A 6-month-old infant diagnosed with gastroesophageal reflux disease (GERD) presents with poor weight gain, frequent regurgitation, and occasional respiratory distress. The nurse must prioritize interventions to manage GERD effectively. Which nursing action is most appropriate to include in the care plan?

Instruct parents to feed the infant large volumes less frequently to reduce reflux episodes.

Advise parents to allow the infant to sleep on their stomach to reduce reflux symptoms during sleep.

Recommend thickening all infant feedings with cereals to improve satiety and reduce vomiting

Educate parents to position the infant at a 30-degree angle for 30 minutes after feeding and avoid propping bottles during feedings.

Answer and Explanation

The Correct Answer is D

A. Instruct parents to feed the infant large volumes less frequently is incorrect because large feedings increase gastric distention and can worsen reflux. Small, frequent feedings are preferred.

B. Advise parents to allow the infant to sleep on their stomach is incorrect because placing infants on their stomach increases the risk of sudden infant death syndrome (SIDS) and is not recommended. Infants should be placed on their back for sleep.

C. Recommend thickening all infant feedings with cereals is partially correct for some infants, but thickening should be guided by a healthcare provider, as it is not appropriate for all infants and can pose risks if done incorrectly.

D. Educate parents to position the infant at a 30-degree angle for 30 minutes after feeding and avoid propping bottles during feedings is correct because upright positioning after feedings uses gravity to reduce reflux and prevents aspiration. Avoiding bottle propping reduces the risk of choking, overfeeding, and increased reflux episodes.

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Free Nursing Study Resources

Correct Answer is ["October 17th"]

Explanation

Naegele’s rule is the standard method for estimating a due date. The formula is:

LMP + 1 year – 3 months + 7 days = Estimated Due Date (EDD)

Step-by-step calculation:

Start with the LMP: January 10th
Add 1 year: January 10th → January 10th of the following year
Subtract 3 months: January 10th → October 10th
Add 7 days: October 10th + 7 days = October 17th

Therefore, the estimated due date is October 17th.

A. "You should be encouraged to eat more of these items to satisfy cravings. B. "This is a normal behavior during pregnancy and does not require intervention." C. This behavior, called PICA, may lead to nutritional deficiencies and should be assessed." D. "PICA only occurs in the first trimester and will resolve on its own."

Correct Answer is C

Explanation

A. "You should be encouraged to eat more of these items to satisfy cravings." is incorrect because consuming non-food items like ice, clay, or dirt can be harmful. These substances may contain toxins or pathogens and can interfere with nutrient absorption. Encouraging this behavior would be unsafe.

B. "This is a normal behavior during pregnancy and does not require intervention." is incorrect because while cravings are common in pregnancy, PICA is an abnormal eating behavior involving non-food items and requires assessment and intervention due to potential health risks.

C. "This behavior, called PICA, may lead to nutritional deficiencies and should be assessed." is correct. PICA is the recurrent consumption of non-nutritive substances and is often associated with iron deficiency anemia and other nutritional deficiencies. The nurse should assess for nutritional status, laboratory abnormalities, and educate the client on potential risks to both mother and fetus.

D. "PICA only occurs in the first trimester and will resolve on its own." is incorrect because PICA can occur at any time during pregnancy and may persist throughout gestation if untreated. It does not resolve spontaneously in all cases.

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Naxlex Comprehensive Predictor Exams

A patient who is pregnant asks the nurse for her due date. The patient's last menstrual period began on January 10th. What is the patient's due date based on Naegele's rule?

Correct Answer is ["October 17th"]

Explanation

A 22-year-old pregnant woman reports craving and eating non-food items such as ice, clay, and dirt. Which of the following statements by the nurse is correct?

Correct Answer is C

Explanation

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