A nurse is assessing the sexual maturity of a 14-year-old male during a routine check-up. Based on Tanner's stages of sexual development, which of the following characteristics would the nurse expect to observe in a male at Tanner stage 3?
Enlargement of the testes and scrotum with the appearance of pubic hair
Penile enlargement and deepening of the voice
Increased muscle mass and facial hair growth
Full development of genitalia and the growth of axillary hair
The Correct Answer is B
A. Enlargement of the testes and scrotum with the appearance of pubic hair is characteristic of Tanner stage 2, which marks the early stages of puberty. This is when initial changes in the genitalia and pubic hair begin.
B. Penile enlargement and deepening of the voice is correct because these changes occur during Tanner stage 3, representing continued pubertal development. Stage 3 includes further growth of the penis, continued enlargement of the testes, increased pubic hair that is darker and coarser, and the beginning of voice changes.
C. Increased muscle mass and facial hair growth is incorrect because these changes are more characteristic of Tanner stage 4–5, the later stages of puberty, when secondary sexual characteristics become more pronounced.
D. Full development of genitalia and the growth of axillary hair is incorrect because this represents Tanner stage 5, which indicates full sexual maturity and adult genital development.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
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Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"B"}
Explanation
Pathologic jaundice (Select 1): The most critical factor here is that the jaundice appeared within the first 24 hours of life. Physiologic jaundice typically appears after 24 hours, peaks between days 3–5, and usually does not reach levels as high as 13 mg/dL so rapidly. A level of 13 mg/dL at only 12 hours old is significantly elevated and indicates a rapid rise, which is characteristic of pathologic conditions like Rh/ABO incompatibility or sepsis.
Phototherapy (Select 2): This is the first-line medical intervention for significant hyperbilirubinemia. It uses light energy to change unconjugated bilirubin into a water-soluble form (lumirubin) that can be excreted in the bile and urine without needing to be processed by the liver.
Correct Answer is A
Explanation
A. Excessive oral secretions, coughing, and cyanosis during feeding is correct. These are classic signs of esophageal atresia with tracheoesophageal fistula (TEF). TEF results in an abnormal connection between the trachea and esophagus, causing ingested fluids to enter the airway. This leads to choking, coughing, cyanosis, and excessive drooling, especially during feeding. Early recognition is critical to prevent aspiration and respiratory complications.
B. Poor suck reflex and hypotonia is incorrect because these findings are associated with neurologic or metabolic disorders, not TEF. While feeding difficulties may occur, they do not specifically indicate a fistula between the trachea and esophagus.
C. Projectile vomiting with blood-tinged emesis is incorrect because this is more characteristic of pyloric stenosis or upper gastrointestinal bleeding, not TEF. TEF primarily affects swallowing and airway protection, not gastric emptying.
D. Bilious vomiting with abdominal distension is incorrect because these signs suggest intestinal obstruction, such as malrotation or intestinal atresia, rather than TEF.
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