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: 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.
Correct Answer is C
Explanation
Choice A reason: 1/2 cup cooked broccoli contains about 2.6 grams of fiber, which is moderate compared to other foods. Broccoli is also a good source of vitamin C, folate, and antioxidants.
Choice B reason: 1 slice whole wheat bread contains about 2 grams of fiber, which is low compared to other foods. Whole wheat bread is also a good source of carbohydrates, B vitamins, and magnesium.
Choice C reason: 1 medium apple with peel contains about 4.4 grams of fiber, which is high compared to other foods. Apple is also a good source of vitamin C, potassium, and phytochemicals.
Choice D reason: 1/2 cup corn flakes with skim milk contains about 0.5 grams of fiber, which is very low compared to other foods. Corn flakes are also high in sugar and low in nutrients, while skim milk is a good source of protein and calcium.
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