula for one feeding, and any formula left after the feeding should be discarded to prevent bacterial growth.
4. Once formula is mixed, it must be used within two hours or refrigerated.

Cognitive Level: Evaluation

Category of Client Need: Health Promotion and Maintenance

Nursing Process: Analysis

Learning Outcome: 27.1 Compare the nutritional values and compositions of breast milk and formula preparations in relation to the nutritional needs of the newborn.

Chapter 27_LO02 _Q04

Which statements by a breastfeeding class participant indicate that teaching was effective? Select all that apply.

1. “Breastfed infants get more skin-to-skin contact, and sleep better.”
2. “Breastfeeding raises the level of a hormone that makes me feel good.”
3. “Breastfeeding is complex and difficult, and I probably won’t succeed.”
4. “Breastfeeding is worthwhile, even if it costs more overall.”
5. “Breastfed infants have fewer digestive and respiratory illnesses.”

Correct Answers: 1, 2, 5

Rationale:

1. This is a true statement.
2. Every time an infant suckles, the prolactin level doubles; prolactin creates feelings of euphoria and relaxation.
3. Although there is skill involved in getting a baby to nurse successfully and coordinating the infant’s efforts with the maternal efforts, breastfeeding is not perceived as difficult by the majority of women who attempt to do so.
4. Breastfeeding actually costs substantially less than formula feeding, even considering the need for increased calcium and protein intake during lactation.
5. This is a true statement. Reduced infections are due to immunologic properties in breast milk, and to the fact that breastfed infants are not put to bed with a bottle, a practice known to increase ear infections.

Cognitive level: Analysis

Category of Client Need: Health Promotion and Maintenance

Nursing Process: Evaluation

Learning Outcome: 27.2 Explain the advantages and disadvantages of breastfeeding and formula-feeding in determining the nursing care of both mother and newborn.