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 D
Explanation
A. While anxiety and withdrawal are concerning, they may not require immediate intervention compared to behaviors that pose risks to the child or others.
B. A stable child with a concerned parent may benefit from reassurance and support, but they do not require urgent intervention.
C. Stomach pain without an apparent cause should be assessed, but it may not be as urgent as aggressive behavior that can harm others.
D. A child exhibiting aggressive behavior poses a risk to themselves and others, necessitating immediate assessment and intervention to ensure safety and manage the behavior effectively.
Correct Answer is A
Explanation
A. Giving pancreatic enzymes before snacks and meals is essential for children with cystic fibrosis to help with digestion and nutrient absorption due to their pancreatic insufficiency.
B. Children with CF often require increased salt intake, especially during hot weather or heavy exercise, due to higher salt losses in sweat.
C. A child with CF typically needs a high-calorie, high-fat diet to meet their energy requirements and to support growth, rather than low-fat meals with limited protein.
D. Limiting fluid intake is not recommended; children with CF often need to stay well-hydrated to help manage thick secretions and promote overall health.