A NICU nurse is completing an assessment on a premature infant male born at 29 weeks gestation. It is noted that the male infant has no palpable testes in the scrotum. The nurse should:

Document this expected finding.

Insert a urinary catheter to collect a urine specimen.

Initiate a social work consult.

Call the provider for this unexpected finding.

Answer and Explanation

The Correct Answer is A

Choice A reason:

In premature infants, it is common for the testes to not be palpable in the scrotum at birth. This condition, known as cryptorchidism, affects about 30% of preterm infants1. The testes usually descend into the scrotum by the time the infant reaches term or within the first few months of life. Therefore, the nurse should document this as an expected finding and continue to monitor the infant’s development.

Choice B reason:

Inserting a urinary catheter to collect a urine specimen is not necessary in this situation. The absence of palpable testes in a premature infant is a common finding and does not indicate a need for immediate urinary evaluation. Urinary catheterization should be reserved for specific medical indications, such as suspected urinary tract infection or urinary retention.

Choice C reason:

Initiating a social work consult is not relevant to the clinical finding of undescended testes in a premature infant. Social work consultations are typically initiated for psychosocial issues, family support, or discharge planning. The absence of palpable testes is a medical finding that should be documented and monitored by the healthcare team.

Choice D reason:

Calling the provider for this unexpected finding is not necessary because the absence of palpable testes in a premature infant is an expected finding. The nurse should document the finding and continue to monitor the infant’s development. If the testes do not descend by the time the infant reaches term or within the first few months of life, further evaluation and management may be needed.

Nursing Test Bank

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Correct Answer is ["A","B","C","D","E","F","G","H","I"]

Explanation

The correct answer is

A. Unable to roll over back to front

B. Head lag

C. Feeding difficulties

D. Floppy posture

E. Arms are stiff

F. Does not smile

G. Unable to sit without support

H. Irritable and cries often

I. Unable to pass an object between hands

Choice A reason

Unable to roll over back to front: At 3 months, infants typically start to develop the ability to roll over from their stomach to their back. Rolling over from back to front usually occurs later, around 4 to 6 months. However, the inability to roll over at all by 3 months could indicate developmental delays or muscle weakness, which requires follow-up.

Choice B Reason

Head lag: By 3 months, infants should have enough neck muscle strength to hold their head up when pulled to a sitting position. Persistent head lag at this age can be a sign of developmental delay or neuromuscular disorders, necessitating further evaluation.

Choice C Reason

Feeding difficulties: Infants should be able to suck and swallow effectively by 3 months. Feeding difficulties can lead to inadequate nutrition and growth, and may indicate underlying issues such as gastrointestinal problems or neurological disorders. This requires prompt attention and intervention.

Choice D Reason

Floppy posture: A 3-month-old should start to show more control over their body movements and have a more stable posture. Floppy posture, also known as hypotonia, can be a sign of various conditions, including genetic disorders, muscle diseases, or central nervous system issues. It is important to investigate the cause of hypotonia.

Choice E Reason

Arms are stiff: Stiffness in the arms, or hypertonia, can indicate neurological problems such as cerebral palsy or other motor disorders. It is crucial to assess the underlying cause of increased muscle tone and provide appropriate interventions.

Choice F Reason

Does not smile: Social smiling typically begins around 6 to 8 weeks of age. If a 3-month-old does not smile, it could be a sign of developmental delay, visual impairment, or other social and emotional issues. This warrants further assessment to determine the cause.

Choice G Reason

Unable to sit without support: While sitting without support is not expected until around 6 months, the inability to show any signs of trying to sit or maintain a sitting position with support at 3 months could indicate developmental delays. This should be monitored and addressed if necessary.

Choice H Reason

Irritable and cries often: Excessive irritability and frequent crying can be signs of discomfort, pain, or underlying medical conditions such as infections, gastrointestinal issues, or neurological problems. It is important to identify and address the cause of the infant’s distress.

Choice I Reason

Unable to pass an object between hands: By 3 months, infants should start to develop hand-eye coordination and the ability to grasp objects. The inability to pass an object between hands may indicate developmental delays or motor skill issues, which require further evaluation.

A. The infant can have weight gain B. The infant can have rapid gut motility and diarrhea C. Infancy is a critical period for brain development D. The infant may become hyperactive and irritable

Correct Answer is C

Explanation

Choice A reason:

Weight gain is not a primary concern in the management of hypothyroidism in infancy. While hypothyroidism can lead to weight gain due to a slower metabolism, the more critical issue is the impact on brain development. Early and adequate treatment of hypothyroidism is essential to prevent intellectual disabilities and ensure normal neurocognitive outcomes.

Choice B Reason:

Rapid gut motility and diarrhea are not typical symptoms of hypothyroidism. In fact, hypothyroidism is more commonly associated with constipation due to a slower metabolism. Therefore, this choice is not relevant to the prompt management of hypothyroidism in infancy.

Choice C Reason:

Infancy is indeed a critical period for brain development. Untreated hypothyroidism during this time can lead to severe intellectual disabilities and developmental delays. Early diagnosis and treatment with thyroid hormone replacement are crucial to ensure normal brain development and cognitive function.

Choice D Reason:

Hyperactivity and irritability are not common symptoms of hypothyroidism. In fact, hypothyroidism often leads to lethargy and decreased activity levels. Therefore, this choice is not relevant to the prompt management of hypothyroidism in infancy.

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A NICU nurse is completing an assessment on a premature infant male born at 29 weeks gestation. It is noted that the male infant has no palpable testes in the scrotum. The nurse should:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["A","B","C","D","E","F","G","H","I"]

Explanation

Prompt management of hypothyroidism in infancy is necessary because:

Correct Answer is C

Explanation

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A NICU nurse is completing an assessment on a premature infant male born at 29 weeks gestation. It is noted that the male infant has no palpable testes in the scrotum. The nurse should: