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. 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.
Correct Answer is B
Explanation
A. Doubling the dose if a dose is missed can increase the risk of bleeding and is not recommended for warfarin. Instead, the client should take the missed dose as soon as remembered unless it's almost time for the next dose.
B. Using an electric razor is recommended to minimize the risk of cuts and bleeding, which is particularly important for clients on anticoagulants like warfarin.
C. While increasing fiber intake can be beneficial for overall health, it is not specifically necessary for addressing constipation related to warfarin therapy.
D. While mild nosebleeds may occur, they are not typically common during initial treatment. Clients should be informed to report any unusual or severe bleeding.