A nurse is reinforcing instructions about car-seat use with the parents of a newborn who is preparing for discharge. Which of the following Instructions should the nurse include?

"Swaddle the newborn before securing the clips."

"Add a soft head support in the car seat if necessary."

"Secure the straps across the newborn's chest at the level of their armpits."

"Ensure that the car seat is positioned at a 90 degree incline.”

Answer and Explanation

The Correct Answer is C

Rationale:

A. "Swaddle the newborn before securing the clips.": Swaddling before placing the newborn in the car seat is unsafe because it can prevent proper restraint and increase the risk of injury during a crash. The newborn should be secured directly by the harness straps.

B. "Add a soft head support in the car seat if necessary.": Adding aftermarket soft head supports can interfere with the car seat’s harness system and safety performance. Only manufacturer-approved accessories should be used.

C. "Secure the straps across the newborn's chest at the level of their armpits.": The harness straps should be positioned at or just below the newborn’s shoulders, with the chest clip placed at the armpit level to ensure optimal restraint and prevent movement during sudden stops.

D. "Ensure that the car seat is positioned at a 90 degree incline.": The car seat should be reclined at approximately a 45-degree angle to prevent the newborn’s head from falling forward and obstructing the airway during travel.

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Correct Answer is D

Explanation

Rationale:

A. "Store ready-to-feed formula at room temperature for up to 4 hours.": Ready-to-feed formula should be used promptly or refrigerated if not used immediately. Leaving it at room temperature for up to 4 hours increases the risk of bacterial growth and contamination.

B. "Warm the bottle of formula by immersing it in a container of warm tap water.": This is a safe and recommended method to gently warm formula without overheating or creating hot spots that could burn the infant’s mouth.

C. "Keep open cans of concentrated formula uncovered and refrigerated.": Open cans of concentrated formula should always be covered to prevent contamination and should be refrigerated promptly after opening.

D. "Discard any formula left in the bottle within 2 hours after beginning feeding.": Formula left in the bottle after feeding should be discarded within 1 to 2 hours to prevent bacterial growth that can cause illness in the infant. This practice helps ensure feeding safety.

A. Recommend the client spend time alone in his room. B. Encourage the client to use positive self-talk C. Offer the client low-protein snacks throughout the day. D. Suggest the client exercise before going to bed.

Correct Answer is B

Explanation

Rationale:

A. Recommend the client spend time alone in his room: Isolation can worsen depressive symptoms by reducing social interaction and support. Clients with major depressive disorder benefit more from structured, supportive environments that encourage engagement.

B. Encourage the client to use positive self-talk: Promoting positive self-talk helps challenge negative thought patterns common in depression. This cognitive-behavioral strategy can improve mood, self-esteem, and overall coping ability.

C. Offer the client low-protein snacks throughout the day: Nutritional support is important, but there is no specific reason to offer low-protein snacks for depression. A balanced diet with adequate protein may better support brain function and mood regulation.

D. Suggest the client exercise before going to bed: Regular exercise is beneficial for managing depression, but exercising before bedtime can disrupt sleep patterns. Physical activity is better scheduled earlier in the day to promote restfulness at night.

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A nurse is reinforcing instructions about car-seat use with the parents of a newborn who is preparing for discharge. Which of the following Instructions should the nurse include?

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