Cover the newborn’s eyes with a mask or shield.This is because phototherapy can cause eye damage and the mask or shield protects the newborn’s eyes from the light.

Some additional explanations are:

• Choice A is wrong because increasing fluid intake by 25% to prevent dehydration is not necessary for a newborn receiving phototherapy.The newborn should be fed on demand or according to a regular schedule and monitored for signs of dehydration such as poor skin turgor, dry mucous membranes, sunken fontanels, and decreased urine output.

• Choice C is wrong because applying lotion or oil to the newborn’s skin to prevent drying is not recommended for a newborn receiving phototherapy.Lotion or oil can increase the absorption of light and cause skin burns.

• Choice D is wrong because turning off the phototherapy lights during feedings is not advised for a newborn receiving phototherapy.The lights should be on continuously to maximize the effectiveness of the treatment and reduce the duration of exposure.

Hold the newborn in a semi-upright position during feeding.This prevents the formula from flowing back into the baby’s ears and causing infections.It also helps the baby swallow less air and reduces the risk of choking.

Choice A is wrong because warming the formula in a microwave oven can create hot spots that can burn the baby’s mouth.The formula should be warmed by running it under warm tap water or placing it in a bowl of warm water.

Choice B is wrong because discarding any unused formula after 2 hours at room temperature is too long.Bacteria can grow rapidly in warm milk that is left sitting out and unused.The formula should be discarded after one hour at room temperature or within 24 hours if refrigerated.

Choice D is wrong because burping the newborn after finishing each ounce of formula is not necessary.Burping can interrupt the feeding and make the baby lose interest in finishing the bottle.The baby should be burped only when they show signs of discomfort or after finishing the feeding.

Normal ranges for formula intake vary depending on the baby’s age, weight and appetite.In general, newborn babies need around 150 to 200 ml per kilo of their weight a day until they’re 6 months old.The baby should be fed when they show signs of hunger, such as rooting, sucking or crying, and not forced to finish the bottle if they are full.

Hemoglobin level of 11 g/dL.This is within the normal range for a newborn, which is 13.4-19.9 g/dL for the first month.

Hemoglobin is the oxygen-carrying protein in red blood cells.

Choice B is wrong because serum calcium level of 8 mg/dL is below the normal range for a newborn, which is 8.5-10.6 mg/dL for the first month.

Calcium is important for bone health and muscle function.

Choice C is wrong because serum bilirubin level of 15 mg/dL is above the normal range for a newborn, which is less than 12 mg/dL for the first week.

Bilirubin is a waste product from the breakdown of red blood cells.

High levels can cause jaundice, a yellowing of the skin and eyes.

Choice D is wrong because serum sodium level of 130 mEq/L is below the normal range for a newborn, which is 135-145 mEq/L.

Sodium is an electrolyte that helps regulate fluid balance and nerve impulses.

Eat small, frequent meals throughout the day.This will help prevent dumping syndrome, which is a condition that occurs when food moves too fast from the stomach to the duodenum, causing symptoms such as abdominal cramps, diarrhea, nausea, vomiting, flushing, dizziness and rapid heart rate.Eating small, frequent meals will reduce the amount of food that enters the small intestine at once and slow down gastric emptying.

Choice B is wrong because drinking fluids with meals rather than between meals will increase the volume of food that enters the small intestine and worsen dumping syndrome symptoms.Fluids should be consumed at least 30 minutes after a meal.

Choice C is wrong because increasing intake of simple carbohydrates such as fruit juice will cause a rapid rise and fall of blood sugar levels, leading to late dumping syndrome symptoms such as sweating, hunger, low blood sugar, fatigue, dizziness and weakness.Simple carbohydrates should be avoided and replaced with complex carbohydrates such as whole grains, fruits and vegetables.

Choice D is wrong because avoiding foods that are high in fat and protein will not help prevent dumping syndrome.In fact, fat and protein can slow down gastric emptying and stabilize blood sugar levels.A moderate amount of fat and protein should be included in each meal.However, too much fat at one time can have the opposite effect and trigger dumping syndrome symptoms.

Grilled cheese sandwich with tomato soup.This food choice indicates an understanding of the teaching because it is low in purines, which are chemicals that break down into uric acid and can trigger gout attacks.

Some additional information for the response are:

• Choice A.Liver and onions with mashed potatoes is wrong because liver is an organ meat that is high in purines and should be avoided by people with gout.

• Choice C.Roast beef with green beans and rice is wrong because roast beef is a red meat that is high in purines and should be limited by people with gout.

• Choice D.Sardines on whole wheat crackers with cheese is wrong because sardines are a type of oily fish that is high in purines and should be avoided by people with gout.

• A low-purine diet for gout management should include fruits, vegetables, whole grains, legumes, nuts, and low-fat dairy products.It should also limit sugar, alcohol, and meat consumption.

The nurse should assess for proper latch-on technique and encourage skin-to-skin contact between mother and infant.

These actions promote successful breastfeeding and bonding.

Choice C is wrong because limiting feeding time to 10 min per breast can interfere with the infant’s intake of hindmilk, which is rich in fat and calories.The infant should be allowed to nurse until satisfied, which may take longer than 10 min per breast.

Choice D is wrong because instructing the client to offer both breasts at each feeding can lead to nipple soreness and engorgement.The client should offer one breast until it is emptied, then switch to the other breast if the infant is still hungry.

Choice E is wrong because advising the client to feed the infant every 2 to 3 hr can disrupt the infant’s natural feeding cues and rhythms.The client should feed the infant on demand, which may be more or less frequent than every 2 to 3 hr.

I will drink at least eight glasses of water every day.This statement indicates that the client understands the importance of hydration for breast milk production and the prevention of constipation.

