A nurse is collecting a blood phenylketonuria (PKU) test for a newborn prior to discharge. The newborn's guardian asks the nurse what a positive PKU test would mean.
Which of the following statements should the nurse make?
A positive finding indicates the inability to metabolize galactose.
A positive finding indicates the infant will have a slow metabolism.
A positive finding indicates an inability to metabolize certain amino acids.
A positive finding indicates an increased risk for neurologic anomalies.
The Correct Answer is C
Choice A rationale
A positive phenylketonuria (PKU) test indicates an inability to metabolize the amino acid phenylalanine, not galactose. Galactosemia is a separate metabolic disorder characterized by the body's inability to break down galactose, a sugar found in milk. Both are inborn errors of metabolism, but their biochemical pathways and dietary interventions differ significantly.
Choice B rationale
A positive PKU test does not indicate a slow metabolism in general. Instead, it specifically points to a deficiency in the enzyme phenylalanine hydroxylase (PAH), which is necessary for converting phenylalanine into tyrosine. This enzymatic defect leads to an accumulation of phenylalanine in the blood and tissues, which can become neurotoxic if untreated.
Choice C rationale
A positive finding for phenylketonuria (PKU) signifies a genetic disorder where the body lacks or has insufficient amounts of the enzyme phenylalanine hydroxylase. This enzyme is crucial for metabolizing the essential amino acid phenylalanine into tyrosine. Without proper enzyme function, phenylalanine accumulates in the blood, leading to neurotoxic effects if a specialized diet is not initiated promptly.
Choice D rationale
A positive PKU finding, if left untreated, directly leads to severe intellectual disability and other neurological problems due to the accumulation of phenylalanine, which is toxic to the developing brain. Therefore, it indicates an increased risk for neurologic anomalies if the condition is not managed through a strict low-phenylalanine diet from early infancy. .
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
For clients prescribed methadone during pregnancy, breastfeeding is generally encouraged due to the benefits of breast milk for the infant. Methadone excretion into breast milk is minimal and not considered harmful, and it can help to reduce the severity of neonatal abstinence syndrome.
Choice B rationale
Methamphetamine use during pregnancy is associated with several adverse fetal outcomes, but fetal macrosomia (abnormally large baby) is not typically one of them. Instead, it is more commonly linked to intrauterine growth restriction, preterm birth, and small for gestational age infants due to vasoconstrictive effects.
Choice C rationale
For newborns experiencing neonatal abstinence syndrome due to prenatal substance exposure, environmental stimuli should be decreased, not increased. Reducing stimuli like bright lights, loud noises, and excessive handling helps to minimize agitation, irritability, and seizures in these vulnerable infants.
Choice D rationale
Increased head circumference is not an expected finding in a newborn with fetal alcohol syndrome (FAS). In fact, microcephaly (abnormally small head circumference) is a characteristic diagnostic criterion for FAS, reflecting the detrimental effects of alcohol on fetal brain development.
Correct Answer is B
Explanation
Choice A rationale
Holding the newborn during the initial visit can inadvertently convey a message of displacement to the older sibling. This is due to the older child's developing cognitive understanding of parental attention and resources. The immediate focus on the new baby might lead to feelings of jealousy or being replaced, potentially hindering positive sibling bonding.
Choice B rationale
Spending individual time with the older sibling reinforces their continued importance within the family structure. This dedicated attention helps mitigate feelings of neglect or competition, promoting a sense of security and love. It allows the older child to process the family change and feel valued, fostering a more positive acceptance of the newborn.
Choice C rationale
While involving the older sibling in purchasing a gift can be a positive step, it might not fully address the emotional and psychological adjustments required. The act itself is a superficial gesture and doesn't substitute for direct parental reassurance and quality time, which are crucial for true sibling acceptance and emotional well-being.
Choice D rationale
Postponing the introduction can create anxiety and resentment in the older sibling. Children often perceive delays as exclusion or secrecy, which can foster negative feelings towards the new baby. An early, supervised introduction, with parental guidance, allows for a more natural and integrated family adjustment.
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