A breastfeeding infant, screened for congenital hypothyroidism, is found to have low levels of thyroxine (T4) and high levels of thyroid stimulating hormone (TSH). Which is the best explanation for this finding?
The TSH is high because of the low production of T4 by the thyroid.
The thyroxine level is low because the TSH level is high.
The thyroid gland does not produce normal levels of thyroxine for several weeks after birth.
High thyroxine levels normally occur in breastfeeding infants.
The Correct Answer is A
In a normal infant, T4 levels increase after birth due to stimulation by TSH from the pituitary gland. In this case, the T4 level is low and the TSH level is high, indicating that the thyroid gland is not producing enough T4 in response to TSH stimulation. This suggests that the infant may have congenital hypothyroidism, which requires prompt treatment to prevent developmental delays and other complications.
The low T4 level is not a direct cause of the high TSH level; rather, the high TSH level is a compensatory mechanism to increase T4 production. It is not normal for a breastfeeding infant to have high thyroxine levels. While the thyroid gland may take a few weeks to reach normal function after birth, the persistent low T4 and high TSH levels in this infant suggest a more serious issue.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
At the age of 3, children should be able to speak in simple sentences with a minimum of four words. This is a normal developmental milestone for this age group. Choices B, C, and D are not appropriate developmental milestones for speech and language skills for a 3-year-old child.
Correct Answer is A
Explanation
The nurse should report the findings of significant erythema and swelling in the scrotum immediately to the healthcare provider. The adolescent's symptoms may be indicative of testicular torsion, which is a medical emergency and requires prompt treatment to prevent loss of the testicle. Obtaining a swab of secretions from the penis and urethra or collecting a sterile urine sample for culture and sensitivity are not appropriate actions for this presentation. Providing a urinal for urinary hesitancy may be appropriate if the adolescent is experiencing difficulty urinating, but this should not take precedence over reporting the findings to the healthcare provider.
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