A nurse is teaching a client who gave birth to a term newborn 24 hours ago about the newborn screening for phenylketonuria. Which of the following statements should the nurse include in the teaching?
Your newborn will have a heel stick blood test now for the newborn screening and phenylketonuria test.
Your newborn does not have manifestations, so the test will not be done.
Your newborn will be tested one week after birth.
Your newborn will be given nothing by mouth for 6 hours prior to testing.
The Correct Answer is A
Choice A reason: Newborn screening for phenylketonuria involves a heel stick blood test within 24-48 hours post-birth to detect elevated phenylalanine levels. Early testing ensures timely diagnosis, preventing intellectual disability from untreated phenylketonuria, a genetic disorder impairing phenylalanine metabolism, requiring immediate dietary intervention.
Choice B reason: Lack of manifestations does not exempt newborns from phenylketonuria screening, as symptoms appear later. Screening is universal, as early detection prevents severe neurological damage from phenylalanine accumulation, making this statement incorrect for standard newborn care protocols.
Choice C reason: Testing one week after birth delays phenylketonuria screening, risking untreated phenylalanine buildup, which causes irreversible brain damage. Screening occurs within 24-48 hours to ensure early intervention, making this timing incorrect for effective management of this metabolic disorder.
Choice D reason: Fasting for 6 hours is not required for phenylketonuria screening. The heel stick test is performed regardless of feeding status, as phenylalanine levels are detectable early. Fasting risks hypoglycemia in newborns, making this an unnecessary and harmful requirement.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Increased insulin resistance relates to type 2 diabetes, not diabetes insipidus, which involves water balance, not glucose metabolism. Insulin resistance affects peripheral tissues’ response to insulin, causing hyperglycemia, unrelated to the pituitary’s role in antidiuretic hormone secretion.
Choice B reason: Autoimmune destruction of pancreatic beta cells causes type 1 diabetes, leading to insulin deficiency. Diabetes insipidus is a distinct condition involving antidiuretic hormone deficiency from the pituitary, affecting water reabsorption, not pancreatic function or glucose regulation.
Choice C reason: Decreased insulin production is associated with type 1 diabetes, not diabetes insipidus. The latter results from antidiuretic hormone deficiency, causing excessive water loss via urine. Insulin is irrelevant to the renal water retention mechanism disrupted in diabetes insipidus.
Choice D reason: Diabetes insipidus results from inadequate antidiuretic hormone secretion by the posterior pituitary, impairing renal water reabsorption. This leads to excessive dilute urine output, causing dehydration and thirst, the hallmark pathophysiology distinguishing it from diabetes mellitus, which involves glucose metabolism.
Correct Answer is B
Explanation
Choice A reason: Administering acetaminophen may mask symptoms of shunt malfunction, such as headache, without addressing the underlying issue. Increased intracranial pressure from a blocked shunt can cause rapid neurological deterioration, requiring urgent evaluation to prevent brain damage or death, making this response inadequate.
Choice B reason: Headache, blurry vision, irritability, and lethargy suggest shunt malfunction, potentially causing increased intracranial pressure due to cerebrospinal fluid buildup. Immediate emergency department evaluation is critical to assess shunt function, prevent herniation, and initiate interventions like shunt revision to restore normal cerebrospinal fluid drainage.
Choice C reason: Attributing symptoms to menstrual cycles is inappropriate, as headache, blurry vision, and lethargy indicate possible shunt malfunction. Hormonal changes do not typically cause these neurological symptoms, and delaying care risks severe complications like brain herniation due to increased intracranial pressure.
Choice D reason: Dismissing symptoms because the shunt has functioned for 9 years is dangerous. Shunts can fail at any time due to blockage or infection, causing increased intracranial pressure. Symptoms like headache and blurry vision require urgent evaluation to prevent irreversible neurological damage or death.
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