A nurse is teaching an expectant parent about the differences between the skeletal system of an adult compared to that of a child.
Which of the following statements should the nurse include in their teaching?
The plates of the skull of a newborn fuse just prior to birth.
Growth plates function to fuse bones together in adolescents.
Adults have 300 bones, but newborns have only 206 bones.
As infants reach 1 or 2 years of age, they have fewer bones than they did at birth.
The Correct Answer is D
Pediatric anatomy differs significantly from adult physiology regarding ossification and skeletal structure. Knowledge of bone development, including the transition from cartilage to mineralized bone and the fusion of growth centers, is required to differentiate between newborn and adult skeletal systems.
Choice A rationale
The cranial plates do not fuse prior to birth; they remain separated by fontanels and sutures to allow for brain growth and passage through the birth canal. The posterior fontanel closes at two months, while the anterior fontanel closes later.
Choice B rationale
Growth plates, or epiphyseal plates, are areas of active longitudinal bone growth consisting of hyaline cartilage. They do not function to fuse bones together until the end of puberty when they ossify completely, marking the end of physical height increase.
Choice C rationale
This statement is factually reversed; newborns have approximately 300 bones, many of which are cartilaginous. As the child grows, these structures fuse into the 206 distinct mineralized bones found in the typical adult skeletal system following complete ossification.
Choice D rationale
Infants have more bones than adults because many skeletal segments have not yet fused. As the child reaches one or two years, several bones begin the process of fusion, resulting in a lower total count compared to birth.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Identifying ventricular septal defects (VSD) requires knowledge of cardiac hemodynamics and auscultation. The nurse must understand how high-pressure left-to-right shunting through a structural opening in the septum creates specific acoustic turbulence during the systolic phase of the cardiac cycle.
Choice A rationale
Cyanosis is not typically a primary sign of an isolated VSD because the shunt is left-to-right, meaning oxygenated blood enters the lungs. Cyanosis only occurs if pulmonary hypertension develops, eventually causing a reversal of the blood flow.
Choice B rationale
A wide pulse pressure is a classic clinical finding associated with patent ductus arteriosus (PDA) due to diastolic runoff into the pulmonary circulation. It is not a characteristic finding for a ventricular septal defect in a newborn.
Choice C rationale
The high-pressure gradient between the left and right ventricles forces blood through the defect, creating a holosystolic murmur. This loud, harsh sound is best heard at the lower left sternal border where the turbulent flow occurs.
Choice D rationale
Clubbing of the fingernails is a sign of chronic, long-term hypoxia and is seen in cyanotic heart defects or long-standing uncorrected shunts. It would not be present in a newborn with a recently diagnosed ventricular septal defect.
Correct Answer is B
Explanation
Identifying pediatric migraine characteristics requires knowledge of neurological symptoms and developmental presentations. Clinicians must differentiate migraines from tension-type headaches by focusing on the quality of pain, associated sensory sensitivities, and the impact of movement on the child's symptom severity.
Choice A rationale
Migraines are actually less common in children under 5 years old and increase in prevalence as children age through adolescence. Early childhood headaches are often associated with other conditions or abdominal variants rather than classic migraine patterns.
Choice B rationale
Pediatric migraines typically present as pulsating or throbbing pain due to neurovascular changes and vasodilation of cranial vessels. This sensation is a hallmark diagnostic feature that distinguishes vascular headaches from the steady pressure seen in tension headaches.
Choice C rationale
Physical activity typically exacerbates migraine pain due to increased intracranial pressure and sensory overload during an attack. Diagnostic criteria for migraines specifically include the worsening of symptoms with routine movements like walking, climbing stairs, or playing.
Choice D rationale
Migraines in children frequently occur with associated symptoms like nausea, vomiting, photophobia, and phonophobia. These autonomic and sensory disturbances are critical for diagnosis, as migraines are rarely isolated to head pain without any other systemic or sensory signs.
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