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 A
Explanation
A. The harness maintains the hips in flexion, abduction, and external rotation
The factor that the nurse should include when teaching a parent about the care of a newborn
in a Pavlik harness for hip dysplasia is that the harness maintains the hips in flexion,
abduction, and external rotation. The Pavlik harness is a commonly used device for the
treatment of developmental dysplasia of the hip (DDH) in infants. It is designed to hold the
hips in a position that promotes proper alignment and development.
The harness maintains the hips in flexion, abduction and external rotation in (Option B) is
incorrect. The Pavlik harness should not be removed with every diaper change. The harness
needs to be worn consistently as directed by the healthcare provider to ensure the
effectiveness of the treatment.
The harness is the only first step of treatment in (Option C) is incorrect. While the Pavlik
harness is an important step in the treatment of hip dysplasia, it is not the only step.
Additional treatments, such as bracing or surgical interventions, may be required depending
on the severity of the condition.
The harness in worn for 2 weeks in (Option D) is incorrect. The duration for which the Pavlik
harness is worn can vary depending on the individual case and the healthcare provider's
instructions. It is typically worn for several weeks to months, and the specific duration will be
determined by the healthcare provider based on the child's progress and response to
treatment.

Correct Answer is A
Explanation
The most appropriate statement by the nurse to a 15-year-old whose friend has mentioned suicide is option A. The statement acknowledges the seriousness of the situation and emphasizes the importance of taking the friend's threat seriously. It also highlights the need for immediate help and intervention. Suicide threats should never be dismissed or taken lightly, and it is crucial to involve professionals who can provide appropriate support and assistance.
"Tell your friend to come to the clinic immediately," in option B is incorrect because places the responsibility solely on the 15-year-old to relay the message to their friend, which may not be the most effective or timely approach.
"If your friend mentions suicide again, get your friend some help," in (option C) is incorrect because it does not address the urgency of the situation. Waiting for the friend to mention suicide again before acting may lead to potential harm.
"You need to gather details about your friend's suicide plan," is incorrect because places the responsibility on the 15-year-old to gather information about the friend's suicidal intentions. While understanding the situation and obtaining relevant details is important, the immediate priority is ensuring the friend's safety and seeking professional help.
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