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 C
Explanation
In a 5-week-old infant presenting with a history of projectile vomiting after feedings, the nurse should expect to assess an olive-size mass in the epigastric area. This finding is consistent with pyloric stenosis, a condition in which the muscle at the bottom of the stomach that controls the flow of food into the small intestine becomes thickened and narrowed.
Rebound tenderness in the left lower abdominal quadrant, stool that consists of mucus and blood, and frequent burping accompanied by poor feeding are not typically associated with pyloric stenosis.
Correct Answer is C
Explanation
Administer the injection into the middle of the lateral aspect of the thigh is the correct choice. This is the recommended site for intramuscular injection in toddlers who have been walking for at least one month, as it is a large muscle with minimal nerves and blood vessels. Choices A, B, and D are not appropriate techniques for administering an intramuscular injection to a toddler with pneumonia.
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