RNC-NIC Questions Ch 8-10 General Assessment and Management Questions with correct answers
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Course
RNC
Institution
RNC
Which of the following substrates is the most influential to achieve optimal weight gain for the premature infant?
A. Carbohydrate
B. Fat
C. Protein
D. Sodium Correct Answer-C. Proteins are the driving source for weight gain in the premature infant as the major functional and structural compone...
RNC-NIC Questions Ch 8-10 General Assessment and
Management Questions with correct answers
Which of the following substrates is the most influential to achieve
optimal weight gain for the premature infant?
A. Carbohydrate
B. Fat
C. Protein
D. Sodium Correct Answer-C. Proteins are the driving source for weight
gain in the premature infant as the major functional and structural
components of all human cells. Carbohydrates have been used to
augment energy nutrition; however, their benefits do not appear to be
independent of protein supply. Additionally, if carbohydrates exceed
desirable amounts, glucose polymers can lead to hyperosmolality in the
gut lumen., resulting in diarrhea. Fat provides the major source for
energy of growing preterm infants; however, the nutritional value of
human milk fat may vary with time and does not always provide a
complete source of nutrients for premature infants. Sodium is an
important electrolyte for cell metabolism, but is not as imperative to
growth as protein.
The proteins whey and casein exist in a ratio of 80 (whey) to 20 (casein)
in which of the following?
A. Mature breast milk
B. Colostrum
C. Cow milk-based formula
D. Soy-based formula Correct Answer-B. Colostrum whey:casein ratio
is 80:20. Mature breast milk whey:casein ration is 55:45. Cow milk-
,based formula whey:casein ratio is 60:40. Soy-based infant formula does
not contain whey and casein proteins.
The nurse should anticipate the tapering of parenteral amino acid intake
in the extremely low-birth-weight infant when enteral nutrition reaches
how many milliliters per kilogram per day?
A. 20
B. 40
C. 75
D. 140 Correct Answer-C. A minimum of 75 mL/kg/day of enteral
nutrition should be achieved before parenteral amino acids are tapered in
the ELBW and VLBW infants. Protein malnutrition can easily develop
in this patient population during the transition from parenteral to enteral
nutrition. Enteral intake of 20mL/kg/day involves hypocaloric low-
volume feeds and does not supply enough enteral protein to warrant
parenteral amino acid tapering. A significant part of the enteral protein
intake does not reach the systemic circulation and is not immediately
available for the growth of other tissues. Enteral intake of 40 mL/kg/day,
although greater in volume than trophic feeds, still does not supply
enough enteral protein to warrant parenteral amino acid tapering. Enteral
intake of 140 mL/kg/day is approaching a full enteral feeding volume,
and the infant will most likely not require parenteral nutrition.
In extremely premature infants, initial enteral feedings of colostrum will
result in which of the following?
A. Delay induction of many digestive enzymes
B. Prohibit the endocytosis of proteins
C. Deliver low concentrations of secretory IgA
,D. Facilitate rapid growth of the intestinal mucosal surface Correct
Answer-D. Colostrum contains growth factors, and initial enteral
feedings of colostrum in the premature infant stimulates rapid growth in
the intestinal mucosa surface area and propagation of many digestive
enzymes. It also promotes endocytosis of proteins and delivers high
concentrations of secretory IgA.
The predominant disaccharide in human milk is:
A. sucrose.
B. lactose.
C. fructose.
D. glucose. Correct Answer-B. Lactose is the main disaccharide in
human milk and is hydrolyzed into glucose and galactose in the small
intestine by the enzyme lactase. Sucrose is a disaccharide and is
hydrolyzed into glucose and fructose in the small intestine. Fructose is a
monosaccharide that is predominately found in plants. Glucose is a
monosaccharide that is predominately found in food as a building block
in complex carbohydrates.
The nursing plan of care for the growing preterm infant includes
approximately how many calories per kilogram per day to sustain
adequate energy intake?
A. 40
B. 80
C. 120
D. 150 Correct Answer-C. The average energy intake for preterm infants
to support weight gain is 105-130 kcal/kg/day. 40-80 kcal/kg/day are
, both lower energy intakes and may not be adequate to support basal
metabolism and net protein/fat balance. 150 kcal/kg/day is a higher
energy intake and can result in greater fat accumulations and does not
enhance neurologic development or achieve proper growth and body
composition in comparison to their normal fetal equivalents.
Carbohydrates should supply what percent of an infant's total caloric
intake?
A. 7-16
B. 25-35
C. 40-50
D. 80-90 Correct Answer-C. Carbohydrates are the principal source of
energy for the brain and heart and should supply 40%-50% of an infant's
total caloric intake. Values less than the recommended amount may
result in hypoglycemia. Values higher than the recommended amount
may lead to diarrhea and are associated with high-energy diets.
Increasing evidence suggests that high-energy diets in the neonatal
period have the potential to result in rapid adipose gains and may
contribute to obesity, insulin resistance, and type 2 diabetes later in life.
The nurse should explain to the parents that their premature infant needs
to gain approximately how may grams per day to achieve adequate
growth?
A. 5
B. 15
C. 80
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