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.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Celiac disease is an autoimmune disorder triggered by the ingestion of gluten, a protein found in wheat, barley, and rye. It causes damage to the lining of the small intestine, leading to malabsorption of nutrients. The characteristic symptoms of celiac disease include abdominal distention, underweight or failure to thrive, thin arms and legs, and foul-smelling stools.
intussusception in (option A) is incorrect because it, refers to a condition where a portion of the intestine telescopes into an adjacent section, causing an obstruction. While intussusception can present with symptoms such as abdominal pain, vomiting, and currant jelly-like stools, it is not typically associated with failure to thrive.
imperforate anus, in (option B) is incorrect because it is a congenital condition in which the opening of the anus is blocked or absent. It can cause difficulties with passing stools, but it is not typically associated with failure to thrive or the specific assessment findings described.
irritable bowel syndrome (IBS) in (option D) is incorrect because it, is a chronic disorder of the gastrointestinal tract characterized by recurrent abdominal pain, changes in bowel habits, and bloating. While IBS can cause gastrointestinal symptoms, it is not typically associated with failure to thrive, underweight, or the specific assessment findings mentioned.
Correct Answer is D
Explanation
When the skin surface is caked with desquamated skin and sebaceous secretions after the removal of a cast, the nurse should suggest washing the area with warm water and soap. This will help to gently cleanse the skin and remove the accumulated material without causing unnecessary trauma or irritation.
Option A, applying powder to absorb the material, may not effectively remove the caked material and could potentially lead to further clumping or discomfort.
Option B, vigorously scrubbing the leg, can be harsh on the skin and may cause skin irritation, redness, or even abrasions. It is important to be gentle and avoid excessive scrubbing, especially on the fragile and recently exposed skin.
Option C, carefully picking the material off the leg, can increase the risk of skin injury or introduce bacteria into the skin. Picking at the skin should be avoided to prevent further damage or infection.
Therefore, option D, washing the area with warm water and soap, is the most appropriate and gentle method to remove the caked material from the skin surface
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