A nurse is teaching a class about providing care within the legal scope of practice to a group of nurses. The nurse should include that which of the following procedures is outside the legal scope of practice for an RN?

Choice A reason: Wearing a snug-fitting bra continuously for 72 hours supports breasts, reducing milk production and engorgement discomfort during lactation suppression. This non-pharmacological method is effective, critical for client comfort, preventing mastitis, and ensuring successful transition to bottle feeding in postpartum clients choosing not to breastfeed.

Choice B reason: Limiting fluid to 1 liter daily is unsafe and ineffective for lactation suppression; hydration doesn’t significantly affect milk production. This risks dehydration, potentially causing fatigue or urinary issues. Correct teaching avoids this, focusing on supportive measures like a snug bra, critical for safe postpartum care.

Choice C reason: Manually expressing milk stimulates production, counteracting lactation suppression, and risks prolonged engorgement or mastitis. A snug bra is appropriate. Advising expression misguides the client, delaying suppression, critical to avoid for ensuring comfort and successful cessation of lactation in bottle-feeding postpartum clients.

Choice D reason: Moist heat increases blood flow, stimulating milk production, not suppressing lactation; cold packs or snug bras are used instead. Recommending heat risks prolonged engorgement, causing discomfort or infection. Correct teaching avoids this, ensuring effective suppression, critical for postpartum comfort in non-breastfeeding clients.

Choice A reason: Lying down for 30 minutes after meals promotes acid reflux by allowing stomach contents to enter the esophagus, worsening GERD. Clients should remain upright for at least 2 hours post-meals to reduce reflux, making this an incorrect instruction for GERD management.

Choice B reason: Avoiding chocolate is critical for GERD management, as it relaxes the lower esophageal sphincter and delays gastric emptying, increasing acid reflux. This dietary modification reduces symptom frequency and severity, making it the correct instruction for effective GERD control.

Choice C reason: Mint-containing antacids can worsen GERD by relaxing the esophageal sphincter, increasing reflux. Plain antacids or proton pump inhibitors are preferred to neutralize acid or reduce production, making this an inappropriate recommendation for managing GERD symptoms.

Choice D reason: Increasing citrus fruit intake exacerbates GERD, as their acidity irritates the esophagus and stimulates acid production. Clients should avoid acidic foods to minimize reflux, making this an incorrect dietary instruction for effective GERD symptom management.