A nurse is reinforcing teaching about phenylketonuria (PKU) testing with the parent of a newborn. Which of the following statements by the parent indicates a need for further teaching?
"My baby will be placed under special lights if the test is elevated.".
"My baby must take formula or breast milk before the test is done.".
"This test checks for a genetic disorder that can be corrected by diet.".
"Sometimes the test is repeated in the doctor's office at the 2-week check-up.".
The Correct Answer is A
"My baby will be placed under special lights if the test is elevated.”.
Choice A rationale:

This statement indicates a need for further teaching. Phenylketonuria (PKU) is a metabolic disorder that leads to the accumulation of phenylalanine in the body. If the PKU test is elevated, it means that the baby has high levels of phenylalanine, and immediate dietary intervention is required. The parent's statement about special lights suggests a confusion with jaundice treatment, which is not related to PKU.
Choice B rationale:
This statement is accurate. Before the PKU test is done, the baby needs to consume formula or breast milk to ensure accurate test results.
Choice C rationale:
This statement is also accurate. PKU is a genetic disorder that can be managed with a special diet low in phenylalanine. By adhering to the prescribed diet, the harmful effects of PKU can be minimized.
Choice D rationale:
This statement is accurate. It is common for the PKU test to be repeated at the 2-week check- up to confirm the initial results and ensure early detection and management of PKU if present.
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Related Questions
Correct Answer is B
Explanation
Choice A rationale:
A white blood cell count of 15,000 does not necessarily indicate a severe infection. In newborns, WBC counts are typically higher than in adults, and they gradually decrease over the first few days after birth. A value of 15,000 falls within the normal range for a newborn and is not indicative of a severe infection.
Choice B rationale:
A white blood cell count of 15,000 is considered a normal range for a newborn. Newborns have higher WBC counts as a natural response to the stress of birth and exposure to the outside environment. The immune system is still developing, and elevated WBC counts are normal during this period.
Choice C rationale:
Assuming there are no other indications of lab error, such as abnormal results in other tests, it would be premature to label the WBC count as a lab error. Additionally, healthcare professionals should always consider the overall clinical picture before assuming a lab error based on a single result.
Choice D rationale:
There is no immediate need to call the doctor based solely on the WBC count of 15,000. Medical decisions should be made in the context of the newborn's overall clinical condition, and a single lab result does not warrant an immediate call to the doctor.
Correct Answer is A
Explanation
Choice A rationale:
This is the priority finding because a bilirubin level of 18 mg/dL in a 4-hour-old newborn is significantly elevated. High bilirubin levels in newborns can lead to jaundice, which can be harmful if not promptly addressed. Hyperbilirubinemia in newborns requires close monitoring and, in some cases, treatment with phototherapy.
Choice B rationale:
A hemoglobin level of 22 g/dL is within the normal range for a newborn and is not a priority concern at this time.
Choice C rationale:
A blood glucose level of 50 mg/dL is within the normal range for a newborn. While monitoring blood glucose levels is essential, it is not the priority in this situation.
Choice D rationale:
A platelet count of 200,000/mm³ is within the normal range for a newborn and does not require immediate action.
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