A breastfed newborn 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:
Stop breastfeeding. This is the correct answer because newborns and infants with galactosemia cannot metabolize galactose, a sugar found in milk and lactose-containing formulas, including breast milk. Galactose can build up in their blood and cause serious complications such as liver damage, cataracts, brain damage, and even death. Therefore, the therapeutic management for this newborn is to stop breastfeeding and switch to a soy or elemental formula that contains no galactose.
Choice B reason:
Add amino acids to the breast milk. This is incorrect because adding amino acids to breast milk will not prevent the accumulation of galactose in the newborn's blood. Amino acids are the building blocks of proteins, not sugars. Adding amino acids to breast milk will not change its galactose content or help the newborn metabolize it.
Choice C reason:
Substitute a lactose-containing formula for breast milk. This is incorrect because lactose is a disaccharide composed of glucose and galactose. Lactose-containing formulas will also expose the newborn to galactose, which they cannot break down. Lactose-containing formulas should be avoided in newborns and infants with galactosemia.
Choice D reason:
Give the appropriate enzyme along with breast milk. This is incorrect because there is no enzyme therapy available for galactosemia. Galactosemia is caused by a genetic defect in one of the enzymes involved in the breakdown of galactose, such as galactose-1-phosphate uridyltransferase (GALT), galactokinase (GALK), or uridine diphosphate galactose-4-epimerase (GALE). Giving an enzyme along with breast milk will not correct this defect or prevent the harmful effects of galactose accumulation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason:
Intermittent abdominal pain following passage of bloody mucus is not a sign of placenta previa, but rather of bloody show, which is a normal occurrence in late pregnancy as the cervix begins to dilate and efface.
Choice B reason:
Abdominal pain with minimal red vaginal bleeding is not a sign of placenta previa, but rather of abruptio placentae, which is a serious complication where the placenta detaches from the uterine wall before delivery.
Choice C reason:
A large amount of bright red vaginal bleeding without pain is a sign of placenta previa, which is a condition where the placenta covers part or all of the cervical opening. This can cause bleeding when the cervix dilates or contracts, especially in the third trimester. This is a medical emergency that requires immediate attention.
Choice D reason:
Severe abdominal pain with increasing fundal height is not a sign of placenta previa, but rather of uterine rupture, which is a rare but life-threatening complication where the uterus tears open along the scar line from a previous cesarean delivery or other uterine surgery. This can cause severe bleeding, fetal distress, and shock.
Correct Answer is ["A","B","D","E"]
Explanation
Choice A reason:
Heel to ear is a test that measures the flexibility of the newborn's hip and knee joints. The nurse should gently flex the newborn's hip and knee and bring the foot toward the ear on the same side. The closer the foot is to the ear, the higher the score. This test is part of the neuromuscular assessment for gestational age.
Choice B reason:
Popliteal angle is a test that measures the angle of flexion at the knee joint. The nurse should flex the newborn's hip and knee at 90 degrees and then extend the lower leg until resistance is felt. The smaller the angle, the higher the score. This test is also part of the neuromuscular assessment for gestational age.
Choice C reason:
Moro reflex is a test that evaluates the newborn's startle response. The nurse should hold the newborn in a semi-sitting position and then allow the head to fall back slightly. The newborn should extend and abduct the arms and legs, then flex and adduct them. This test is not part of the neuromuscular assessment for gestational age, but rather a reflex assessment for neurological function. •
Choice D reason:
Scarf sign is a test that measures the flexibility of the newborn's shoulder and elbow joints. The nurse should draw one of the newborn's arms across the chest toward the opposite shoulder. The farther the elbow can be moved across the body, the lower the score. This test is part of the neuromuscular assessment for gestational age.
Choice E reason:
Arm recoil is a test that measures the degree of flexion at the elbow joint. The nurse should extend both of the newborn's arms for 5 seconds and then release them. The arms should return to a flexed position quickly and fully. The faster and more complete the recoil, the higher the score. This test is part of the neuromuscular assessment for gestational age.
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