A postpartum nurse is conducting a newborn screening for a 36-hour old baby.
The parents inquire about the purpose of this test since the baby is not showing any signs of illness.
What would be the nurse’s best response?
“This is a blood test to determine blood type.”
“This is a diagnostic test that will confirm whether your baby has one of these diseases.”
“This is a routine test to detect who may be at risk for developing one of these diseases.”
“Since you are a carrier for a disease, we will find out if it has been passed down.”
The Correct Answer is C
Choice A rationale:
This response is incorrect because newborn screening tests do not determine blood type. Blood type is typically determined through a separate blood test, such as an ABO and Rh typing test.
While knowing a baby's blood type is important for medical reasons, it's not the primary purpose of newborn screening.
Focusing solely on blood type could mislead parents about the broader scope of conditions that newborn screening aims to identify.
Choice B rationale:
This response is incorrect because newborn screening tests are not diagnostic tests. They are screening tests, which means they identify babies who may be at risk for certain diseases, but they do not confirm whether or not a baby actually has a disease.
Diagnostic tests are typically more specific and are performed after a screening test has indicated a potential problem.
It's crucial to clarify the distinction between screening and diagnosis to avoid causing undue alarm or confusion for parents.
Choice C rationale:
This is the correct response. It accurately explains that newborn screening tests are routine procedures that are performed to detect babies who may be at risk for developing certain diseases.
The emphasis on "risk" is important because it highlights that a positive screening result does not necessarily mean that a baby has a disease, but rather that further testing is needed to confirm the diagnosis.
This response also avoids making assumptions about the parents' carrier status, which is a sensitive topic that should be addressed with care and discretion.
Choice D rationale:
This response is incorrect because it assumes that the parents are carriers for a disease, which may not be the case.
Even if the parents are carriers, newborn screening tests are not designed to specifically determine whether a disease has been passed down from parent to child.
Making such assumptions could create unnecessary anxiety or confusion for parents, and it's important to provide information that is accurate and relevant to their specific situation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C","E","F"]
Explanation
The correct answers are B, C, E, and F.
Rationale for each choice:
- Albuterol
Mechanism of action: Albuterol is a beta-2 agonist that stimulates beta-2 receptors in the cell membranes of skeletal muscle, liver, and adipose tissue. This stimulation causes an increase in intracellular cyclic AMP (cAMP), which activates protein kinase A (PKA). PKA then phosphorylates a number of proteins, including the sodium-potassium ATPase pump. This pump is responsible for transporting potassium ions into cells and out of the bloodstream. By increasing the activity of this pump, albuterol can help to lower serum potassium levels.
Onset of action: Albuterol has a rapid onset of action, typically within 30 minutes.
Duration of action: The duration of action of albuterol is relatively short, usually 4-6 hours.
Dosage: The dosage of albuterol for hyperkalemia is typically 10-20 mg nebulized every 4-6 hours.
Additional considerations: Albuterol can cause tachycardia and tremors. It should be used cautiously in patients with heart disease or hyperthyroidism.
- Kayexalate
Mechanism of action: Kayexalate is a cation exchange resin that binds to potassium ions in the gastrointestinal tract. This prevents the potassium from being absorbed into the bloodstream.
Onset of action: Kayexalate has a relatively slow onset of action, usually 1-2 hours.
Duration of action: The duration of action of Kayexalate is relatively long, usually 4-6 hours.
Dosage: The dosage of Kayexalate for hyperkalemia is typically 15-30 grams orally or rectally every 6 hours.
Additional considerations: Kayexalate can cause constipation and hypocalcemia. It should be used cautiously in patients with bowel obstruction or kidney disease.
- Insulin & dextrose
Mechanism of action: Insulin promotes the movement of potassium into cells, thus lowering serum potassium levels. Dextrose is given along with insulin to prevent hypoglycemia.
Onset of action: Insulin has a rapid onset of action, typically within 30 minutes.
Duration of action: The duration of action of insulin is relatively short, usually 4-6 hours.
Dosage: The dosage of insulin for hyperkalemia is typically 10 units of regular insulin IV push, followed by an infusion of 5-10 units per hour. The dosage of dextrose is typically 50 grams IV push, followed by an infusion of 10% dextrose at 100 mL/hour.
Additional considerations: Insulin can cause hypoglycemia. It should be used cautiously in patients with diabetes mellitus.
Correct Answer is A
Explanation
Choice A rationale:
A positive contraction stress test (CST) indicates that the fetal heart rate decelerates late in response to uterine contractions, suggesting potential uteroplacental insufficiency. However, the scenario does not describe a CST being performed, as it does not mention any assessment of uterine contractions or their relationship to fetal heart rate changes.
Choice C rationale:
A negative contraction stress test (CST) would demonstrate no late decelerations in response to contractions, suggesting adequate placental function. However, as mentioned earlier, a CST is not the test being performed in this scenario.
Choice D rationale:
A non-reactive nonstress test (NST) means that there were not enough fetal heart rate accelerations (at least 2, each lasting at least 15 seconds and peaking at least 15 beats above baseline) within a 20-minute period. This finding sometimes warrants further evaluation of fetal well-being. However, the scenario clearly states that 3 accelerations meeting the criteria for reactivity were observed.
Choice B rationale:
A reactive nonstress test (NST) is considered reassuring and indicates that the fetal heart rate is responding appropriately to fetal movement, suggesting that the fetus is likely healthy and well-oxygenated. The presence of 3 accelerations meeting the criteria for reactivity within a 20-minute period is the hallmark of a reactive NST.
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