The nurse is providing anticipatory teaching to parents about pubescent changes in school-aged and young adolescent girls. Which of the following changes should the nurse include in the teaching?
Vocal changes
Decreased height
Breast development
Menarche
Increased axillary hair
Correct Answer : C,D,E
A. Vocal changes are more pronounced in boys during puberty; girls typically do not experience significant vocal changes.
B. Height does not decrease; instead, girls experience a growth spurt during puberty before reaching their adult height.
C. Breast development is one of the first signs of puberty in girls, typically occurring between ages 8 and 13.
D. Menarche, the first menstrual period, usually occurs later in puberty and is an important milestone indicating the onset of reproductive capability.
E. Increased axillary hair growth is also a common change that occurs during puberty as hormone levels rise.
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Correct Answer is A
Explanation
A. A child with varicella (chickenpox) should return to school only after all the blisters have crusted over, indicating that the infectious stage has passed and they are no longer contagious.
B. Receiving the varicella vaccine does not apply to children who already have the infection; vaccination is preventive, not a treatment for those already infected.
C. Completing one week of antiviral medication is not a sufficient criterion for returning to school, as the child may still be contagious until all lesions are crusted.
D. Returning to school as soon as the rash appears is not safe, as the child is highly contagious during the initial rash stage and until all lesions have crusted.
Correct Answer is B
Explanation
A. Tricuspid atresia typically leads to decreased pulmonary blood flow due to the absence of normal blood flow to the lungs.
B. Patent ductus arteriosus results in increased pulmonary blood flow because it allows blood to flow from the aorta to the pulmonary artery, increasing the volume of blood going to the lungs.
C. Coarctation of the aorta can cause decreased blood flow to the lower body, which may not directly relate to increased pulmonary blood flow.
D. Tetralogy of Fallot is characterized by decreased pulmonary blood flow due to right ventricular outflow obstruction, making it not associated with increased pulmonary blood flow.