NR 602 week 2 Exams Questions and Answers (100% CORRECT) Guaranteed A.

NR 602 week 2 Exams Questions and Answers (100% CORRECT) Guaranteed A. Which interventions are recommendations suggested as preventive services for neonates? (Select all that apply.) a. Breastfeeding b. Screening neonates for sickle hemoglobinopathies c. Newborns screened for phenylketonuria (PKU) before being 24 hours old should be rescreened by 2 weeks old d. Screening for developmental hip dysplasia e. Screening for congenital hyperthyroidism within the first 4 days of life a. Breastfeeding b. Screening neonates for sickle hemoglobinopathies c. Newborns screened for phenylketonuria (PKU) before being 24 hours old should be rescreened by 2 weeks old d. Screening for developmental hip dysplasia When providing post delivery information regarding her infant, the nurse will confirm to the mother that which fetal cardiac structures have no function after her child is born? (Select all that apply.) a. Mitral valve b. Foramen ovale c. Cardiac septum d. Ductus arteriosus e. Pulmonary vein b. Foramen ovale d. Ductus arteriosus The nurse will contribute which neonate characteristics noted in the first period of reactivity to sympathetic system changes? (Select all that apply.) a. Transient rales b. Tachycardia c. Presence of oral mucus d. Passage of meconium e. Alertness a. Transient rales b. Tachycardia e. Alertness Which assessment factors are included in a 5-minute APGAR score? (Select all that apply.) a. Heart rate b. Respiratory rate c. Skin color d. Muscle tone e. Crying a. Heart rate b. Respiratory rate c. Skin color d. Muscle tone Which assessment findings suggest that the neonate is demonstrating stabilization of physiological functions? a. Temperature: 97.7° F b. Heart rate: 200 bpm c. Systolic pressure: 100 mm Hg d. Respiratory rate: 28 breaths/minute a. Temperature: 97.7° F The parent of a newborn infant asks the primary care pediatric nurse practitioner when to intervene to help the infant's future intellectual growth. What will the nurse practitioner tell the parent? a. Cognitive learning begins during the toddler years. b. Intellectual growth begins when speech develops. c. Language and literacy skills begin at birth. d. Preschool is an optimal time to begin general learning. c. Language and literacy skills begin at birth. We have an expert-written solution to this problem! The primary care pediatric nurse practitioner performs a well baby examination on a 7-day-old infant who is nursing well, according to the mother. The nurse practitioner notes that the infant weighed 3250 grams at birth and 2990 grams when discharged on the second day of life. The infant weighs 3080 grams at this visit. Which action is correct? a. Follow up at the 2-month checkup. b. Refer to a lactation consultant. c. Schedule a weight check in 1 week. d. Suggest supplementing with formula. c. Schedule a weight check in 1 week. During an assessment of a 4-week-old infant, the primary care pediatric nurse practitioner learns that a breastfed infant nurses every 2 hours during the day but is able to sleep for a 4-hour period during the night. The infant has gained 20 grams per day in the interval since last seen in the clinic. What will the nurse practitioner recommend? a. Continuing to nurse the infant using the current pattern b. Nursing the infant for longer periods every 4 hours c. Supplementing with formula at the last nighttime feeding d. Waking the infant every 2 hours to nurse during the night a. Continuing to nurse the infant using the current pattern The primary care pediatric nurse practitioner is performing a well baby examination on a 2-month-old infant who has gained 25 grams per day in the last interval. The mother is nursing and tells the nurse practitioner that her infant seems fussy and wants to nurse more often. What will the nurse practitioner tell her? a. She may not be making as much breastmilk as before. b. She should keep a log of the frequency and duration of each feeding. c. The infant may be going through an expected growth spurt. d. The infant should stay on the previously established nursing schedule. c. The infant may be going through an expected growth spurt. The mother of a 6-week-old breastfeeding infant tells the primary care pediatric nurse practitioner that her baby, who previously had bowel movements with each feeding, now has a bowel movement once every second day. What will the nurse practitioner tell her? a. Her baby is probably constipated. b. It may be related to her dietary intake. c. She should consume more water. d. This may be normal for breastfed babies. d. This may be normal for breastfed babies. The parent of a 5-month-old is worried because the infant becomes fussy but doesn't always seem interested in nursing. What will the nurse practitioner tell this parent? a. The infant may be expressing a desire to play or to rest. b. The parent should give ibuprofen for teething pain before nursing. c. This is an indication that the infant is ready for solid foods. d. This may indicate gastrointestinal discomfort such as constipation. a. The infant may be expressing a desire to play or to rest. The mother of a 6-month-old infant is distressed because the infant can say "dada" but not "mama" and asks the primary care pediatric nurse practitioner why