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 B
Explanation
Biliary atresia is a condition that can cause jaundice in newborns and infants, and it can also lead to tea-colored urine due to the presence of bilirubin in the urine. Infants with biliary atresia require further assessment and treatment, including possible surgery, to prevent liver damage and other complications.
A. Intussusception is a condition in which a part of the intestine folds into itself, causing an obstruction, but it does not typically present with jaundice or tea-colored urine.
C. Hirschsprung's disease is a congenital condition that affects the large intestine and can cause bowel obstruction, but it also does not typically present with jaundice or tea-colored urine.
D. Huntington's disease is a genetic neurological disorder that typically does not present in infants and does not cause jaundice or tea-colored urine.

Correct Answer is ["1.3"]
Explanation
1.3 mL of amoxicillin suspension with each dose.
To calculate the correct dose of amoxicillin to give to the child, follow these steps:
Step 1: Convert the child's weight from pounds to kilograms. 18 pounds ÷ 2.2 = 8.18 kilograms
Step 2: Calculate the total daily dose of amoxicillin. 25 mg/kg/day x 8.18 kg = 204.5 mg/day
Step 3: Divide the total daily dose into two equal doses to be given every 12 hours. 204.5 mg/day ÷ 2 doses = 102.25 mg/dose
Step 4: Determine how many mL of the suspension contain 102.25 mg of amoxicillin. 400 mg/5 mL = 80 mg/mL 102.25 mg ÷ 80 mg/mL = 1.28 mL

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