When assessing a newborn girl with salt-wasting congenital adrenal hyperplasia due to 21 hydroxylase deficiency, the nurse notes that the infant has an enlarged clitoris. Which intervention should the nurse implement?

Review transcutaneous bilirubin levels with a bilirubinometer.

Observe and palpate newborn's breast tissue for enlargement.

Assess for signs of fluid retention and bilateral pedal edema.

Explain to the mother that the finding is due to increased androgen.

Answer and Explanation

The Correct Answer is D

A)   Incorrect- Reviewing transcutaneous bilirubin levels is unrelated to the presence of an enlarged clitoris. Bilirubin levels are typically assessed to monitor jaundice in newborns.
B)   Incorrect- Observing and palpating breast tissue for enlargement is not relevant to the condition of salt-wasting congenital adrenal hyperplasia. Breast tissue enlargement would not be associated with this hormonal disorder.
C)   Incorrect- Assessing for signs of fluid retention and bilateral pedal edema is important for monitoring for other conditions, but it is not relevant to the enlarged clitoris seen in this specific scenario.
D)   Correct- Salt-wasting congenital adrenal hyperplasia is a genetic disorder that results in a deficiency of certain enzymes required for cortisol and aldosterone production. This deficiency leads to an overproduction of androgens, which can cause virilization of female external genitalia. The enlarged clitoris is a result of increased androgen levels. Explaining this finding to the mother provides her with accurate information about the condition and its effects on the infant's anatomy.

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Correct Answer is B

Explanation

A) Incorrect- Genetically inherited disorders of family members: While a family history of certain disorders might provide some insight, it is not typically the primary cause of elevated serum magnesium levels in an older adult.
B) Correct- Elevated serum magnesium levels are commonly associated with chronic laxative use, especially those containing magnesium-based compounds. Laxatives can lead to excessive magnesium intake, causing hypermagnesemia.
C. Incorrect- Smoking is not a common cause of elevated serum magnesium levels.

D. Incorrect- While dietary sources can contribute to magnesium intake, chronic laxative use is a more likely cause in this context.

A. Repeat information to the client. B. Write information on a whiteboard. C. Talk loudly into the affected ear. D. Speak directly facing the client.

Correct Answer is D

Explanation

A) Incorrect- While repeating information can be helpful, it might not address the specific needs of a client with unilateral hearing loss. Simply repeating information may not improve comprehension if the client's hearing loss is in one ear.
B) Correct- Providing education for a client with unilateral hearing loss requires consideration of their specific communication needs. Writing information on a whiteboard allows the client to visually process the information, which can be particularly helpful for those with hearing loss in one ear. This method ensures that the client can access the information accurately and effectively.
C) Incorrect- Speaking loudly into the affected ear is not a recommended approach. It can be uncomfortable for the client and may not necessarily improve communication if the hearing loss is unilateral.
D) Incorrect- While speaking directly facing the client is a good practice in general, it may not fully address the communication challenges of someone with unilateral hearing loss. Providing visual information through writing is a more effective way to ensure the client receives the information accurately.

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When assessing a newborn girl with salt-wasting congenital adrenal hyperplasia due to 21 hydroxylase deficiency, the nurse notes that the infant has an enlarged clitoris. Which intervention should the nurse implement?

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Naxlex Comprehensive Predictor Exams

The nurse discovers that an older client with no history of cardiac or renal disease has an elevated serum magnesium level. To further investigate the cause of this electrolyte imbalance, what information is most important for the nurse to obtain from the client's medical history?

Correct Answer is B

Explanation

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Correct Answer is D

Explanation

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