this is when she is the one who spends more time with the infant. How will the nurse practitioner respond? a. "At this age, your baby does not understand the meaning of sounds." b. "Babies at this age cannot make the 'ma' sound." c. "Most sounds made by babies at this age are accidental." d. "This may mean that your baby doesn't hear well." a. "At this age, your baby does not understand the meaning of sounds." The primary care pediatric nurse practitioner is performing a well child examination on a 8-month-old infant whose hearing is normal but who responds to verbal cues with only single syllable vocalizations. What will the nurse practitioner recommend to the parents to improve speech and language skills in this infant? a. Provide educational videos that focus on language. b. Read simple board books to the infant at bedtime. c. Sing to the child and play lullabies in the baby's room. d. Turn the television to Sesame Street during the day. b. Read simple board books to the infant at bedtime. The primary care pediatric nurse practitioner is evaluating a 2-year-old with a documented speech delay. Screenings to assess motor skills and cognition are normal, and the child passed a recent hearing test. What will the pediatric nurse practitioner do next? a. Ask the child's parents whether they read to the child. b. Give parents educational materials to encourage speech. c. Refer the child to an early intervention program. d. Suggest that they purchase age-appropriate music videos. a. Ask the child's parents whether they read to the child. The primary care pediatric nurse practitioner performs a developmental assessment on a 32-month-old child. The child's parent reports that about 70% of the child's speech is intelligible. The pediatric nurse practitioner observes that the child has difficulty pronouncing "t," "d," "k," and "g" sounds. Which action is correct? a. Evaluate the child's cognitive abilities. b. Obtain a hearing evaluation. c. Reassure the parent that this is normal. d. Refer the child to a speech therapist. c. Reassure the parent that this is normal. During a well child assessment of an 18-month-old child, the primary care pediatric nurse practitioner observes the child point to a picture of a dog and say, "Want puppy!" The nurse practitioner recognizes this as an example of what type of speech? a. Holophrastic b. Receptive c. Semantic d. Telegraphic d. Telegraphic The primary care pediatric nurse practitioner is offering anticipatory guidance to the parents of a 12-month-old child. The parents are bilingual in Spanish and English and have many Spanish-speaking relatives nearby. They are resisting exposing the child to Spanish out of concern that the child will not learn English well. What will the pediatric nurse practitioner tell the parents? a. Children who learn two languages simultaneously often confuse them in conversation. b. Children with multi-language proficiency do not understand that others cannot do this. c. Learning two languages at an early age prevents children from developing a dominant language. d. Most bilingual children are able to shift from one language to another when appropriate. d. Most bilingual children are able to shift from one language to another when appropriate. The primary care pediatric nurse practitioner is counseling the parents of a toddler about appropriate discipline. The parents report that the child is very active and curious, and they are worried about the potential for injury. What will the pediatric nurse practitioner recommend? a. Allow the child to explore and experiment while providing appropriate limits. b. Be present while the child plays to continually teach the child what is appropriate. c. Let the child experiment at will and to make mistakes in order to learn. d. Say "no" whenever the child does something that is not acceptable. a. Allow the child to explore and experiment while providing appropriate limits. The mother of a 3-year-old child takes the child to a play group once a week. She expresses concern that the child plays with toys but does not interact with the other toddlers. What will the primary care pediatric nurse practitioner counsel the mother? a. The child probably is very shy but will outgrow this tendency with repeated exposure to other children. b. The toddler may have a language delay that interferes with socialization with other children. c. Toddlers may be interested in other children but usually do not engage in interactive play. d. Toddlers need more structured play to encourage interaction and socialization with others. c. Toddlers may be interested in other children but usually do not engage in interactive play. The parent of a 24-month-old child asks the primary care pediatric nurse practitioner when toilet training should begin. How will the pediatric nurse practitioner respond? a. "Begin by reading to your child about toileting." b. "Most children are capable by age 2 years." c. "Tell me about your child's daily habits." d. "We should assess your child's motor skills." c. "Tell me about your child's daily habits." The primary care pediatric nurse practitioner performs a physical examination on a 9-month-old infant and notes two central incisors on the lower gums. The parent states that the infant nurses, takes solid foods three times daily, and