Some possible explanations for the other choices are:

• Choice A is wrong because iron supplements are not necessary for breastfeeding mothers unless they have anemia.Iron supplements can also cause constipation and stomach upset in some women.

• Choice C is wrong because dairy products are not harmful for breastfeeding mothers or their infants, unless there is a history of allergy or intolerance.Dairy products can provide calcium, protein and vitamin D for the mother and the infant.

• Choice D is wrong because infants should not be given any solid foods before 6 months of age, according to the American Academy of Pediatrics.Introducing solids too early can interfere with breastfeeding, increase the risk of allergies and infections, and cause choking or aspiration.

90 mL.According to the CDC, babies who are only getting infant formula and no breast milk need about2.5 ounces (75 mL) of formula per pound of body weight each day.

A newborn who weighs 3 kg (6 lb 10 oz) would need about15 ounces (450 mL) of formula per day, divided into 8 to 12 feedings.

This means that at each feeding, the newborn would consume about90 mLof formula.

Choice A is wrong because30 mLis too little for a newborn who weighs 3 kg.

This would only provide about10 ounces (300 mL) of formula per day, which is not enough for adequate growth and development.

Choice B is wrong because60 mLis also too little for a newborn who weighs 3 kg.

This would only provide about20 ounces (600 mL) of formula per day, which is still below the recommended amount.

Choice D is wrong because120 mLis too much for a newborn who weighs 3 kg.This would provide about40 ounces (1200 mL) of formula per day, which is more than the maximum amount of32 ouncesthat most babies need before they start solids.

Overfeeding can cause problems such as spitting up, gas, and obesity.

Breasts are soft without engorgement or leakage.This indicates that lactation suppression has been successful and the woman is not experiencing any discomfort or risk of infection from milk accumulation.

Breasts are firm with mild tenderness or leakage is wrong because it suggests that lactation is still occurring and the woman may need to express some milk for comfort or use other non-pharmacological methods to suppress it.

Breasts are hard with moderate pain or leakage is wrong because it indicates that the woman is suffering from breast engorgement, which can lead to mastitis if not treated.The woman may need pharmacological intervention to suppress lactation and relieve pain.

Breasts are swollen with severe pain or leakage is wrong because it shows that the woman has developed mastitis, which is a bacterial infection of the breast tissue that requires antibiotics and analgesics.The woman may also need to drain the infected breast by expressing milk or using a pump.

Normal ranges for lactation suppression vary depending on the individual and the method used.Generally, lactation suppression can take from a few days to a few weeks.

Breasts are soft without engorgement or leakage.This indicates that lactation suppression has been successful and the woman is not experiencing any discomfort or risk of infection from milk accumulation.

Breasts are firm with mild tenderness or leakage is wrong because it suggests that lactation is still occurring and the woman may need to express some milk for comfort or use other non-pharmacological methods to suppress it.

Breasts are hard with moderate pain or leakage is wrong because it indicates that the woman is suffering from breast engorgement, which can lead to mastitis if not treated.The woman may need pharmacological intervention to suppress lactation and relieve pain.

Breasts are swollen with severe pain or leakage is wrong because it shows that the woman has developed mastitis, which is a bacterial infection of the breast tissue that requires antibiotics and analgesics.The woman may also need to drain the infected breast by expressing milk or using a pump.

Normal ranges for lactation suppression vary depending on the individual and the method used.Generally, lactation suppression can take from a few days to a few weeks.

Iron is essential for brain development.Iron helps red blood cells carry oxygen through the body and supports a child’s ability to learn.Iron deficiency can cause anemia, which is when there are not enough red blood cells in the body or the child’s ability to carry oxygen throughout the body is lowered.

Choice B is wrong because iron does not prevent constipation in infants.In fact, iron-fortified formula may cause constipation in some infants.

Choice C is wrong because iron does not enhance immune system function.Iron is important for hemoglobin production, but it does not directly affect the immune system.

Choice D is wrong because iron does not improve skin color and tone.Iron deficiency can cause pale skin, but iron supplementation does not change the natural color or tone of the skin.

Breast milk does not contain enough vitamin D for bone health.Vitamin D is needed to support healthy bone development and to prevent rickets, a condition that causes weak or deformed bones.Breast milk alone does not provide infants with an adequate amount of vitamin D.The Dietary Guidelines for Americans and American Academy of Pediatrics recommend breastfed and partially breastfed infants be supplemented with 400 IU per day of vitamin D beginning in the first few days of life.

Choice B is wrong because breast milk does not interfere with vitamin D absorption from sunlight.However, reducing sun exposure is important for preventing skin cancer, and other factors such as clothing, air pollution, and skin type can also decrease the amount of vitamin D a person can make from sunlight.

Choice C is wrong because breast milk does not increase vitamin D excretion in urine.

Vitamin D is a fat-soluble vitamin that is stored in the body and not easily lost in urine.

Choice D is wrong because breast milk does not inhibit vitamin D synthesis in the liver.Vitamin D is synthesized in the skin from exposure to sunlight, and then activated in the liver and kidneys to its active form.

Breast milk does not affect this process.

Use an oral syringe to squirt the medication into the side of the mouth.

This is because an oral syringe allows the nurse to measure the exact dose of the medication and deliver it slowly and safely into the infant’s mouth, avoiding choking or aspiration.

The other choices are wrong for the following reasons:

• Choice A) Mixing the medication with formula in a bottle can alter the taste and effectiveness of the medication, and also make it difficult to ensure that the infant receives the full dose.

• Choice C) Placing the medication on a pacifier can cause the infant to spit out the pacifier or the medication, and also increase the risk of infection from contaminated pacifiers.

