The nurse is teaching a parent of a 6-month-old infant with gastroesophageal reflux (GER) before discharge. What instructions should the nurse include?

Correct Answer: D

Rationale: In this scenario, option D is the correct answer: "Prescribed cimetidine (Tagamet) should be given 30 minutes before feedings." This instruction is crucial because cimetidine is a histamine-2 receptor antagonist that helps reduce gastric acid secretion, thus alleviating symptoms of gastroesophageal reflux (GER) in infants. Administering it before feedings ensures optimal effectiveness in controlling reflux episodes. Option A, elevating the head of the bed in the crib to a 90-degree angle while the infant is sleeping, is a common recommendation for GER. However, it is not the best choice in this case as medication management is more specific and effective. Option B, holding the infant in the prone position after a feeding, is not recommended for infants with GER due to the increased risk of aspiration and worsening of symptoms. Option C, discontinuing breastfeeding so that a formula and rice cereal mixture can be used, is not appropriate as breastfeeding is beneficial for infants with GER. Breast milk is easier to digest and less likely to aggravate reflux compared to formula or rice cereal. In an educational context, it is essential for nurses to provide evidence-based instructions to parents of infants with GER to ensure effective management and optimal outcomes. Understanding the rationale behind each instruction helps caregivers make informed decisions regarding their child's care.

Correct Answer: B

Rationale: The correct answer is B: All are correct. High-fiber foods like oranges, lima beans, baked beans, and raisin bran cereal are effective in preventing constipation. Oranges are a good source of fiber, lima beans and baked beans are high in fiber content, and raisin bran cereal is also rich in fiber. Bananas, which are not listed but could be considered by some as a high-fiber food, are actually low in fiber and may not be as effective in preventing constipation. Therefore, the nurse should include all the options provided in the teaching to help prevent constipation effectively.

Correct Answer: B

Rationale: The correct answer is B: All of the above. Citrus, spicy foods, and peppermint are known to exacerbate GER symptoms by increasing acid production or relaxing the lower esophageal sphincter. Therefore, these foods should be avoided by a child with GER disease. Bananas, on the other hand, are generally safe and do not contribute to acid reflux. Choice B is correct because all the mentioned foods can worsen GER symptoms, while bananas are considered safe.

Correct Answer: B

Rationale: Celiac disease often presents with steatorrhea, malnutrition, and foul-smelling stools due to the malabsorption of nutrients. Therefore, all the manifestations listed (steatorrhea, malnutrition, foul-smelling stools) are expected in a child with celiac disease. Polycythemia is not associated with celiac disease, making choice B the correct answer.

Correct Answer: D

Rationale: Correct! Typical signs of appendicitis include fever, vomiting, and tachycardia due to infection and inflammation. These clinical manifestations are commonly observed in patients with appendicitis. Hyperactive bowel sounds are not typically associated with appendicitis, so they are not expected findings in this situation. Therefore, the correct answer is 'All of the above.'