A neonate is displaying mottled skin, has a large fontanel and tongue, is lethargic, and is having difficulty feeding. The nurse recognizes that this is most suggestive of which disorder?
Hypoglycaemia
Hypothyroidism
Hypocalcaemia
Phenylketonuria (PKU)
The Correct Answer is B
Hypothyroidism refers to an underactive thyroid gland that does not produce enough thyroid hormones. In newborns, this condition is known as congenital hypothyroidism. The symptoms mentioned—mottled skin, a large fontanel (soft spot on the baby's head), a large tongue, lethargy, and difficulty feeding—are characteristic of hypothyroidism inneonates.
Mottled skin can occur due to decreased circulation and low body temperature associated with hypothyroidism. A large fontanel and tongue are common physical features seen in infants with hypothyroidism. Lethargy and poor feeding are also typical signs of this condition.
Hypoglycaemia in (option A) is incorrect because it refers to low blood sugar levels and usually presents withdifferent symptoms such as jitteriness, tremors, and sweating.
Hypocalcaemia in (option C) is incorrect because it is low calcium levels and can manifest with symptoms like muscle cramps, twitching, and seizures.
Phenylketonuria (PKU) in (option D) it is incorrect because it is a metabolic disorder characterized by the inability to metabolize the amino acid phenylalanine, and it typically presents with different symptoms such as intellectual disability and a musty door to the skin.
Therefore, based on the symptoms described, hypothyroidism (B) is the most likely disorder in this neonate. It isimportant to consult a healthcare professional for a proper diagnosis and appropriate treatment.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
The best response for the nurse to give a parent regarding contacting the physician about an
infant with diarrhea is option B. In infants, dehydration can occur quickly, and a decrease in
urine output is an important indicator of fluid imbalance. Not having a wet diaper for 6 hours
can be a sign of inadequate fluid intake or excessive fluid loss, which warrants contacting the
paediatrician for further assessment and guidance.
"Call the doctor immediately if the infant has a temperature greater than 100° F,"in (option
A) is incorrect because it is not directly related to the concern of diarrhea. While a high fever
can be a sign of an underlying infection, it is not the primary concern in this case.
"The paediatrician should be contacted if the infant has two loose stools in an 8-hour
period,” in (option B) is incorrect because it may not necessarily require immediate medical
attention. While increased frequency of stools can be concerning, the absence of urine output
is a more critical indicator of dehydration.
"Notify the paediatrician if the infant naps more than 2 hours," in (option D) is incorrect
because it is unrelated to the concern of diarrhea and dehydration.
Correct Answer is B
Explanation
These symptoms are indicative of hypoglycaemia, which occurs when the blood sugar levels drop too low. Providing a source of fast-acting carbohydrates, such as orange juice, can quickly raise the child's blood sugar levels and alleviate the symptoms.
Administering insulin (Option A) is incorrect because it is not appropriate in this situation because it would further lower the child's blood sugar levels.
Offering water (Option C) is incorrect because it would not effectively address the low blood sugar.
Glucagon (Option D) is incorrect because it is typically used in severe cases of hypoglycaemia when the child is unconscious or unable to swallow, and it requires a prescription. In this case, providing orange juice is the safest and most appropriate initial intervention. However, it is important to seek medical attention and inform the child's healthcare provider about the incident.
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