Neonatal Nurse Practitioner Practice Exam

What is the most likely cause of rib fractures in a 3-month-old premature infant?

1. Congenital hypoparathyroidism

2. Inadequate calcium and phosphorus intake

3. Vitamin D deficiency due to malabsorption

4. Osteogenesis imperfecta

The correct answer is: Inadequate calcium and phosphorus intake

The most likely cause of rib fractures in a 3-month-old premature infant is inadequate calcium and phosphorus intake. Premature infants are particularly vulnerable to nutritional deficiencies due to their early arrival, which can lead to insufficient mineral intake critical for bone health. During this rapid growth phase, the body requires adequate calcium and phosphorus for bone mineralization. If these minerals are not sufficiently provided through nutrition, it can result in weakened bones that are more susceptible to fractures, even with minimal trauma. In neonates, especially preterm infants, there is also a higher incidence of conditions affecting their nutritional intake, which can lead to insufficient levels of these important minerals. Therefore, inadequate calcium and phosphorus intake is a key factor influencing the risk of rib fractures in this vulnerable population.