A nurse is teaching adolescent boys about pubertal changes. The first sign of pubertal change seen with boys is

Infants and children have open growth plates, also known as epiphyseal plates, at the ends of
their long bones. These plates are responsible for bone growth and are not fully fused until
the child reach skeletal maturity. Due to the presence of open growth plates, infants and
children are more prone to fractures because their bones are still developing and are less
dense than those of adults.

Their bones have less blood flow in (Option A) is incorrect because cchildren’s bones
actually have a greater blood flow compared to adults. This increased blood flow supports the
rapid growth and development of bones in children.

Growth occurs in children as a result of an increase in the number of muscle fibers in (option
B) is incorrect because ggrowth in children occurs primarily due to the elongation and
thickening of existing muscle fibres, not an increase in their number. This option inaccurately
suggests that children's muscles increase in fibber count to facilitate growth.

Because soft tissues are resilient in children, dislocations and spirals are less common than in
adults in (Option D is) incorrect. While soft tissues may be more resilient in children, it does
not mean that dislocations and sprains are less common than in adults. In fact, children's
ligaments and joint structures are still developing and may be more susceptible to injuries
such as sprains and dislocations compared to adults.

The assessment finding that the nurse should expect in an infant with Hirschsprung disease is option A, constipation with the passage of foul-smelling, ribbon-like stools. Hirschsprung disease is a congenital condition characterized by the absence of ganglion cells in the distal part of the colon, leading to functional obstruction. The affected segment of the colon lacks the normal peristaltic movements, resulting in an accumulation of faecal matter. The stools passed by infants with Hirschsprung disease are often constipated, and the narrow, ribbon- like appearance is a result of the narrowed segment of the colon.

diarrhea (option B) is incorrect because it, is not typically associated with Hirschsprung disease. Instead, the condition presents with constipation due to the obstructed bowel.

foul-smelling, fatty stools in (option C) is incorrect because it, is not characteristic of Hirschsprung disease. This finding may be associated with malabsorption disorders such as cystic fibrosis or celiac disease, but not specifically with Hirschsprung disease.

"currant jelly" stools in (option D) is incorrect because it, is a term commonly used to describe the stools seen in intussusception, which is a different condition involving the telescoping of one segment of the bowel into another. It is not an expected finding in Hirschsprung disease.