• Choice D) Dipping a cotton swab in the medication and rubbing it on the gums can irritate the oral mucosa and cause pain or bleeding, and also waste some of the medication on the swab.

Meat is a good source of zinc for infants who are six months old and exclusively breastfed.Zinc is a mineral that is important for immune function, wound healing, and the senses of smell and taste.Children 7 to 24 months need 3 mg of zinc each day.

Choice B is wrong because yogurt is not a good source of zinc for infants.Yogurt is a dairy product that contains some zinc, but not as much as meat.

Choice C is wrong because broccoli is not a good source of zinc for infants.Broccoli is a vegetable that contains very little zinc.

Choice D is wrong because mango is not a good source of zinc for infants.Mango is a fruit that contains almost no zinc.

“I will give my baby soft finger foods that he can pick up and eat by himself.” This statement indicates an understanding of the teaching because it shows that the mother knows how to provide appropriate complementary foods for her infant who is eight months old.Complementary feeding, also known as weaning, mixed feeding or introduction of solid foods, should begin for infants by six months of age (26 weeks) but not before 17 weeks.Breast milk or infant formula should continue during the complementary feeding period with amounts gradually reduced as the variety of foods increases.WHO and UNICEF recommend that infants start receiving complementary foods at 6 months of age in addition to breast milk.Initially, they should receive complementary foods 2–3 times a day between 6–8 months and increase to 3–4 times daily between 9–11 months and 12–24 months of age.Complementary foods should be nutritionally adequate, safe, and properly fed.

Choice A is wrong because pureed foods are not suitable for an eight-month-old infant who can handle more textured foods.

Pureed foods are recommended for infants who are just starting complementary feeding at around six

Honey should be limited or avoided to prevent dental caries in infants.

Honey is a type of sugar that can feed the bacteria that cause cavities, especially if it is left on the teeth for a long time.Honey can also contain spores of a bacterium that can cause botulism, a serious illness, in infants.

Choice B is wrong because cheese is not a risk factor for dental caries in infants.Cheese can actually help prevent cavities by stimulating saliva production and neutralizing acids in the mouth.

Choice C is wrong because avocado is not a risk factor for dental caries in infants.Avocado is a healthy fat that does not contain sugars that can feed cavity-causing bacteria.

Choice D is wrong because green leafy vegetables are not a risk factor for dental caries in infants.Green leafy vegetables are rich in vitamins and minerals that can support oral health and general health.

Breastfeeding provides optimal nutrition and immunological protection for infants.This is because breastmilk contains all the energy and nutrients that the infant needs for the first six months of life, and it also contains antibodies that help protect against many common childhood illnesses.

Choice A is wrong because breastfeeding reduces the risk of infections, allergies, and chronic diseases in infants and children, but this is not the only benefit of breastfeeding.Breastfeeding also has benefits for mothers, such as reducing the risk of breast and ovarian cancers.

Choice B is wrong because breastfeeding enhances maternal-infant bonding and attachment, but this is not the only benefit of breastfeeding.Breastfeeding also has benefits for the environment, such as reducing waste and greenhouse gas emissions.

Choice C is wrong because breastfeeding helps mothers lose weight and prevent postpartum hemorrhage, but this is not the only benefit of breastfeeding.Breastfeeding also has benefits for society, such as reducing health care costs and improving productivity.

The nurse should suggest all of these strategies to help the mother maintain her milk supply when she returns to work or school.

Choice A is correct because pumping or expressing milk at least every 3 to 4 hours during work or school hours stimulates the production of prolactin, the hormone that regulates milk synthesis.

Choice B is correct because storing milk in clean glass or plastic containers with tight-fitting lids in a refrigerator or freezer preserves the quality and safety of the milk.

Choice C is correct because labeling milk containers with the date and time of expression and using them in order of oldest to newest ensures that the milk is used before it spoils.

Choice D is correct because it includes all of the above strategies.

All of these conditions would warrant a referral to specialized care for severe diseases or complications related to nutrition and feeding.

Choice A is wrong because phenylketonuria (PKU) in the infant is a genetic disorder that causes an amino acid called phenylalanine to build up in the body.This can lead to intellectual disability, seizures, and other neurological problems if not treated with a special diet that limits phenylalanine.

Choice B is wrong because gestational diabetes mellitus (GDM) in the mother is a condition where the mother has high blood sugar levels during pregnancy.This can increase the risk of complications for both the mother and the baby, such as preeclampsia, macrosomia, birth injuries, and neonatal hypoglycemia.

Choice C is wrong because cleft lip or palate in the infant is a birth defect where the upper lip or roof of the mouth does not form properly.This can affect the infant’s ability to feed, speak, and breathe, and may require surgery and other interventions.

Growth and development evaluation should be done annually until adulthood, plotted on appropriate growth charts and compared with expected norms for age and sex, and used to identify any deviations from normal or expected patterns of growth and development.

Choice A is wrong because growth and development evaluation should not be done only annually, but also at specific ages recommended by the American Academy of Pediatrics (AAP), such as 9 months, 18 months, 24 months, and 30 months.

Choice B is wrong because growth and development evaluation should not only be plotted on appropriate growth charts and compared with expected norms for age and sex, but also include developmental milestones in playing, learning, speaking, behaving, and moving.

Choice C is wrong because growth and development evaluation should not only be used to identify any deviations from normal or expected patterns of growth and development, but also to monitor the child’s progress and provide early intervention if needed.

Runs with a wide stance.This indicates normal gross motor development for an 18-month-old toddler.Gross motor skills are the abilities to use large muscles for movements such as walking, running, jumping, and climbing.

Choice A is wrong because walking up and down stairs with assistance is a skill that most toddlers can do by 24 months.

