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 B
Explanation
A. This option is incorrect as it does not describe the expected blood pressure difference in coarctation of the aorta.
B. Coarctation of the aorta typically presents with higher blood pressure in the upper body (arms) and lower blood pressure in the lower body (legs) due to the obstruction of blood flow distal to the aortic arch.
C. This option is incorrect because while coarctation can lead to decreased perfusion in the lower extremities, it does not typically result in decreased blood pressure in both the arms and legs simultaneously.
D. While increased blood pressure may occur in the arms, the legs would not typically show increased blood pressure in cases of coarctation.
Correct Answer is D
Explanation
A. Weak pulses are more indicative of reduced cardiac output or other cardiac issues, rather than specifically a large patent ductus arteriosus (PDA).
B. Cyanosis with crying can occur in various conditions, but it is not a hallmark of a large PDA; it typically presents with other symptoms.
C. Chronic hypoxemia is more associated with severe heart defects or lung conditions, whereas a large PDA may present with other signs first.
D. A systolic murmur is a classic finding in large PDAs due to the left-to-right shunting of blood, making it the most expected manifestation in this scenario.