A 17-year-old female is brought to the family practice clinic by ...

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A 17-year-old female is brought to the family practice clinic by her mother, who is worried that her daughter has not yet developed secondary sex characteristics. Which action by the nurse is best?
 
  A.
  Assess a family pedigree for genetic influences.
  B.
  Explain that some girls don't develop until their 20s.
  C.
  Inform them that the daughter will be tested for estrogen deficiency.
  D.
  Obtain a urine sample for a pregnancy test.

Question 2

In providing anticipatory guidance to a 12-year-old female who has developed breast buds, what information should the nurse provide?
 
  A.
  Breast self-exam is now important.
  B.
  First period will occur in 6 months.
  C.
  Growth of pubic hair will occur next.
  D.
  Maximum height has been obtained.

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Answer to Question 1

ANS: C
Estrogen is the primary female hormone and is responsible for the development of secondary sex characteristics. Physical changes associated with puberty usually begin between ages 11 and 13. A 17-year-old female who has not yet developed these features may have an estrogen deficiency. A family pedigree may be beneficial, but not as the first step. A pregnancy test would not illustrate the cause of the problem.

Answer to Question 2

ANS: C
Thelarche (breast budding) is followed by the growth of pubic hair. Breast self-exam is not vital until the breasts have developed, and then self-exam is taught as a component of breast awareness. Menarche, the first period, usually occurs 1 year after peak height velocity. It is not possible to state if maximum height has been obtained. Thelarche starts on average at age 9.8 years and is complete on average at age 14.6 years. The growth spurt starts on average at age 10 years and is complete on average by age 11.8