Choice C is wrong because kicking a ball forward without falling is a skill that most toddlers can do by 24 months.

Choice D is wrong because jumping in place with both feet is a skill that most toddlers can do by 30 months.

The child has frequent temper tantrums.This is because temper tantrums are not a normal part of a 3-year-old child’s development and can indicate emotional or behavioral problems.According to the height and weight chart for children, a 3-year-old child should be able to do the following:

• Speak in three-word sentences

• Copy a circle with a crayon

• Ride a tricycle using pedals

Therefore, choices A, B and C are wrong because they are expected developmental milestones for a 3-year-old child.

A nurse should collect data from the child and the parents to determine the cause and frequency of the temper tantrums and provide appropriate interventions and referrals.

Breastfeeding reduces the risk of infection by providing IgA antibodies and other immune factors.These antibodies help the baby fight off viruses and bacteria by forming a protective layer in the baby’s nose, throat, and digestive system.Breastfeeding also lowers the baby’s risk of sudden infant death syndrome (SIDS), obesity, and cardiovascular disease in adulthood.

Choice B is wrong because breastfeeding does not promote rapid brain growth due to large amounts of protein and fat.Breast milk contains the right amount of nutrients for the baby’s needs, but it does not have more protein and fat than formula.

Choice C is wrong because breastfeeding does not require iron supplementation for the newborn after 3 months of age.Breast milk has enough iron for the baby’s first 6 months of life, and after that solid foods can provide additional iron.

Choice D is wrong because breastfeeding is recommended exclusively for the first 6 months of age by the American Academy of Pediatrics, not 4 months.After 6 months, breastfeeding can continue along with solid foods until at least 1 year or longer.

Pale yellow or clear urine indicates adequate hydration in a newborn.

The other choices are wrong because:

• Choice A: Weight loss of 8% in the first week is excessive and may indicate dehydration or inadequate feeding.

• Choice B: Urine output of 1 to 2 mL/kg/hr is too low for a newborn.The normal range is 2 to 5 mL/kg/hr.

• Choice C: Sunken fontanels and dry mucous membranes are signs of dehydration and should be reported to the provider.

Normal ranges for urine output vary by age.For a newborn, the normal range is 2 to 5 mL/kg/hr.

For a toddler, it is 1.5 mL/kg/hr, and for an older child

Feed the newborn when he shows signs of hunger, such as rooting or sucking.This is the best way to ensure that the newborn gets enough breast milk and that the mother’s milk supply is maintained.Breastfeeding on demand also helps prevent engorgement and mastitis.

Choice A is wrong because feeding the newborn every 4 to 5 hours during the day and night is too infrequent and may lead to insufficient weight gain, dehydration, jaundice, and low milk supply.Breastfed newborns should be fed at least every 2 to 3 hours or 8 to 12 times in 24 hours.

Choice B is wrong because feeding the newborn on one breast for 10 minutes and then switching to the other breast may not allow the newborn to get enough of the hindmilk, which is richer in fat and calories than the foremilk.The newborn should be allowed to nurse on one breast until it is emptied or until the baby releases it, and then offered the other breast.

Choice D is wrong because feeding the newborn 4 to 5 ounces of breast milk per feeding is too much for a newborn’s stomach capacity and may cause overfeeding, spitting up, or colic.

360 to 504 mL.This is because the fluid intake for a healthy newborn is about120 to 168 mL/kg/day.

Since the newborn weighs 3 kg, the fluid intake per day is 3 x 120 to 3 x 168 mL, which equals 360 to 504 mL.

Choice A is wrong because 300 to 420 mL is too low for a 3 kg newborn.

Choice B is wrong because 330 to 462 mL is also too low for a 3 kg newborn.

Choice D is wrong because 390 to 546 mL is too high for a 3 kg newborn.

Normal ranges for fluid intake vary depending on the age and weight of the infant.For example, infants 0–6 months of age need about700 mLof fluid per day, assumed to be from milk.Infants 7–12 months of age need about800 mLof fluid per day from milk and complementary foods and beverages.Children 1–3 years of age need about1300 mLof fluid per day.

Vitamin B12.The mother should provide vitamin B12 supplements to her newborn because vitamin B12 is only found in animal products and is essential for the development of the nervous system and the production of red blood cells.A deficiency of vitamin B12 can cause anemia, weakness, fatigue, and neurological problems.

Choice A is wrong because vitamin D can be obtained from sunlight exposure, fortified foods, or supplements.

The mother and the newborn should get enough vitamin D from these sources.

Choice C is wrong because vitamin C is abundant in plant foods, such as fruits and vegetables.

The mother and the newborn should get enough vitamin C from their diet.

Choice D is wrong because vitamin K is produced by bacteria in the gut and is also found in green leafy vegetables.

The mother and the newborn should get enough vitamin K from these sources.However, all newborns are given a vitamin K injection at birth to prevent bleeding disorders.

Breastfeeding will make my baby smarter and more attached to me.

This statement indicates a need for further teaching because it is not based on scientific evidence and may create unrealistic expectations for the mother and the baby.Breastfeeding does not directly affect the baby’s intelligence or attachment, although it may provide some benefits for cognitive development and bonding.

Choice A is wrong because breastfeeding will help the uterus contract and reduce bleeding.This is a benefit of breastfeeding that helps the mother recover from childbirth and prevent postpartum hemorrhage.

Choice B is wrong because breastfeeding will lower the risk of breast and ovarian cancer.This is another benefit of breastfeeding that reduces the mother’s exposure to estrogen and other hormones that may promote cancer growth.

Choice C is wrong because breastfeeding will protect the baby from infections and allergies.This is a benefit of breastfeeding that provides the baby with antibodies and other immune factors that help fight off diseases and reduce the risk of allergies.

