A nurse is providing teaching to the parent of a newborn who has gastroesophageal reflux. Which of the following instructions should the nurse include?
"Provide a small feeding just before bedtime."
"Place the newborn in a side-lying position if vomiting."
"Position the newborn at a 20-degree angle after feeding."
"Dilute formula with 1 tablespoon of water."
The Correct Answer is C
"Position the newborn at a 20-degree angle after feeding": This is the correct instruction. After feeding, it is beneficial to position the newborn at a slight angle, usually around 20 degrees, to help reduce gastroesophageal reflux. This position helps gravity keep the stomach contents down and prevents them from regurgitating back into the esophagus.
"Provide a small feeding just before bedtime": This instruction is not recommended for a newborn with gastroesophageal reflux. It is advisable to avoid feeding the baby just before bedtime as lying down can worsen the reflux symptoms. Instead, it is generally recommended to keep the baby upright for some time after feeding to allow for proper digestion and minimize reflux.
"Place the newborn in a side-lying position if vomiting": Placing the newborn in a side-lying position after vomiting is not recommended. This position does not provide adequate support to prevent choking or aspiration in case of vomiting. Instead, it is recommended to keep the newborn in an upright or slightly elevated position after feeding to minimize reflux.
"Dilute formula with 1 tablespoon of water": Diluting formula with water is not a recommended practice unless specifically advised by a healthcare provider. It is important to follow the instructions on the formula packaging or the healthcare provider's guidance regarding formula preparation to ensure appropriate nutrition and hydration for the newborn.

Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Iron deficiency can have various manifestations, but one of the significant effects is its impact on cognitive function. Iron is essential for the proper functioning of the brain and nervous system. In children, iron deficiency can lead to lowered intellectual performance, including difficulties with concentration, learning, memory, and problem-solving skills. It can also affect overall cognitive development and academic performance.
The other options listed are not typically associated with iron deficiency:
"Elevated temperature": Elevated temperature or fever is not a direct manifestation of iron deficiency. Fever is commonly associated with infections, inflammatory conditions, or other illnesses, but not specifically with iron deficiency.
"Decreased sleeping time": While iron deficiency can cause various symptoms, changes in sleep patterns, such as decreased sleeping time, are not a typical manifestation. Iron deficiency may cause fatigue and general weakness, which could potentially impact sleep quality and duration, but it is not directly associated with decreased sleeping time.
"Increased risk of infection": Iron deficiency can affect the immune system, making individuals more susceptible to infections. However, an increased risk of infection is a consequence of impaired immune function rather than a direct manifestation of iron deficiency itself.
Correct Answer is D
Explanation
Prealbumin (also known as transthyretin): Prealbumin is a protein synthesized in the liver and has a shorter half-life compared to albumin. It is considered a more sensitive marker for
short-term nutritional changes and can reflect the effectiveness of TPN within a few days.
Prealbumin levels can indicate the response to nutritional interventions and provide a more immediate assessment of nutritional adequacy.
Hemoglobin: Hemoglobin is a measure of the oxygen-carrying capacity of red blood cells and is typically used to assess anemia. While hemoglobin can be affected by nutritional status, it is not a specific marker for the short-term effectiveness of TPN.
Total albumin: Total albumin is a measure of protein status and can be affected by various factors, including inflammation and liver disease. However, it has a longer half-life and slower response to nutritional changes, so it may not be the best indicator for short-term effectiveness.
Transferrin: Transferrin is a protein involved in iron transport and can be used as an indicator of iron status. However, it may not reflect short-term changes in nutritional status and is not specific to TPN effectiveness.
Monitoring prealbumin levels can help determine the short-term effectiveness of TPN and guide adjustments to the nutritional plan.
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