When should the nurse instruct parents to administer a daily proton pump inhibitor to their child with gastroesophageal reflux?

Correct Answer: D

Rationale: Proton pump inhibitors (PPIs) like omeprazole or lansoprazole are most effective when given 30 minutes before breakfast. This timing allows the medication to inhibit the proton pumps in the stomach that produce acid, providing better symptom control throughout the day. Administering the PPI at bedtime (choice A) may not be as effective as giving it before breakfast due to the timing of peak acid production during the day. Giving it with a meal (choice B) might affect the absorption and effectiveness of the medication. Midmorning administration (choice C) is not the recommended time for optimal PPI efficacy.

Correct Answer: C

Rationale: Corrected Rationale: Currant jelly-like stools, which contain blood and mucus, are characteristic of Meckel diverticulum. This symptom occurs due to the bleeding from the ectopic gastric mucosa present in the diverticulum. Steatorrhea (choice A) is not typically associated with Meckel diverticulum. Clay-colored stools (choice B) are seen in conditions affecting the biliary system. Loose stools with undigested food (choice D) may indicate malabsorption issues, but it is not specifically linked to Meckel diverticulum.

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 applicable. Ice, raw vegetables, and unpeeled fruits can be sources of contamination in areas where water purity is questionable. It's safer to avoid these during a mission trip to prevent waterborne illnesses. Choice A (Ice), C (Raw vegetables), and D (Unpeeled fruits) are all potential sources of contamination in areas with questionable water quality. Including all these items in the teaching will help adolescents make informed decisions to stay healthy during their mission trip.

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.