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 C

Explanation

Rationale:

A. "I will wait 1 hour after getting up in the morning to have breakfast.": Delaying breakfast may worsen nausea, as symptoms of hyperemesis gravidarum are often worse in the morning. It is recommended to eat a small, dry carbohydrate-rich snack, such as crackers, soon after waking.

B. "I will try to eat balanced meals instead of only foods that appeal to my taste.": While balanced meals are ideal, during hyperemesis gravidarum, the priority is tolerating any nutrition. Clients are encouraged to eat whatever foods they can tolerate, as nutritional intake is often severely limited.

C. “I will eat or drink something every 2 to 3 hours throughout the day": Eating or drinking small amounts frequently helps prevent an empty stomach, which can trigger or worsen nausea and vomiting. This approach improves tolerance and supports hydration and nutrition.

D. “I will eat a low protein snack 30 minutes before going to bed each night.": Protein-rich snacks, not low-protein ones, are better for stabilizing blood glucose levels overnight and may help reduce morning nausea. A high-protein snack before bed is more appropriate.

A. Tilt the client's head forward during meals. B. Encourage socialization during meal times. C. Elevate the head of the client's bed to 30", D. Provide three large meals per day.

Correct Answer is A

Explanation

Rationale:

A. Tilt the client's head forward during meals: Tilting the head forward, also known as the chin-tuck technique, helps close the airway and reduce the risk of aspiration in clients with dysphagia. This position facilitates safer swallowing by improving bolus control and airway protection.

B. Encourage socialization during meal times: While social interaction is generally beneficial, clients with dysphagia require focused attention during meals to prevent choking or aspiration. Distractions can compromise concentration on swallowing techniques and safety precautions.

C. Elevate the head of the client's bed to 30": Although elevating the head of the bed helps reduce aspiration risk, a 30" elevation is not optimal for swallowing. A 45–90 degree upright position is typically recommended during meals to support safer swallowing mechanics.

D. Provide three large meals per day: Clients with dysphagia benefit more from small, frequent meals to reduce fatigue and lower the risk of aspiration. Large meals can overwhelm their ability to chew and swallow safely, increasing the risk of complications.

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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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