A child's skeletal age is best determined by: a. assessment of ...

[theo]

A child's skeletal age is best determined by:
 
  a. assessment of dentition.
  b. assessment of height over time.
  c. facial bone development.
  d. radiographs of the hand and wrist.

Question 2

Parents express concern that their pubertal daughter is taller than the boys in her class. The nurse should respond with which statement regarding how the onset of pubertal growth spurt compares in girls and boys?
 
  a. It occurs earlier in boys.
  b. It occurs earlier in girls.
  c. It is about the same in both boys and girls.
  d. In both boys and girls, the pubertal growth spurt depends on growth in infancy.

[cswans24]

Answer to Question 1

ANS: D
The most accurate measure of skeletal age is radiologic examinations of the growth plates. These are the epiphyseal cartilage plates. Radiographs of the hand and wrist provide the most useful screening to determine skeletal age. Age of tooth eruption has considerable variation in children. It would not be a good determinant of skeletal age. Assessment of height over time will provide a record of the child's height but not skeletal age. Facial bone development will not reflect the child's skeletal age, which is determined by radiographic assessment.

Answer to Question 2

ANS: B
Usually, the pubertal growth spurt begins earlier in girls. It typically occurs between the ages of 10 and 14 years for girls and 11 and 16 years for boys. The average earliest age at onset is 1 year earlier for girls. There does not appear to be a relation to growth during infancy.