A nurse is providing teaching to the parent of a newborn who has gastroesophageal reflux (GER). Which of the following instructions should the nurse include?
Dilute formula with 1 tablespoon of water.
Place the newborn in a side-lying position if vomiting.
Position the newborn at a 20-degree angle after feeding.
Provide a small feeding just before bedtime.
The Correct Answer is C
Choice A reason: Dilute formula with 1 tablespoon of water is not a correct instruction for GER. Diluting formula can reduce the nutritional value and increase the volume of the feedings, which can worsen GER symptoms and cause dehydration and malnutrition.
Choice B reason: Place the newborn in a side-lying position if vomiting is not a correct instruction for GER. This position can increase the risk of aspiration, which is the inhalation of vomit into the lungs. Aspiration can cause pneumonia, respiratory distress, and death.
Choice C reason: Position the newborn at a 20-degree angle after feeding is a correct instruction for GER. This position can help prevent reflux by using gravity to keep the stomach contents down. The newborn should be kept upright for at least 30 minutes after each feeding.
Choice D reason: Provide a small feeding just before bedtime is not a correct instruction for GER. This can increase the likelihood of reflux during sleep, as the stomach will be full and prone to regurgitation. The last feeding should be given at least 2 to 3 hours before bedtime.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Avocado dip is high in fat and calories, even though it is mostly unsaturated fat. It is not a good choice for a low-fat diet.
Choice B reason: Fish is a good source of protein and omega-3 fatty acids, which can lower blood cholesterol and triglycerides. The American Heart Association recommends eating at least two servings of fish per week, especially fatty fish like salmon, tuna, and mackerel.
Choice C reason: Margarine is made from vegetable oils and may contain trans fats, which can raise LDL (baD. cholesterol and lower HDL (gooD. cholesterol. It is better to use a small amount of butter or a non-fat spread on waffles.
Choice D reason: The skin on poultry is high in fat and cholesterol, and should be removed before cooking or eating. Broiling does not reduce the fat content of the skin.
Correct Answer is B
Explanation
Choice A reason: Telling the client to lie down after eating can increase the risk of aspiration pneumonia, as food or liquids can enter the lungs more easily when lying down.
Choice B reason: Instructing the client to tuck her chin when swallowing can help prevent aspiration pneumonia, as it closes off the airway and directs food or liquids into the esophagus.
Choice C reason: Placing the client in a Fowler's position to eat can help prevent aspiration pneumonia, as it elevates the head and chest and allows gravity to assist with swallowing.
Choice D reason: Encouraging the client to drink water before each meal can increase the risk of aspiration pneumonia, as it can thin out saliva and make it harder to control swallowing.
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