A nurse is providing teaching to the parent of a newborn who has gastroesophageal reflux. Which of the following instructions should the nurse include?
Position the newborn at a 20-degree angle after feeding.
Dilute formula with 1 tablespoon of water.
Place the newborn in a side-lying position if vomiting.
Provide a small feeding just before bedtime.
The Correct Answer is A
Choice A reason: Positioning the newborn at a 20-degree angle after feeding can help prevent the reflux of gastric contents into the esophagus. This position allows gravity to keep the food in the stomach and reduces the pressure on the lower esophageal sphincter. The nurse should instruct the parent to keep the newborn in this position for at least 30 minutes after each feeding.
Choice B reason: Diluting formula with 1 tablespoon of water is not recommended, as it can cause water intoxication, electrolyte imbalance, and malnutrition in the newborn. Water intoxication can lead to seizures, coma, and death. The nurse should advise the parent to follow the manufacturer's instructions for preparing the formula and not to add extra water.
Choice C reason: Placing the newborn in a side-lying position if vomiting is not a safe practice, as it can increase the risk of aspiration and sudden infant death syndrome (SIDS). Aspiration is when food or liquid enters the lungs and causes pneumonia or respiratory distress. SIDS is when a healthy baby dies suddenly and unexpectedly during sleep. The nurse should instruct the parent to place the newborn on the back for sleeping and to avoid soft bedding, pillows, and stuffed animals.
Choice D reason: Providing a small feeding just before bedtime is not a good idea, as it can worsen the gastroesophageal reflux and disrupt the newborn's sleep. The nurse should suggest the parent to feed the newborn smaller and more frequent meals throughout the day and to avoid feeding the newborn within 2 to 3 hours of bedtime.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice D reason: Tuna is a good source of iodine, which is a mineral that is essential for the production of thyroid hormones. A goiter is an enlargement of the thyroid gland that can be caused by iodine deficiency. Eating more iodine-rich foods, such as tuna, can help prevent or treat a goiter.
Choice A reason: Red meat is not a good source of iodine, and it can also be high in saturated fat and cholesterol, which can increase the risk of heart disease and other health problems. Eating more red meat is not advisable for a client who has a goiter.
Choice B reason: Blueberries are not a good source of iodine, and they have no direct effect on the thyroid gland or a goiter. Blueberries are rich in antioxidants and other nutrients, but they are not a specific food choice for a client who has a goiter.
Choice C reason: Bananas are not a good source of iodine, and they have no direct effect on the thyroid gland or a goiter. Bananas are a good source of potassium and fiber, but they are not a specific food choice for a client who has a goiter.
Correct Answer is B
Explanation
Choice A reason: Flossing dentures is not necessary, as dentures do not have spaces between the teeth where plaque and food particles can accumulate. Flossing dentures may damage the denture material or cause it to loosen.
Choice B reason: Dentures should be cleaned with a soft material to prevent scratches or damage. A washcloth is gentle enough to clean the denture surfaces without causing harm.
Choice C reason: Wiping dentures before storing them in a dry container at night is not advisable, as it may cause the dentures to crack or warp. Dentures should be soaked in water or a denture cleanser solution overnight to keep them moist and prevent them from losing their shape.
Choice D reason: Wrapping gloved fingers with gauze to remove dentures is not a standard practice. Dentures should be removed carefully by rocking them slightly to break the seal with the gums. Using gauze is unnecessary and may not be as effective or safe for the dentures or the oral tissues.
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