The school nurse is teaching a group of female students about the female reproductive system. A student asks how she will know she is starting puberty. Which information should the nurse discuss?

A dark line of pigmentation occurs along the midline of the abdomen.

Weight gain becomes obvious as the hip circumference increases.

The areolar color of the nipples changes from pink to dark brown.

The development of breast buds will form under the nipples.

Answer and Explanation

The Correct Answer is D

A. A dark line of pigmentation occurs along the midline of the abdomen: This refers to linea nigra, which is more commonly associated with hormonal changes during pregnancy rather than puberty. It is not a typical sign of puberty in adolescent females.

B. Weight gain becomes obvious as the hip circumference increases: While changes in body shape and fat distribution occur during puberty especially with increased fat around the hips and thighs, it is usually a gradual process and not the first noticeable sign.

C. The areolar color of the nipples changes from pink to dark brown: Areolar pigmentation may darken with puberty in some individuals, but it varies by skin tone and is not a reliable or universal first sign of puberty.

D. The development of breast buds will form under the nipples: The appearance of breast buds or thelarche, small, firm lumps form under the nipples, which can sometimes be tender, is typically the first visible sign of puberty in girls, usually occurring around ages 8–13. It signals the beginning of hormonal changes and physical development.

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Correct Answer is D

Explanation

A. Observe the client's eye movements through the cardinal fields of vision: This test evaluates extraocular muscle function and cranial nerves III, IV, and VI. It helps detect muscle weakness or nerve damage but does not measure visual acuity or diagnose legal blindness.

B. Observe the client's pupillary response to a penlight: This assesses the integrity of the optic and oculomotor nerves and reflexes, such as pupil constriction. While useful in neurological assessments, it does not determine the level of visual acuity needed to confirm legal blindness.

C. Observe the client's optic disc through an ophthalmoscope: Direct visualization of the optic disc can reveal issues like glaucoma or optic atrophy. However, it does not quantify vision loss or determine functional blindness as defined by acuity measurements.

D. Assess the client's ability to read a Snellen chart from a distance of 20 feet: This is the standard method for evaluating visual acuity. Legal blindness is defined in the U.S. as visual acuity of 20/200 or worse in the better eye with corrective lenses, making this test the most appropriate for supporting the client’s statement.

A. Borborygmi sounds. B. Hyperactive bowel sounds. C. Hypoactive bowel sounds. D. Normal bowel sounds.

Correct Answer is D

Explanation

A. Borborygmi sounds: Borborygmi are loud, prolonged, gurgling bowel sounds typically associated with increased gastrointestinal motility. They are usually heard without a stethoscope and are often linked to hunger or certain GI conditions, not the normal rhythm described.

B. Hyperactive bowel sounds: These are frequent, high-pitched, loud sounds that may occur more than 30 times per minute. They are associated with diarrhea, gastroenteritis, or early bowel obstruction—not the steady, moderate-frequency sounds described.

C. Hypoactive bowel sounds: These are infrequent bowel sounds (fewer than 5 per minute), often soft and low-pitched, possibly indicating slowed intestinal activity from surgery, inflammation, or ileus. The client’s pattern of sounds every 5–10 seconds does not meet this definition.

D. Normal bowel sounds: Bowel sounds occurring every 5 to 15 seconds and lasting a few seconds (gurgles, clicks) are considered normal. These reflect regular peristaltic activity and digestion, making this the correct documentation for the described findings.

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The school nurse is teaching a group of female students about the female reproductive system. A student asks how she will know she is starting puberty. Which information should the nurse discuss?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client states, "I am legally blind." Which assessment technique should the nurse use to obtain data to support the client's statement?

Correct Answer is D

Explanation

While auscultating for bowel sounds in an adult client, the nurse notes a series of gurgles that last about 3 seconds and occur every 5 to 10 seconds in all quadrants. How should the nurse document this finding?

Correct Answer is D

Explanation

Which question by the nurse is likely to elicit the most information regarding a client's use of medications to treat a chronic cough?

A nurse performs a Tinetti assessment on an older adult client and calculates a balance score of 12 and a gait score of 8. Which do these results indicate?

The nurse observes that the lower legs of a client with diabetes mellitus are shiny, and with no hair growth. To obtain additional data to support these findings, which assessment should the nurse perform?

A client asks the nurse to look at a mole located on the back. The client tells the nurse that the mole has changed from brown to black and enlarged in size. Which is the priority nursing action?

The nurse is assessing older adult clients in a community health clinic. Which assessment finding is an indicator for immediate medical follow-up?

The nurse auscultates the precordium of a client who is diagnosed with mitral valve regurgitation and hears a grade IV systolic murmur. When documenting the comparison of systolic murmurs, which characteristics should the nurse use to support this systolic finding?

The nurse plans to assess a client's ability to think abstractly. Which question or statement is likely to provide the best information about the client's abstract thinking?