Encourage the mother to continue feeding as usual.This is because the newborn’s nose, cheeks, and chin touching the mother’s breast during feeding indicates a good latch and positioning.A good latch and positioning help the baby to get enough milk and prevent nipple soreness for the mother.

Choice A is wrong because repositioning the newborn to avoid suffocation is not necessary.The newborn’s nose should not be squashed against the mother’s breast, but it should be clear and able to breathe.

Choice C is wrong because instructing the mother to burp the newborn frequently is not related to the newborn’s latch and positioning.Burping the newborn may help to release air that they swallow during feeding, but it does not affect how well they feed.

Choice D is wrong because suggesting the mother to switch to another position is not helpful.The mother may use different positions to breastfeed, but the most important thing is that the baby is well attached and comfortable.If the mother and baby are happy with their current position, there is no need to change it.

Praise the client for choosing a suitable position for breastfeeding.The football hold is a common and comfortable breastfeeding position that allows the mother to support the baby’s head and help with latching.It is especially good for mothers who had a cesarean section, have large breasts, or are breastfeeding twins.

Choice B is wrong because there is no need to change to a cradle hold position if the mother and baby are comfortable with the football hold.

Different positions may work better for different mothers and babies.

Choice C is wrong because the mother does not need to support her breast with her hand during feeding.

This may interfere with the baby’s latch and cause nipple soreness.

Choice D is wrong because asking the client if she is experiencing pain or discomfort in her incision may imply that she is doing something wrong by holding her baby in that position.

It may also make the mother feel anxious or guilty about her pain.

The nurse should assess the incision site regularly and provide pain relief as needed, but not question the mother’s choice of breastfeeding position.

The correct answer is choice A, C, D, and E. Here is why:

• Choice A is correct because colostrum is thick, yellowish, and high in protein, vitamins, minerals, immune cells, and immunoglobulins.Immunoglobulins are antibodies that provide passive immunity to the newborn.

• Choice B is wrong because it describes the characteristics of mature milk, not colostrum.Mature milk is thin, whiter, and higher in fat, carbohydrates, lactose, water, vitamins, immunoglobulins, and growth factors.

• Choice C is correct because colostrum protects the infant’s gastrointestinal tract from infections and helps establish normal flora.Normal flora are beneficial bacteria that aid in digestion and immunity.

• Choice D is correct because colostrum has a laxative effect that helps clear meconium and prevent jaundice.Meconium is the first stool of the newborn, which contains waste products from the fetal life.Jaundice is a yellowing of the skin and eyes caused by excess bilirubin, a breakdown product of red blood cells.

• Choice E is correct because colostrum meets all the nutritional needs of the newborn during the first few days of life.Colostrum is rich in calories and nutrients and provides adequate hydration to the newborn.

The correct answer is choice A, B and E.These foods are good sources of protein, calcium, iron, folate, vitamin B12, vitamin D, iodine, selenium, zinc, omega-3 fatty acids, and antioxidants that are essential for milk production and quality.

Choice C is wrong because coffee, tea, soda, energy drinks, chocolate, and alcohol are not nutritious foods and can have negative effects on the mother and the baby.They can cause dehydration, irritability, insomnia, poor weight gain, and fetal alcohol syndrome.

Choice D is wrong because whole grains, fruits, vegetables, vegetable oils, and herbs are not sufficient to provide all the nutrients needed by the mother and the baby.They are good sources of carbohydrates, fiber, vitamin C, vitamin E, and phytochemicals, but they lack protein, calcium, iron, folate, vitamin B12, vitamin D, iodine, selenium, and zinc.

The normal ranges for these nutrients are:

• Protein: 71 g/day for lactating women

• Calcium: 1000 mg/day for lactating women

• Iron: 9 mg/day for lactating women

• Folate: 500 mcg/day for lactating women

• Vitamin B12: 2.8 mcg/day for lactating women

• Vitamin D: 15 mcg/day for lactating women

• Iodine: 290 mcg/day for lactating women

• Selenium: 70 mcg/day for lactating women

• Zinc: 12 mg/day for lactating women

• Omega-3 fatty acids: 1.3 g/day for lactating women

• Antioxidants: no specific recommendation but fruits and vegetables are good sources

Shake the bottle well to dissolve any clumps.

This is because clumps of powder can clog the nipple and make it hard for the baby to drink.Clumps can also cause inaccurate measurements of formula and water, which can affect the baby’s nutrition and hydration.

Choice A is wrong because tap water may contain harmful bacteria or contaminants that can cause infections or illnesses in the baby.Tap water should be boiled first and then cooled to kill any germs before mixing with powdered formula.

Choice B is wrong because one scoop of powder should be mixed with one ounce of water, not two.

Mixing too much water with the powder can dilute the formula and make it less nutritious for the baby.Mixing too little water can make the formula too concentrated and cause dehydration or kidney problems in the baby.

Choice D is wrong because leftover formula should not be stored at room temperature for more than one hour.

Bacteria can grow quickly in warm formula and make the baby sick.Leftover formula should be discarded or refrigerated immediately and used within 24 hours.

It may increase the risk of developing peanut allergy later in life.According to a study published in the Journal of Allergy and Clinical Immunology, infants who were fed soy-based formula had a higher risk of developing peanut allergy than those who were fed cow’s milk formula or breast milk.

This may be because soy and peanut are both legumes and share some common proteins that can trigger allergic reactions.

Choice A is wrong because soy-based formula may causelessgas and bloating than cow’s milk formula, since it does not contain lactose, which some babies have trouble digesting.

