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 A

Explanation

A. Repeat vocalizing the letter "E" while the thorax is auscultated: Egophony is assessed by having the client say "E" while the nurse auscultates the chest. In the presence of lung consolidation, such as in a lung abscess, the "E" sound may be auscultated as an "A"—a finding known as the "E-to-A" change, which is a hallmark of egophony.

B. Whisper "one, two, three" in sequence during auscultation of the thorax: This technique is used to assess whispered pectoriloquy, not egophony. It helps detect areas of lung consolidation if whispered words are heard clearly through the stethoscope.

C. Repeat the number "99" during a systematic auscultation of the thorax: This test is used to assess bronchophony, increased loudness and clarity of spoken words, another sign of lung consolidation. Clear transmission of "99" may suggest fluid or consolidation in the lungs.

D. Breathe in and out while all lobes of both lungs are auscultated: This is a standard part of respiratory assessment but is not specific for egophony. It helps detect abnormal breath sounds like wheezes, crackles, or diminished sounds, not vocal resonance changes.

A. He would have difficulty falling to sleep, and sleep very lightly with more frequent arousals. B. He would sleep soundly during the first half of the night, with increased arousals during the second half. C. Increase sleep latency, and reduce total sleep time. D. Decrease the need for rapid eye movement (REM) sleep.

Correct Answer is A

Explanation

A. He would have difficulty falling to sleep, and sleep very lightly with more frequent arousals: Nicotine is a stimulant that can interfere with sleep by increasing heart rate and causing difficulty in falling asleep. Smokers also tend to experience more fragmented sleep, with frequent awakenings and lighter sleep stages due to withdrawal symptoms during the night which include restlessness, irritability, and difficulty relaxing.

B. He would sleep soundly during the first half of the night, with increased arousals during the second half: This is not typically associated with smoking. While nicotine withdrawal can cause sleep disruption, it does not usually result in sound sleep in the first half of the night followed by arousals. Smoking-related sleep disturbances are more generalized throughout the night.

C. Increase sleep latency, and reduce total sleep time: While nicotine can increase sleep latency (the time it takes to fall asleep), smoking is more likely to cause fragmented sleep and increased arousals rather than just reducing total sleep time. The effect on sleep is often more about poor-quality sleep than simply reduced duration.

D. Decrease the need for rapid eye movement (REM) sleep: Nicotine does not decrease the need for REM sleep, but it disrupts the sleep cycle, including REM sleep, by causing lighter sleep and more frequent awakenings. Smokers tend to have a lower proportion of REM sleep due to these disruptions, but not necessarily a decreased need for it.

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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

To assess for the presence of egophony, which instruction should the nurse give the client who has a lung abscess?

Correct Answer is A

Explanation

An adult male client tells the nurse that he smokes approximately one pack of cigarettes daily. How can the nurse expect smoking to affect this client's sleep?

Correct Answer is A

Explanation

The nurse assesses that a client has nailbed clubbing. Which additional information is consistent with this finding?

An older adult client is being evaluated for admission to an assisted living facility. During the health assessment, the nurse implements which technique to determine the client's ability to reside in this environment?

The nurse examines a client who is concerned about the amount of menstrual flow she is having. Which finding indicates an abnormality related to the client's current menstruation?

During a routine health screening of an adult female, the nurse notes several changes that have occurred over the past year. Which change indicates the need for a bone density screening?

The nurse completes inspection of the abdomen on an adult client. Which finding is considered normal for this client?

While assessing a client, the nurse notices that the client's legs are asymmetrical. Which additional physical data should the nurse collect?

The nurse observes generalized weakness and diminished deep tendon reflexes on the right side of an older adult client who has a history of a cerebrovascular accident. Which deep tendon reflex response should the nurse document to support the client's clinical assessment?

Which assessment finding, obtained during chest auscultation, should the nurse consider a normal finding?