occasionally takes water from a cup. What will the pediatric nurse practitioner counsel the parent to promote optimum dental health? a. To begin brushing the infant's teeth with toothpaste b. To consider weaning the infant from breastfeeding c. To discontinue giving fluoride supplements d. To make an appointment for an initial dental examination d. To make an appointment for an initial dental examination The parents of a 3-year-old child are concerned that the child has begun refusing usual foods and wants to eat mashed potatoes and chicken strips at every meal and snack. The child's rate of weight has slowed, but the child remains at the same percentile for weight on a growth chart. What will the primary care pediatric nurse practitioner tell the parents to do? a. Allow the child to choose foods for meals to improve caloric intake. b. Place a variety of nutritious foods on the child's plate at each meal. c. Prepare mashed potatoes and chicken strips for the child at mealtimes. d. Suggest cutting out snacks to improve the child's appetite at mealtimes. b. Place a variety of nutritious foods on the child's plate at each meal. The primary care pediatric nurse practitioner (PNP) is evaluating health literacy in the mother of a new preschool-age child. How will the nurse practitioner assess this? a. Ask the child how many books he has at home. b. Ask the mother about her highest grade in school. c. Ask the mother to determine the correct dose of a drug from a label. d. Ask the mother to read a health information handout aloud. a. Ask the child how many books he has at home. The primary care pediatric nurse practitioner learns that the mother of a 3-year-old child has been treated for depression for over 5 years. Which aspect of this child's development will be of the most concern to the nurse practitioner? a. Fine motor b. Gross motor c. Social/emotional d. Speech and language c. Social/emotional The primary care pediatric nurse practitioner is examining a 6-year-old child who attends first grade. The child reports "hating" school. The parent states that the child pretends to be sick frequently in order to stay home from school. To further assess this situation, the nurse practitioner will first ask the child: a. about school performance and grades. b. why school is so distressing. c. to name one or two friends. d. whether bullying is taking place. c. to name one or two friends. The parent of a 10-year-old boy tells the primary care pediatric nurse practitioner that the child doesn't appear to have any interest in girls and spends most of his time with a couple of other boys. The parent is worried about the child's sexual identity. What will the nurse practitioner tell the parent? a. Children at this age who prefer interactions with same-gender peers usually have a homosexual orientation. b. Children experiment with sexuality at this age as a means of deciding later sexual orientation. c. This attachment to other same-gender children is how the child learns to interact with others. d. It's appropriate to encourage mixed-gender interactions in order to promote development of sexual values. c. This attachment to other same-gender children is how the child learns to interact with others. The parents of a 12-year-old child are concerned that some of the child's older classmates may be a bad influence on their child. What will the primary care pediatric nurse practitioner tell the parent? a. Allowing the child to make poor choices and accept consequences is important for learning values b. Children at this age have a high regard for authority and social norms, so this is not likely to happen c. Moral values instilled in the early school-age period will persist throughout childhood d. The pressures from outside influences may supersede parental teachings and should be confronted. d. The pressures from outside influences may supersede parental teachings and should be confronted. During a well child exam of a school-age child, the primary care pediatric nurse practitioner learns that the child has been having angry episodes at school. The nurse practitioner observes the child to appear withdrawn and sad. Which action is appropriate? a. Ask the child and the parent about stressors at home b. Make a referral to a child behavioral specialist c. Provide information about anger management d. Suggest consideration of a different classroom a. Ask the child and the parent about stressors at home The primary care pediatric nurse practitioner is preparing to conduct a well child assessment of an 8-year-old child. How will the nurse practitioner begin the exam? a. Ask the child about school, friends, home activities, and sports b. Discuss the purpose of the visit and explain the procedures that will be performed c. Offer age-appropriate information about usual developmental tasks d. Provide information about healthy nutrition and physical activities a. Ask the child about school, friends, home activities, and sports A school-age child has begun refusing all cooked vegetables. What will the primary care pediatric nurse practitioner recommend to the parent? a. Allow the child to make food choices since this is usually a phase b. Ensure that the child has three nutritious meals and two nutritious snacks each day c. Prepare vegetables separately for the child to