A nurse measures a client's weight as 70 kg and height as 1.1 m. What is the client's body mass index? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

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.

Choice A reason: Alternating the first breast that is offered to the baby with each feeding is a good practice for breastfeeding because it can ensure equal stimulation and drainage of both breasts, which can prevent engorgement, mastitis, or low milk supply. Alternating breasts can also provide the baby with both foremilk and hindmilk, which have different compositions and benefits.

Choice B reason: Storing breast milk in the refrigerator up to 48 hours is not a good practice for breastfeeding because it can reduce the quality and safety of the milk. Breast milk should be stored in the refrigerator for no longer than 24 hours or in the freezer for no longer than 6 months. Breast milk should also be stored in clean, sterile containers and labeled with the date and time of expression.

Choice C reason: Nursing the baby once every 4 hours is not a good practice for breastfeeding because it can decrease the milk production and supply, which can affect the growth and development of the baby. Breastfeeding should be done on demand or at least every 2 to 3 hours during the day and every 3 to 4 hours at night. Breastfeeding should also last for at least 10 to 15 minutes per breast or until the baby is satisfied.

Choice D reason: Offering the baby water between feedings is not a good practice for breastfeeding because it can interfere with the baby's appetite and intake of breast milk, which can cause dehydration, malnutrition, or failure to thrive. Breast milk contains enough water and nutrients to meet the baby's needs for the first six months of life. Water should be avoided or limited until the baby starts solid foods.