A nurse is planning care for multiple children on a pediatric unit who have gastroesophageal reflux. Which of the following children requires a revision to their plan of care?
A 14-year-old child who eats small but frequent meals throughout the day
A 16-year-old child who takes their proton pump inhibitor 30 min before meals
A 6-year-old child who underwent a Nissen fundoplication and is tolerating a full liquid diet
A 4-month-old child who is experiencing weight loss
The Correct Answer is D
A. A 14-year-old child who eats small but frequent meals throughout the day: This is an appropriate intervention for gastroesophageal reflux, as smaller, more frequent meals reduce gastric distention and minimize reflux episodes. No revision to the plan of care is needed for this child.
B. A 16-year-old child who takes their proton pump inhibitor 30 min before meals: Administering proton pump inhibitors before meals is correct because these medications are most effective when taken prior to food intake, allowing for optimal acid suppression. The current plan aligns with best practice.
C. A 6-year-old child who underwent a Nissen fundoplication and is tolerating a full liquid diet: Progressing to a full liquid diet after Nissen fundoplication is appropriate and indicates the child is tolerating postoperative dietary advancement. The plan of care is appropriate and requires no changes.
D. A 4-month-old child who is experiencing weight loss: Weight loss in an infant with gastroesophageal reflux is concerning and indicates inadequate nutrition or complications. The plan of care should be revised to address feeding adequacy, possible medical interventions, and close monitoring of growth and hydration status.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. "I can change my cat's litter box every day.": Clients with leukemia are immunocompromised and at increased risk for infections such as toxoplasmosis from cat feces. They should avoid changing litter boxes or use protective measures like gloves and masks, so this statement indicates a misunderstanding of infection prevention.
B. "I will avoid blowing my nose when I feel congested.": Avoiding forceful nose blowing helps prevent mucosal trauma and bleeding, which is important for clients with leukemia who may have thrombocytopenia or fragile mucous membranes. This statement demonstrates an understanding of precautions to reduce injury and infection risk.
C. "I can continue gardening in my yard.": Gardening exposes the client to soilborne pathogens and bacteria, increasing the risk of infection. Clients with leukemia should avoid activities that involve soil contact unless using strict protective measures, so this statement indicates a lack of understanding.
D. "I will clean my toothbrush with an alcohol-based mouthwash.": Cleaning a toothbrush with mouthwash is not sufficient to prevent microbial contamination. Clients with leukemia should use a soft-bristled toothbrush and replace it regularly to minimize infection risk. This statement reflects incomplete understanding of oral care precautions.
Correct Answer is A
Explanation
A. "You should increase your daily fluid intake.": Adequate hydration is important during early pregnancy to support maternal blood volume expansion, amniotic fluid production, and overall health. Increasing fluid intake can also help alleviate common symptoms such as constipation and mild nausea.
B. "Headaches are expected throughout pregnancy.": While mild headaches can occur, persistent or severe headaches are not considered normal and may indicate complications such as hypertension. Clients should be advised to report significant or recurrent headaches to their provider.
C. "You will feel your baby moving within the next month.": Fetal movement, or “quickening,” typically occurs between 16–20 weeks of gestation for primigravid clients, not at 9–10 weeks. Early reassurance should focus on expected developmental milestones for this stage.
D. "Hormone shifts often cause severe vomiting.": Mild nausea and vomiting are common in early pregnancy due to hormonal changes, but severe vomiting (hyperemesis gravidarum) is not expected and requires medical evaluation for hydration and nutritional management.
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