the first sign of puberty in girls is
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Nursing Elites

ATI RN

RN Nursing Care of Children Online Practice 2019 A

1. What is the first sign of puberty in girls?

Correct answer: C

Rationale: The correct answer is C, Thelarche. Thelarche refers to the onset of breast development, which is typically the first sign of puberty in girls. This occurs before menarche (the first menstrual period). Choices A and B, acne and hair growth in the pubic area and underarms, are not the first signs of puberty in girls. While acne can be a common occurrence during puberty, it usually appears after other physical changes. Hair growth in the pubic area and underarms also occurs later in the puberty process.

2. The nurse is evaluating research studies according to the GRADE criteria and has determined the quality of evidence on the subject is moderate. Which type of evidence does this determination indicate?

Correct answer: B

Rationale: Moderate evidence typically indicates that results from randomized clinical trials were inconsistent, highlighting the need for further research to confirm findings.

3. An eleven-year-old boy is admitted with a history of type 1 diabetes. What information about school age should the nurse use to formulate the teaching plan for daily injections?

Correct answer: B

Rationale: By the age of eleven, many children are capable of administering their own insulin injections with supervision, fostering independence and better management of their diabetes. This age is appropriate for the child to take on more responsibility for their care. While parental involvement is still crucial for supervision and guidance, the child can start to learn and perform the injections themselves. Choice A is incorrect because parental involvement is important for safety and proper technique. Choice C is incorrect as waiting until closer to adolescence may delay the child's ability to manage their diabetes effectively. Choice D is incorrect as reaching injection sites is not the sole criteria; proper technique and supervision are essential.

4. At a well-visit, a mother voices concern that her 30-month-old has a smaller vocabulary than other children in his daycare. The nurse should:

Correct answer: B

Rationale: When a parent expresses concern about a child's development, it is essential to conduct a comprehensive assessment of all areas of development before jumping to conclusions. Choosing option B allows the nurse to evaluate the child for other age-appropriate developmental milestones to determine if there are any delays or concerns. Admitting the child to the hospital (option A) is not necessary at this point and may cause unnecessary stress. Suggesting hearing impairment (option C) without proper evaluation can lead to misdiagnosis. Explaining a significant developmental delay (option D) should only be done after a thorough assessment and diagnosis.

5. The parent of a 1-month-old infant voices concern about the infant’s respirations. The parent states the respirations are rapid and irregular. Which information should the nurse provide?

Correct answer: B

Rationale: The correct answer is B. Irregular respirations with periodic pauses are normal in a 1-month-old infant. Choice A is incorrect because the normal respiratory rate for an infant at this age is higher than the range provided. Choice C is incorrect as irregular respirations are expected in infants. Choice D is not appropriate as irregular respirations with periodic pauses are a normal finding in young infants and do not necessarily indicate a concern that requires immediate notification of the healthcare provider.

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