A breastfednewborn 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.
The Correct Answer is A
Choice A reason:
All milk- and lactose-containing formulas, including breast milk, must be stopped during infancy. Soy protein is the formula of choice for newborns and infants with galactosemia. Breast milk should not be used in newborns and infants with galactosemia because it contains galactose, which they cannot metabolize properly.
Choice B reason:
Adding amino acids to the breast milk will not help the newborn with galactosemia, because the problem is not a lack of amino acids, but a deficiency of the enzyme that breaks down galactose. Amino acids are the building blocks of proteins, not sugars.
Choice C reason:
Substituting a lactose-containing formula for breast milk will worsen the condition of the newborn with galactosemia because lactose is composed of glucose and galactose. The newborns will still be exposed to galactose, which will accumulate in the blood and tissues and cause damage.
Choice D reason:
Giving the appropriate enzyme along with breast milk is not a feasible option for the newborn with galactosemia, because there is no oral enzyme replacement therapy available for this condition. The only treatment is dietary restriction of galactose.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason:
Contractions every 3 to 4 min are not a definitive sign of labor, as they can also occur in false labor or Braxton Hicks contractions. These are irregular and do not cause cervical changes.
Choice B reason:
Cervical dilation is the most reliable indicator of true labor, as it shows that the uterus is contracting effectively and preparing for delivery. Cervical dilation is measured in centimeters from 0 to 10, with 10 being fully dilated.
Choice C reason:
Pain just above the navel is not a sign of labor, but rather a possible sign of an abdominal problem such as appendicitis or gallbladder disease. Labor pain usually starts in the lower back and radiates to the abdomen and thighs.
Choice D reason:
Amniotic fluid in the vaginal vault is not a conclusive sign of labor, as it can also result from a premature rupture of membranes (PROM) or a high leak of amniotic fluid. PROM occurs when the amniotic sac breaks before the onset of labor, which can increase the risk of infection and complications for the mother and the baby.
Correct Answer is C
Explanation
Choice A reason:
This statement is not appropriate because it does not provide any information or education to the client who wants to know about VBAC. It also implies that the nurse does not have any knowledge or expertise on the topic, which may undermine the client's trust and confidence in the nurse.
Choice B reason:
This statement is not appropriate because it is not evidence-based and may discourage the client from considering VBAC as a possible option. According to research, VBAC is associated with fewer complications than an elective repeat C-section for many women who had prior
cesarean deliveries. A repeat C-section also carries risks such as infection, bleeding, injury to organs, and placental problems in future pregnancies.
Choice C reason:
This statement is appropriate because it is accurate and informative. The type of uterine incision used for the prior C-section is one of the most important factors that determine the eligibility and success of VBAC. A low transverse or low vertical incision is usually compatible with VBAC, while a high vertical (classical) incision is not recommended due to the risk of uterine rupture.
Choice D reason:
This statement is not appropriate because it dismisses the client's concern and does not address their question. It also implies that the nurse does not respect the client's autonomy and right to make informed decisions about their care. The client may benefit from learning about VBAC early in their pregnancy so that they can weigh the pros and cons and discuss their preferences with their provider.
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