encourage adequate intake d. Teach the child how important it is to eat healthy fruits and vegetables b. Ensure that the child has three nutritious meals and two nutritious snacks each day The primary care pediatric nurse practitioner performs a physical examination on a 12-year-old child and notes poor hygiene and inappropriate clothes for the weather. The child's mother appears clean and well dressed. The child reports getting 6 to 7 hours of sleep each night because of texting with friends late each evening. What action by the nurse practitioner will help promote healthy practices? a. Discuss setting clear expectations about self-care with the mother b. Give the child information about sleep and self-care c. Reassure the mother that this "non-compliance" is temporary d. Tell the mother that experimenting with self-care behaviors is normal a. Discuss setting clear expectations about self-care with the mother During a well child exam on a 6-year-old child, the primary care pediatric nurse practitioner assesses the child for school readiness. Which finding may be a factor in limiting school readiness for this child? a. Adherence to daily family routines and regular activities b. Having two older siblings who attend the same school c. Parental concerns about bullying in the school d. The child's ability to recognize four different colors c. Parental concerns about bullying in the school The primary care pediatric nurse practitioner is examining a school-age child who reports frequent stomach pain and headaches. The parent reports that the child misses several days of school each month. The child has a normal exam. Before proceeding with further diagnostic tests, what will the nurse practitioner initially ask the parent? a. About the timing of the symptoms each day and during the week b. How well the child performs in school and in extracurricular activities c. If the parent feels a strong need to protect the child from problems d. Whether there are any unusual stressors or circumstances at home a. About the timing of the symptoms each day and during the week The primary care pediatric nurse practitioner is evaluating recurrent stomach pain in a school-age child. The child's exam is normal. The nurse practitioner learns that the child reports pain most evenings after school and refuses to participate in sports but does not have nausea o r vomiting. The child's grandmother recently had gallbladder surgery. Which action is correct? a. Encourage the child to keep a log of pain, stool patterns, and dietary intake b. Order radiologic studies and laboratory tests to rule out systemic causes c. Reassure the child and encourage resuming sports when symptoms subside d. Refer the child to a counselor to discuss anxiety about health problems a. Encourage the child to keep a log of pain, stool patterns, and dietary intake The primary care pediatric nurse practitioner is performing a well child assessment on a 13-year-old female whose mother asks when her daughter's periods may start. Which information will the nurse practitioner use to help estimate the onset of periods? a. The age of the mother's menarche b. The patient's age at thelarche c. When adrenarche occurred d. Whether linear growth has stopped b. The patient's age at thelarche The primary care pediatric nurse practitioner is examining a 15-year-old female who reports having her first period at age 13. She states that she has had five periods in the last year, with the last one 2 months prior. She participates in basketball at school. Which action is correct? a. Perform biometric screening to determine lean body mass. b. Prescribe oral contraceptives pills to regulate her periods. c. Reassure her that this is perfectly normal at her age. d. Refer her to an endocrinologist for hormonal evaluation. a. Perform biometric screening to determine lean body mass. During a well child assessment of a 13-year-old male, the primary care pediatric nurse practitioner notes small testicles and pubic and axillary hair. To further evaluate these findings, the nurse practitioner will ask the patient about what topic? a. alcohol and tobacco use b. changes in voice c. increase in height and weight d. participation in sports d. participation in sports The mother of a 16-year-old male was recently divorced after several years of an abusive relationship and tells the primary care pediatric nurse practitioner that the adolescent has begun skipping school and hanging out with friends at the local shopping mall. When she confronts her child, he responds by saying that he hates her. What will the nurse practitioner tell this mother? a. Adolescence is marked by an inability to comprehend complex situations. b. Adolescence is typically marked by tempestuous and transient episodes. c. Adolescents normally have extreme, disruptive conflicts with parents. d. Adolescents often need counseling to help them cope with life events. d. Adolescents often need counseling to help them cope with life events. The primary care pediatric nurse practitioner is performing a well child exam on a 12-year-old female who has achieved early sexual maturation. The mother reports that she spends more time with her older sister's friends instead of her own classmates. What will the nurse practitioner tell this parent? a. Early-maturing girls