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. Hearing loss: A tuning fork is commonly used in the Rinne and Weber tests to assess the type and extent of hearing loss. These tests help differentiate between conductive and sensorineural hearing deficits by comparing air and bone conduction.

B. Neurological pathology: While some neurological assessments may include evaluation of hearing or balance, a tuning fork is not a primary tool for identifying central nervous system pathology. Neurological exams rely more on reflexes, motor function, and sensory testing.

C. Otitis media: Otitis media is diagnosed based on otoscopic findings such as tympanic membrane bulging, fluid presence, or redness. A tuning fork cannot visualize internal structures or confirm middle ear infections.

D. Tinnitus: Tinnitus is the perception of ringing or buzzing in the ears, often self-reported by the patient. A tuning fork does not directly diagnose tinnitus but may be used to evaluate associated hearing changes if present.

A. White, curd-like lesions. B. Gingival inflammation. C. Buccal mucosa ulceration. D. Fruity odor of the breath.

Correct Answer is D

Explanation

A. White, curd-like lesions: These are often indicative of oral candidiasis (thrush), a fungal infection that may require antifungal treatment. While it needs follow-up, it is not typically emergent unless the patient is immunocompromised.

B. Gingival inflammation: This suggests gingivitis or periodontal disease and warrants dental evaluation, but it does not pose an immediate systemic risk unless associated with infection or abscess.

C. Buccal mucosa ulceration: Ulcerations can result from trauma, infection, or systemic conditions. They require assessment and possibly treatment but do not usually demand urgent intervention unless severe or rapidly worsening.

D. Fruity odor of the breath: A fruity or sweet breath odor can be a sign of diabetic ketoacidosis (DKA), a life-threatening complication of uncontrolled diabetes. It requires immediate medical attention due to the risk of severe metabolic imbalance and potential for rapid deterioration.

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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

When conducting a physical examination, the nurse uses a tuning fork to assess for which condition?

Correct Answer is A

Explanation

When assessing a client's mouth, which finding requires immediate follow-up by the nurse?

Correct Answer is D

Explanation

The nurse is assessing a client who has a history of kidney stones and returns to the clinic with flank pain. Which intervention should the nurse implement first?

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

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?

The nurse is conducting a physical assessment of a young adult. Which information provides the best indication of the individual's nutritional status?

When preparing a female client for an abdominal examination, the nurse should provide her with which instruction?

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?

After checking a client's pupillary response to light, the practical nurse (PN) tells the registered nurse (RN) that the client's pupils are constricted with minimal response to light. Before verifying the PN's findings, which action should the RN take?