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 C
Explanation
Diarrhea is characterized by increased motility of the intestines, which leads to a decreased absorption of fluid and nutrients. This statement correctly indicates an understanding of the teaching regarding diarrhea.
Organisms destroy intestinal mucosal cells, resulting in an increased intestinal surface area in (Option A) is incorrect because organisms causing diarrhea can lead to damage or inflammation of the intestinal mucosal cells, but they do not destroy them to increase the intestinal surface area.
Malabsorption results in metabolic alkalosis in (Option B) is incorrect because malabsorption does not result in metabolic alkalosis. Malabsorption refers to the impaired absorption of nutrients, but it does not directly affect the acid-base balance in the body.
Diarrhea results from a fluid deficit in the small intestine in (Option D) is incorrect because diarrhea does not result from a fluid deficit in the small intestine. Diarrhea is characterized by an increased volume of fluid in the intestines and increased frequency of bowel movements.
Correct Answer is A
Explanation
In a teaching plan for the mother of an 11-year-old boy with ulcerative colitis, the nurse should stress the importance of coping with stress and avoiding triggers. Ulcerative colitis is a chronic inflammatory bowel disease that can be influenced by various factors, including stress and triggers. Helping the child and the family develop effective stress management strategies and identifying and avoiding triggers can help in reducing the frequency and severity of ulcerative colitis flare-ups.
preventing the spread of illness to others in (option B) is incorrect because it, is not the primary focus of teaching for ulcerative colitis. Ulcerative colitis is not an infectious condition that can be spread to others.
, nutritional guidance and supportive intake of sodas in (option C) is incorrect because it, is an important aspect of managing ulcerative colitis. However, it should be addressed in conjunction with a comprehensive nutritional plan that considers the individual needs and tolerances of the child. The mention of supportive intake of sodas may not be appropriate, as carbonated beverages can potentially aggravate symptoms in some individuals with ulcerative colitis.
teaching daily use of enemas in (option D) is incorrect because it, is not typically a part of routine care for ulcerative colitis in children. The use of enemas may be considered in specific situations or as part of an individualized treatment plan under the guidance of healthcare providers, but it is not a general teaching point for all children with ulcerative colitis.
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