A breastfed newborn has just been diagnosed with galactosemia. The therapeutic management for this newborn is to:

Stop breastfeeding

Add amino acids to the breast milk

Substitute a lactose-containing formula for breast milk

Give the appropriate enzyme along with breast milk.

Answer and Explanation

The Correct Answer is A

Choice A reason:

Stop breastfeeding. This is the correct answer because newborns and infants with galactosemia cannot metabolize galactose, a sugar found in milk and lactose-containing formulas, including breast milk. Galactose can build up in their blood and cause serious complications such as liver damage, cataracts, brain damage, and even death. Therefore, the therapeutic management for this newborn is to stop breastfeeding and switch to a soy or elemental formula that contains no galactose.

Choice B reason:

Add amino acids to the breast milk. This is incorrect because adding amino acids to breast milk will not prevent the accumulation of galactose in the newborn's blood. Amino acids are the building blocks of proteins, not sugars. Adding amino acids to breast milk will not change its galactose content or help the newborn metabolize it.

Choice C reason:

Substitute a lactose-containing formula for breast milk. This is incorrect because lactose is a disaccharide composed of glucose and galactose. Lactose-containing formulas will also expose the newborn to galactose, which they cannot break down. Lactose-containing formulas should be avoided in newborns and infants with galactosemia.

Choice D reason:

Give the appropriate enzyme along with breast milk. This is incorrect because there is no enzyme therapy available for galactosemia. Galactosemia is caused by a genetic defect in one of the enzymes involved in the breakdown of galactose, such as galactose-1-phosphate uridyltransferase (GALT), galactokinase (GALK), or uridine diphosphate galactose-4-epimerase (GALE). Giving an enzyme along with breast milk will not correct this defect or prevent the harmful effects of galactose accumulation.

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Correct Answer is D

Explanation

Choice A reason:

Fetal heart rate irregularities are not a sign of hydatidiform mole, as this condition involves an abnormal fertilization of the egg that results in an abnormal or absent fetus.

Choice B reason:

A hydatidiform mole is more commonly associated with dark brown to bright red vaginal bleeding, not whitish discharge. The bleeding may resemble prune juice and is often a sign of the abnormality.

Choice C reason:

Rapidly dropping human chorionic gonadotropin (hCG) levels are not a sign of hydatidiform mole, as this condition causes very high levels of hCG due to the proliferation of trophoblastic tissue.

Choice D reason:

In a hydatidiform mole, the uterus often enlarges more rapidly than expected for the gestational age due to the overgrowth of trophoblastic tissue and the accumulation of fluid-filled vesicles. This excessive uterine enlargement is a key sign that could indicate the presence of a molar pregnancy.

A. Fundus soft, 2 fingerbreadths below the umbilicus. B. Fundus firm, 2 fingerbreadths above the umbilicus. C. Fundus soft, to the right of the umbilicus. D. Fundus firm, at the level of the umbilicus.

Correct Answer is D

Explanation

Choice A reason:

A soft fundus indicates uterine atony, which is a lack of muscle tone that can lead to postpartum hemorrhage. A soft fundus is an abnormal finding and should be reported to the provider. The fundus should be firm and contracted to prevent bleeding.

Choice B reason:

A fundus that is 2 fingerbreadths above the umbilicus is too high for a client who is 12 hours postpartum. The fundus should descend about 1 centimeter per hour after delivery and should be at the level of the umbilicus at 12 hours postpartum. A high fundus could indicate retained placental fragments or a full bladder, both of which can interfere with uterine contraction and cause bleeding.

Choice C reason:

A fundus that is deviated to the right of the umbilicus is also an abnormal finding for a client who is 12 hours postpartum. A deviated fundus could indicate a full bladder, which can displace the uterus and prevent it from contracting properly. The fundus should be at the midline of the abdomen.

Choice D reason:

A fundus that is firm and at the level of the umbilicus is a normal finding for a client who is 12 hours postpartum. This indicates that the uterus is involuting (returning to its pre-pregnancy size and shape) and that there is no excessive bleeding. The nurse should expect this finding and document it accordingly.

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A breastfed newborn has just been diagnosed with galactosemia. The therapeutic management for this newborn is to:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who might have a hydatidiform mole. The nurse should monitor the client for which of the following findings?

Correct Answer is D

Explanation

A nurse is collecting data from a client who is 12 hr postpartum. Which of the following findings should the nurse expect?

Correct Answer is D

Explanation

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