A Term Newborn Is Undergoing Routine Evaluation in the Nursery

question 586

Multiple Choice

A term newborn is undergoing routine evaluation in the nursery.  The boy was born 12 hours ago via spontaneous vaginal delivery to a 24-year-old woman.  His mother had appropriate prenatal care, and her pregnancy was uncomplicated.  Delivery was unremarkable, and the patient has had a normal nursery course.  He received the hepatitis B vaccine, erythromycin eye ointment, and intramuscular vitamin K after delivery.  Family history reveals factor VIII deficiency in the patient's paternal grandfather.  Vital signs are normal.  Physical examination shows a sleeping newborn with normal tone.  A 1/6 systolic murmur is best heard at the left sternal border.  Peripheral pulses are strong.  Genitourinary examination shows a penis of normal length with no curvature.  The urethral meatus extends to the corona on the ventral aspect of the penis, and the foreskin has a dorsal hood appearance.  The testes are present bilaterally within the scrotum.  The patient urinates through the urethral meatus during examination.  The father requests that a circumcision be performed.  Which of the following is the best next step in management of this patient?

• A)Coagulation studies
• B)Echocardiogram
• C)Karyotype
• D)Renal ultrasound
• E)Urology evaluation

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Definitions:

Density-dependent

Factors whose effects on the size or growth of the population vary with the population density.

Intrinsic Rate

The maximum rate of growth of a population under ideal conditions, reflecting its reproductive potential and sustainability.

Resources

Resources refer to the stock of materials, energy, services, and other assets that can be drawn upon by a person or organization to function effectively.

Growth Capacity

The potential of an entity or environment to expand, increase, or develop further, often measured in terms of productivity or population.