A parent brings a 2-week-old infant to a clinic for a phenylketonuria rescreening blood test. The test indicates a serum phenylalanine level of 1 mg/dL (60.5 mcmol/L). The nurse reviews this result and makes which interpretation?

A. It is inconclusive
Explanation: A serum phenylalanine level within the normal range is considered conclusive in ruling out phenylketonuria. Inconclusive results typically occur when there are issues with the sample or testing process.
B. It is negative
Explanation:
A serum phenylalanine level of 1 mg/dL (60.5 mcmol/L) in a 2-week-old infant is within the normal range. In the context of phenylketonuria (PKU) screening, a "negative" result means that the phenylalanine levels are within the expected range, and there is no evidence of phenylketonuria.
C. It requires rescreening at age 6 weeks.
Explanation: If the initial screening result is within the normal range, rescreening at age 6 weeks may not be necessary for phenylketonuria. The timing and need for rescreening may vary based on local protocols and individual patient factors.
D. It is positive
Explanation: A positive result for phenylketonuria would indicate that the serum phenylalanine levels are elevated, suggesting a potential diagnosis of PKU. In this case, the result is negative, meaning there is no evidence of PKU.

A. "The manifestations are lessened by taking the prednisone every other day instead of daily."
Correct Answer: Cushingoid characteristics can be associated with long-term corticosteroid use. Taking prednisone every other day, rather than daily, can help minimize these manifestations while still providing the needed therapeutic effect.
B. "You need to be sure to talk to the doctor about the Cushingoid characteristics."
Incorrect: While it is important for the parents to communicate with the doctor, this statement is less therapeutic than option 3, which opens up a more collaborative and supportive conversation.
C. "Which manifestations of this condition do you find most troublesome?"
Correct Answer: This open-ended question allows the parents to express their concerns and frustrations. It facilitates communication between the parents and healthcare provider to address specific issues they find most troublesome.
D. "I am sure it will be all right; they hardly look unusual."
Incorrect: Downplaying the parents' concerns may not be the most therapeutic approach. Acknowledging their concerns and providing information about the reversible nature of cushingoid characteristics would be more helpful.
E. "The cushingoid appearance will gradually disappear once the corticosteroids are tapered and discontinued."
Correct Answer: Cushingoid characteristics are reversible, and they tend to improve as the dose of corticosteroids is tapered and eventually discontinued.