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
The nurse's best response to the parents of a 10-year-old child newly diagnosed with type 1
diabetes mellitus, who are concerned about the child's continued participation in soccer, is to
reassure them that it is generally safe for the child to play sports such as soccer unless the
weather is too hot.
Regular physical activity, including participation in sports, is generally encouraged for
children with type 1 diabetes as long as certain precautions are taken. It is important for the
child to have a well-managed diabetes management plan in place, which may include
monitoring blood sugar levels before, during, and after physical activity, adjusting insulin
doses as necessary, and having appropriate snacks available to maintain blood sugar levels.
Option B, suggesting the swim team as an alternative to soccer, may be a viable option if the
child or parents prefer swimming or if the child has specific concerns related to soccer.
However, it is not the best response to the parents' concern about the child's continued
participation in soccer.
Option C, recommending an extra carbohydrate snack before soccer practice, is a valid
suggestion to help maintain the child's blood sugar levels during physical activity. However,
it should be part of a comprehensive diabetes management plan and not the sole response to
the parents' concern.
Option D, encouraging intellectual activity rather than participation in sports, is not
appropriate as physical activity is generally beneficial for children with type 1 diabetes, as
long as appropriate precautions are taken.
Correct Answer is A
Explanation
The scenario describes a 14-year-old male who seems to be always eating, but his weight is appropriate for his height. In this case, it is important to reassure the parents that the behaviour may not necessarily be a cause for concern.
Option A provides an accurate response by explaining that for weight gain to occur, the individual would need to consume an excessive number of calories. Since the adolescent's weight is appropriate for his height, it suggests that his caloric intake is likely balanced and not excessive.
suggesting that he is substituting food for unfilled needs in (option B) is incorrect because it, is speculative and may not be accurate without further assessment or evidence. It is important to avoid making assumptions about underlying psychological or emotional reasons for increased eating without more information.
stating that this is normal due to an increase in body mass during this time in (option C) is incorrect because it, is not necessarily applicable to the scenario. While it is true that adolescents experience growth and changes in body composition during this period, it does not directly explain the constant eating behaviour described.
suggesting that this behaviour is abnormal and indicative of possible future obesity in (option D) is incorrect because it, may be premature and unsupported based solely on the information provided. It is essential to avoid making predictions or assumptions about future health outcomes without proper evaluation.
By providing the parents with information about the caloric intake required for weight gain and reassuring them that their son's eating behaviour may be within a normal range, the nurse can address their concerns and provide accurate guidance. If the parents have further concerned or questions, it may be appropriate to refer them to a healthcare provider for a more comprehensive assessment.
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