Choice C is wrong because soy-based formula provides adequate iron and calcium for the infant’s growth, as well as other nutrients such as protein, fat, carbohydrates, vitamins and minerals.Soy-based formula is also fortified with iron to prevent iron deficiency anemia.

Choice D is wrong because soy-based formula does not interfere with thyroid function and hormone synthesis in healthy infants.However, infants with congenital hypothyroidism who are taking thyroid medication may need to adjust their dosage if they are fed soy-based formula, since soy can affect the absorption of the medication.

Therefore, these infants should be monitored closely by their doctor.

Dental caries, also known as tooth decay or cavities, are a possible complication of ready-to-use infant formula.This type of formula is a liquid breast milk substitute that does not need to be mixed with water and is sterile and safe for babies.However, it may contain more sugar than powdered or concentrated formula and can cause tooth decay if the baby’s teeth are exposed to it for long periods of time.For example, if the baby falls asleep with a bottle of ready-to-use formula in his or her mouth, the sugar can pool around the teeth and erode the enamel.To prevent dental caries, the baby should not be put to bed with a bottle of formula and should have his or her teeth cleaned regularly with a soft cloth or a baby toothbrush.

Choice A is wrong because poor weight gain is not a complication of ready-to-use infant formula.This type of formula provides adequate nutrition and calories for normal growth and development of infants.Poor weight gain may be caused by other factors, such as illness, feeding difficulties, or inadequate intake.

Choice C is wrong because iron deficiency anemia is not a complication of ready-to-use infant formula.This type of formula is fortified with iron and can prevent or treat iron deficiency anemia in infants who are not breastfed or are partially breastfed.

Iron deficiency anemia may be caused by other factors, such as blood loss, infection, or low iron intake from complementary foods.

Choice D is wrong because constipation is not a complication of ready-to-use infant formula.This type of formula has a similar composition and consistency to powdered or concentrated formula and does not cause constipation in infants.

Constipation may be caused by other factors, such as dehydration, low fiber intake, or medication.

The nurse should advise the mother to stop feeding her baby with diluted formula and switch to undiluted formula or breast milk.This is because diluted formula does not provide enough calories and nutrients for the infant and may worsen the dehydration by increasing the osmotic load in the gut.Undiluted formula or breast milk can help maintain the infant’s nutrition and hydration status while also providing some protection against infection.

Choice A is wrong because diluted formula is not recommended for infants with diarrhea and dehydration, and oral rehydration solution (ORS) should be given in addition to, not instead of, breast milk or formula.

Choice B is wrong because oral rehydration solution alone is not sufficient to meet the infant’s nutritional needs and may lead to weight loss and malnutrition.ORS should be used to correct fluid and electrolyte losses, but not as the sole source of hydration.

Choice C is wrong because adding sugar and salt to diluted formula is dangerous and can cause serious complications such as hypernatremia, hyponatremia, hyperglycemia, or cerebral edema.ORS has a specific concentration of sugar and electrolytes that has been shown to increase the absorption of fluid and electrolytes in the gut.

Vitamins, minerals, and carbohydrates.Most powdered infant formulas are made from modified cow’s milk or soy protein that contain added nutrients such as proteins, fats, carbohydrates, vitamins, and minerals.Carbohydrates are usually from lactose, glucose, or corn syrup, and they supply calories and sweetness.Vitamins and minerals are added to meet the nutritional requirements of infants.

Choice A is wrong because antibodies, enzymes, and growth factors are not added to powdered infant formulas.These are components of breast milk that help protect the baby from infections and support digestion and development.

Choice C is wrong because hormones, probiotics, and antioxidants are not added to powdered infant formulas.Hormones are not needed for infant nutrition and may have adverse effects.Probiotics are beneficial bacteria that may help with gut health, but they are not required for infant formulas.Antioxidants are substances that protect cells from damage, but they are not added to infant formulas.

Choice D is wrong because fats, amino acids, and fiber are not added to powdered infant formulas.

Fats are usually from vegetable oils, and they provide energy and fatty acids

The mother should feed her baby when he shows early signs of hunger, such as sucking on his fingers, rooting, bringing his hand to his mouth, or opening and closing his mouth.

These are feeding cues that indicate the baby is ready to feed and will latch on well.

Choice B is wrong because sucking on fingers is an early sign of hunger and not a sign of needing further teaching.

Choice C is wrong because turning his head toward the breast is an early sign of hunger and not a sign of needing further teaching.

Choice D is wrong because opening and closing his mouth is an early sign of hunger and not a sign of needing further teaching.

Choice A is the only statement that indicates a need for further teaching because crying is a late sign of hunger and not an ideal time to feed the baby.

Crying can make it harder for the baby to latch on and feed effectively.The mother should try to feed her baby before he starts to cry by looking for the early signs of hunger

Satiety cue.

A satiety cue is a sign that the infant is full and satisfied after feeding.Pushing away the bottle and falling asleep are examples of satiety cues.

Hunger cue is wrong because hunger cues are signs that the infant is hungry and wants to feed.Hunger cues include rooting, sucking, crying, and bringing hands to mouth.

Distress cue is wrong because distress cues are signs that the infant is upset or uncomfortable and needs soothing.Distress cues include arching back, turning away, grimacing, and fussing.

Discomfort cue is wrong because discomfort cues are signs that the infant is experiencing pain or physical discomfort and needs relief.Discomfort cues include squirming, flailing, grunting, and crying.

The normal range of formula intake for a 2-month-old infant is about 4 to 5 ounces per feeding, every 3 to 4 hours.

However, this may vary depending on the infant’s weight, growth rate, and individual needs.

The nurse should assess the infant’s growth and development, as well as the caregiver’s feeding practices and concerns.

