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.

Answer and Explanation

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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Correct Answer is C

Explanation

Choice A reason: 1 cup green grapes has about 15 mg of calcium, which is low compared to other foods. Green grapes are also a good source of vitamin C, potassium, and antioxidants.

Choice B reason: One medium banana has about 6 mg of calcium, which is very low compared to other foods. Banana is also a good source of potassium, fiber, and vitamin B6.

Choice C reason: 1 cup broccoli has about 180 mg of calcium, which is high compared to other foods. Broccoli is also a good source of vitamin C, folate, and antioxidants.

Choice D reason: One large tomato has about 18 mg of calcium, which is low compared to other foods. Tomato is also a good source of vitamin C, lycopene, and potassium.

A. Hot dog cut in fourths B. Cooked spaghetti with sauce C. Steak cut into small pieces D. Caramel popcorn

Correct Answer is B

Explanation

Choice A reason: Hot dog cut in fourths is not an appropriate food choice for toddlers because it is still a choking hazard. Hot dogs are cylindrical and firm, which can block the airway of a child. Hot dogs should be avoided or cut into thin slices and small pieces before offering to toddlers.

Choice B reason: Cooked spaghetti with sauce is an appropriate food choice for toddlers because it is soft, easy to chew, and provides carbohydrates, protein, and vitamins. Cooked spaghetti can be cut into short strands and mixed with sauce to make it more appealing and moist for toddlers.

Choice C reason: Steak cut into small pieces is not an appropriate food choice for toddlers because it is tough, dry, and hard to chew. Steak can cause choking or difficulty swallowing for toddlers who have not developed their molars and chewing skills. Steak should be avoided or minced and moistened before offering to toddlers.

Choice D reason: Caramel popcorn is not an appropriate food choice for toddlers because it is sticky, sweet, and hard. Caramel popcorn can stick to the teeth and gums, causing dental caries and gum infections. Popcorn can also cause choking or aspiration for toddlers who have not mastered their swallowing reflex. Popcorn should be avoided until the child is at least 4 years old.

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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?

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