The nurse is collecting a heel-stick blood specimen for a neonatal screen, which includes thyroxine (T4) and thyroid- stimulating hormone (TSH) levels, prior to discharging a 2-day-old patient.
When the parents ask why these tests are being conducted, which explanation should the nurse provide?
This is a routine blood test required by law to screen for metabolic deficiencies.
Dosages for thyroid replacement therapy will be determined by this test.
This technique is used for early detection of intellectual disabilities.
These laboratory values will provide data to anticipate delays in growth and development.
The Correct Answer is A
Choice A rationale
The neonatal screening test, which includes thyroxine (T4) and thyroid-stimulating hormone (TSH) levels, is a routine blood test required by law to screen for metabolic deficiencies. This test helps diagnose thyroid conditions. T4 is a thyroid hormone, and too much or too little of it can indicate an issue with the thyroid. TSH is a hormone your pituitary gland makes. It stimulates your thyroid to produce T4 and T3 (triiodothyronine) hormones. A TSH test is the best way to initially assess thyroid function. In fact, T4 tests more accurately reflect thyroid function when combined with a TSH test. Measuring T4 levels might not be necessary in all thyroid conditions. Other names for a T4 test include: Free thyroxine, Total T4 concentration, Thyroxine screen, Free T4 concentration, Free T4 index (FTI)1.
Choice B rationale
While the T4 and TSH tests can help diagnose thyroid conditions, they are not specifically used to determine dosages for thyroid replacement therapy. The dosage of thyroid replacement therapy is usually determined by a healthcare provider based on the patient’s medical condition, weight, age, laboratory test results, and response to treatment.
Choice C rationale
The neonatal screening test is not specifically used for the early detection of intellectual disabilities. However, it is important to note that untreated congenital hypothyroidism can lead to intellectual disabilities. Therefore, early detection and treatment of hypothyroidism generally result in normal growth and development.
Choice D rationale
While these laboratory values can provide data about the thyroid function of the newborn, they do not directly provide data to anticipate delays in growth and development. However, untreated congenital hypothyroidism can lead to growth and developmental delays. Therefore, early detection and treatment of hypothyroidism generally result in normal growth and development.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["6.8"]
Explanation
Step 1: Convert the client’s weight from lbs to kg. 1 kg is approximately 2.2 lbs. So, 198 lbs ÷
2.2 = 90 kg (rounded to the nearest whole number).
Step 2: Calculate the total mcg of Dopamine needed per minute. The prescription is for 2 mcg/kg/minute. So, 90 kg × 2 mcg/kg/minute = 180 mcg/minute.
Step 3: Convert the total mcg of Dopamine in the bag to mcg/mL. The bag contains 400 mg of Dopamine in 250 mL. 1 mg is equal to 1000 mcg. So, 400 mg × 1000 = 400,000 mcg. Therefore, the concentration is 400,000 mcg ÷ 250 mL = 1600 mcg/mL.
Step 4: Calculate the mL of Dopamine needed per minute. So, 180 mcg/minute ÷ 1600 mcg/mL
= 0.1125 mL/minute.
Step 5: Convert mL/minute to mL/hour. There are 60 minutes in an hour. So, 0.1125 mL/minute × 60 = 6.75 mL/hour. The IV pump should be set to deliver 6.8 mL/hour (rounded to the nearest tenth).
Correct Answer is C
Explanation
Choice A rationale
Monitoring the patient’s blood pressure every 1 hour for 2 hours after paracentesis may not be sufficient. Paracentesis is a procedure to remove fluid that has accumulated in the abdominal cavity (a condition called ascites). This is a common problem in people with certain diseases, including liver and kidney disease. Changes in blood pressure can occur rapidly after this procedure, so more frequent monitoring is needed immediately after the procedure.
Choice B rationale
Monitoring the patient’s blood pressure every 5 minutes for one hour after paracentesis may be too frequent and could cause unnecessary stress for the patient. It is important to balance the need for monitoring with the patient’s comfort and well-being.
Choice C rationale
Monitoring the patient’s blood pressure every 15 minutes for one hour, then every 1 hour for 2 hours after paracentesis is a good schedule. This allows for close monitoring immediately after the procedure, when complications are most likely to occur. It then allows for continued monitoring as the patient stabilizes.
Choice D rationale
Monitoring the patient’s blood pressure every 5 minutes for 30 minutes, then every 4 hours thereafter may not provide enough monitoring in the immediate post-procedure period. While it is important to continue monitoring, the first few hours after the procedure are a critical time when complications are most likely to occur.
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