Newborns should be fed about 15 to 20 minutes per breast or 2 to 3 ounces per bottle.This is because breast milk or formula provides the optimal nutrition for newborns and they need about 110 kcal/kg/day for the first 3 months.

Choice A is wrong because newborns do not need to be fed every 2 to 3 hours during the day and night.They should be fed on cue, which means responding to their signs of hunger, such as sucking on fists, lip smacking, or fussing.

Feeding on cue can help establish a good milk supply and prevent overfeeding or underfeeding.

Choice C is wrong because newborns should not be fed on a strict schedule rather than on cue.Feeding on a schedule can interfere with the natural regulation of hunger and satiety cues and can lead to feeding problems later on.

Feeding on cue can also promote bonding and attachment between the parent and the newborn.

Choice D is wrong because newborns should be fed at least 6

Normal for the infant’s age and weight.According to the CDC, breastfed babies may feed as often as every 1 to 3 hours in the first days, and then about every 2 to 4 hours on average by 4 months of age.

The number of feedings may vary depending on the baby’s needs and cues.Breastfeeding six times a day and sleeping through the night is within the normal range for a 4-month-old infant who is breastfed.

Choice B is wrong because the infant’s growth rate and needs are not solely determined by the frequency of breastfeeding, but also by the amount of milk intake, weight gain, and diaper output.If the infant is gaining weight, seems content, and has several wet and dirty diapers a day, then he or she is likely getting enough breast milk.

Choice C is wrong because there is no evidence that the infant is overfed or overweight.Breastfed babies are less likely to overeat than formula-fed babies, as they can regulate their own milk intake according to their hunger and satiety signals.

The infant’s weight should be monitored by a pediatrician and compared to a growth chart for breastfed babies.

Choice D is wrong because there is no standard or regular feeding pattern for breastfed babies.Breastfeeding on demand, or following the baby’s cues, is recommended by the CDCand other health organizations.

The infant’s feeding pattern may change over time as he or she grows and starts eating solid foods.

The mother should not worry about the irregularity of the feeding pattern as long as the infant is healthy and thriving.

Feed every 2 hours and take 60 mL (2 oz) per feeding.This is because newborns need about 150 to 200 mL of formula per kilo of their weight a day until they’re 6 months old.

A newborn who weighs 3 kg would need about 450 to 600 mL of formula a day.

Dividing this by 24 hours, the newborn would need about 19 to 25 mL of formula per hour.

Feeding every 2 hours would provide about 38 to 50 mL of formula per feeding, which is close to the recommended amount of 60 mL (2 oz).

Choice A is wrong because feeding every 4 hours and taking 90 mL (3 oz) per feeding would provide too much formula at once and not enough throughout the day.

The newborn would get about 540 mL of formula a day, which is on the lower end of the recommended range, but would also risk overfeeding and spitting up.

Choice C is wrong because feeding every 3 hours and taking 75 mL (2.5 oz) per feeding would also provide too much formula at once and not enough throughout the day.

The newborn would get about 600 mL of formula a day, which is on the higher end of the recommended range, but would also risk overfeeding and spitting up.

Choice D is wrong because feeding every hour and taking 30 mL (1 oz) per feeding would provide too little formula at once and too much throughout

The woman’s pre-pregnancy BMI is a factor that the nurse should consider when evaluating the adequacy of the woman’s weight gain.

BMI is a measure of body fat calculated from weight and height.The amount of weight a woman should gain during pregnancy depends on her BMI before pregnancy.For example, a woman with a normal BMI (18.5-24.9) should gain 25-35 pounds, while a woman with an obese BMI (30 or more) should gain 11-20 pounds.

Choice B is wrong because the woman’s age and parity are not factors that affect the recommended weight gain during pregnancy.The weight gain recommendations are the same for all women regardless of their age or how many children they have had.

Choice C is wrong because the woman’s food preferences and cravings are not factors that determine the adequacy of the woman’s weight gain.Food preferences and cravings may influence what and how much a woman eats, but they do not change the amount of weight she should gain for a healthy pregnancy.

Choice D is wrong because the woman’s activity level and lifestyle are not factors that affect the recommended weight gain during pregnancy.Activity level and lifestyle may influence how a woman gains weight, but they do not change the amount of weight she should gain for a healthy pregnancy.Physical activity and healthy eating habits are important for all pregnant women to maintain their health and well-being.

“I should push my baby’s chin down if he doesn’t latch on properly.” This statement indicates a need for further teaching because pushing the baby’s chin down can cause pain and damage to the nipple and interfere with the baby’s ability to suckle effectively.The mother should wait for the baby to open his mouth wide before bringing him to her breast and then gently guide his lower jaw onto the breast.

Choice A is correct because holding the baby close to the body with his nose opposite the nipple helps him to latch on well and stimulates the rooting reflex.

Choice B is correct because supporting the breast with a C-shape below the areola prevents the fingers from compressing the milk ducts and allows the baby to grasp more of the breast tissue.

Choice C is correct because waiting for the baby to open his mouth wide ensures that he takes a large mouthful of breast tissue and forms a good seal around the nipple and areola.

Normal ranges for breastfeeding frequency and duration are 8-12 times in 24 hours and 15-20 minutes on each side.

Applying lanolin cream or hydrogel pads to the nipples after each feeding can help soothe and heal sore nipples that are cracked and bleeding.Lanolin cream is safe for the baby and does not need to be washed off before feeding.Hydrogel pads can also provide cooling relief and create a moist wound healing environment.

Choice B is wrong because washing the nipples with soap and water before and after each feeding can dry out and irritate the skin, making the problem worse.The nipples do not need to be washed more than once a day with plain water.

Choice C is wrong because switching to formula feeding until the nipples heal completely can interfere with the establishment of breastfeeding and reduce the milk supply.Formula feeding can also increase the risk of infections and allergies for the baby.Breastfeeding should be continued as much as possible, even with sore nipples, as long as the baby is latched on correctly.

Choice D is wrong because using a nipple shield or a breast pump for every feeding can also affect the milk supply and the baby’s ability to breastfeed effectively.Nipple shields and breast pumps should only be used temporarily and under the guidance of a lactation consultant.They do not address the underlying cause of sore nipples, which is usually a poor latch.

Sucking on his fingers or fists.This is a feeding readiness cue that indicates that the infant is hungry and ready to eat.

Some possible explanations for the other choices are:

• Choice A is wrong because turning his head away from the breast or bottle is a sign of satiety or fullness, not hunger.

• Choice C is wrong because falling asleep or becoming drowsy is a sign of fatigue or satisfaction, not hunger.

• Choice D is wrong because spitting up or burping is a sign of air swallowing or overfeeding, not hunger.

Normal ranges for infant feeding frequency and duration vary depending on the type of feeding (breastfeeding or formula feeding), the age and weight of the infant, and the individual needs and preferences of the infant and the mother.

However, some general guidelines are:

• Breastfed infants should feed 8 to 12 times in 24 hours, with each feeding lasting 10 to 15 minutes per breast.

• Formula-fed infants should feed 6 to 10 times in 24 hours, with each feeding lasting 15 to 20 minutes and providing about 2 to 3 ounces of formula per pound of body weight per day.

Iron-fortified infant cereal.According to the World Health Organization (WHO), infants should start receiving complementary foods at 6 months of age in addition to breast milk.Iron-fortified infant cereal is a good source of iron, which is essential for the development of the infant’s brain and blood cells.

Choice A is wrong because cow’s milk or juice are not recommended as the first complementary foods for infants.Cow’s milk can cause iron deficiency anemia and allergic reactions, and juice can cause dental caries and diarrhea.

Choice B is wrong because pureed fruits or vegetables are not enough to meet the infant’s iron needs.Fruits and vegetables are rich in vitamins and minerals, but they do not provide enough iron for the growing infant.

Choice D is wrong because yogurt or cheese are not suitable as the first complementary foods for infants.Yogurt or cheese can cause allergic reactions and lactose intolerance, and they do not provide enough iron for the infant.

BMI increased by 5% since last visit.

BMI is a measure of body fat based on height and weight.A 5% increase in BMI since the last visit indicates excessive weight gain or growth failure, which should be reported to the provider.

Choice A is wrong because head circumference increased by 2 cm since last visit is normal for a 6-month-old infant.The head circumference should increase by 1.5 cm per month for the first 6 months.

Choice B is wrong because weight increased by 50% since birth is normal for a 6-month-old infant.The weight should double by 5 months and triple by 12 months.

Choice C is wrong because length increased by 25% since birth is normal for a 6-month-old infant.The length should increase by 50% by 12 months.

These are the developmental milestones that a 9-month-old infant should be able to perform according to the Denver II Developmental Screening Test.

Some explanations for each choice are:

• Choice A is correct because a 9-month-old infant should be able to pull up to a standing position by holding on to furniture or other objects.

• Choice B is correct because a 9-month-old infant should be able to say “mama” and “dada” nonspecifically, meaning they do not associate the words with specific people yet.

• Choice C is correct because a 9-month-old infant should be able to use a pincer grasp to pick up small objects, such as cereal or raisins, with the thumb and index finger.

• Choice D is wrong because a 9-month-old infant should not be able to point to objects or pictures when named.This skill usually develops around 12 months of age.

• Choice E is correct because a 9-month-old infant should be able to crawl on hands and knees, although some infants may use other methods of locomotion, such as scooting or rolling.

Classify objects by size, shape, and color.A 4-year-old child should be able to recognize and name a few colors, starting with primary colors of red, yellow and blue.He should also be able to sort objects according to various characteristics, such as color, shape and size.

Choice B is wrong because the concept of conservation of matter is not understood by 4-year-olds.

This is the ability to recognize that the quantity of a substance remains the same even if its shape or appearance changes.

For example, a 4-year-old might think that a ball of clay has more clay than a flattened piece of clay.This concept is usually developed around 7 to 8 years of age.

Choice C is wrong because abstract reasoning is not a cognitive skill that 4-year-olds can perform.

Abstract reasoning is the ability to think beyond the concrete and literal, and use symbols, logic, and imagination to solve problems.

For example, a 4-year-old might not understand what a metaphor or a joke means.

This skill is usually developed around 11 to 12 years of age.

All of the above.

This statement indicates that the parents understand the nutrition needs of a 2-year-old toddler.

Choice A is correct because a 2-year-old should eat three healthy meals a day, plus one or two snacks.

Choice B is correct because a 2-year-old should limit milk intake to 16 oz per day to avoid displacing other foods and nutrients.A 2-year-old can drink lower-fat dairy products, such as 2% or 1% milk, unless advised otherwise by a doctor.

Choice C is correct because a 2-year-old should avoid foods that are potential choking hazards, such as nuts, seeds, popcorn, hard candy, grapes, hot dogs, and raw carrots.A 2-year-old can eat the same food as the rest of the family, but may prefer finger foods instead of soft ones.

Turner syndrome is a genetic disorder in which a female is partially or completely missing an X chromosome.This can cause various physical and developmental problems, such as a webbed neck, low position of posterior hairline, shield-shaped chest with wide space between the nipples, short stature and delayed puberty.

Choice D is wrong because Turner syndrome does not cause tall stature.In fact, most girls and women with Turner syndrome are shorter than average.