A 15-year-old girl tells the school nurse that she has not ...

[michelleunicorn]

A 15-year-old girl tells the school nurse that she has not started to menstruate yet. Onset of secondary sexual characteristics was about 2 1/2 years ago. The nurse should take which action?
 
  a. Explain that this is not unusual.
  b. Refer the adolescent for an evaluation.
  c. Make an assumption that the adolescent is pregnant.
  d. Suggest that the adolescent stop exercising until menarche occurs.

Question 2

A 14-year-old boy is of normal weight, and his parents are concerned about bilateral breast enlargement. The nurse's discussion of this should be based on what?
 
  a. The presence of too much body fat
  b. Symptom that a hormonal imbalance is present
  c. Most likely part of normal pubertal development
  d. Indication that he is developing precocious puberty

[chjcharjto14]

Answer to Question 1

ANS: B
A referral is indicated. Menarche should follow the onset of secondary sexual development within 2 1/2 years. A careful examination is done to reveal any physical abnormalities, signs of androgen excess, and congenital defects of the genital tract. The lack of the onset of menstruation at this age is a potential indication of a physical problem. Assuming that the adolescent is pregnant is inappropriate. The nurse does not have any indication that the adolescent is sexually active. The amount of exercise should be assessed before suggesting that the adolescent stop exercising until menarche occurs.

Answer to Question 2

ANS: C
Gynecomastia is common during midpuberty in about one third of boys. For most, the breast enlargement disappears within 2 years. Although breast enlargement in overweight children can indicate too much body fat, in children of normal body weight, it is a normal occurrence. If the gynecomastia persists beyond 2 years, then a hormonal cause may need to be investigated. Precocious puberty is the early onset of puberty, before age 9 years in boys.

[michelleunicorn]

Excellent

[strudel15]

Gracias!