need to identify with older adolescents to feel a sense of belonging. b. Girls who join an older group of peers may become sexually active at an earlier age. c. Spending time with older adolescents indicates a healthy adjustment to her maturing body. d. The association with older adolescents will help her daughter to gain social maturity. b. Girls who join an older group of peers may become sexually active at an earlier age. The primary care pediatric nurse practitioner is performing an exam on an adolescent male who asks about sexual identity because of concern that a friend is worried about being gay. Which response will the nurse practitioner make in this situation? a. Provide the teen with a questionnaire to gain information about his sexuality. b. Remind the adolescent that mandatory reporting requires disclosure to parents. c. Suggest that the adolescent discuss sexual concerns with his parents. d. Tell the adolescent that, unless he is at risk, what he says will be confidential. d. Tell the adolescent that, unless he is at risk, what he says will be confidential. The parent of a 14-year-old child tells the primary care pediatric nurse practitioner that the child skips classes frequently in spite of various disciplinary measures, such as grounding and extra homework and is earning Cs and Ds in most classes. What will the nurse practitioner recommend? a. Counseling for emotional problems b. Development of an Individual Education Plan c. Evaluation for possible learning disorders d. Referral for a behavioral disorder c. Evaluation for possible learning disorders The parent of a 14-year-old child tells the primary care pediatric nurse practitioner that the adolescent has expressed a desire to be a vegetarian, is refusing all meat served at home, and wants the family to eat vegetarian meals. What will the nurse practitioner tell the parent? a. Do not allow a vegetarian diet in order to maintain appropriate limits for the adolescent. b. Provide vegetarian options for the adolescent that preserve adequate nutrition and protein intake. c. Suggest that the adolescent prepare appropriate vegetarian dishes to complement family meals. d. Tell the adolescent that a vegetarian diet may be considered in adulthood but not while living at home. c. Suggest that the adolescent prepare appropriate vegetarian dishes to complement family meals. The primary care pediatric nurse practitioner is performing a well child exam on a 17-year-old female whose mother is present during the history. The mother expresses concern that her daughter wishes to have an eyebrow piercing and states that she is opposed to the idea. What will the nurse practitioner do? a. Provide information about piercings and encourage continued discussion. b. Remind the adolescent that her mother is responsible for her health. c. State that piercings are relatively harmless and are an expression of individuality. d. Suggest that she wait until she is 18 years old and can make her own decisions. a. Provide information about piercings and encourage continued discussion. The parent of an adolescent reports noting cutting marks on the teen's arms and asks the primary care pediatric nurse practitioner what it means. What will the nurse practitioner tell this parent? a. Cutting is a way of dealing with emotional distress. b. It is a method of fitting in with other adolescents. c. The behavior is common and will usually stop. d. This type of behavior is a type of suicide attempt. a. Cutting is a way of dealing with emotional distress. The mother of a 3-month-old male infant tells the primary care pediatric nurse practitioner that she occasionally notices he has a penile erection just after nursing. What will the nurse practitioner tell the mother? a. Infants should be prevented from masturbating. b. The infant is conscious of the pleasure associated with nursing. c. This is a form of infantile priapism. d. This is a normal, reflexive behavior at this age. d. This is a normal, reflexive behavior at this age. The primary care pediatric nurse practitioner is performing a well child examination on a 3-year-old. The child's parent reports that the child has recently begun masturbating. What will the nurse practitioner counsel this parent? a. To allow the behavior whenever it occurs, since it is normal b. To discuss sexuality with the child c. To explore whether the child is being abused d. To teach the child about privacy and hand hygiene d. To teach the child about privacy and hand hygiene The parent of an 8-year-old child tells the primary care pediatric nurse practitioner that the child has begun to ask questions about why a schoolmate has "2 daddies" and wonders how to talk to the child about this. What will the nurse practitioner recommend? a. Beginning a discussion about different types of sexual relationships and same-sex partners b. Discussing the issue with the child in terms of the parent's religious values and norms c. Explaining that not all families are the same and what is most important is that they love and care for their children d. Telling the child that some adult relationships are complicated and will be understood when the child is older c. Explaining that not all families are the same and what is most important is that they love and care for their children The primary care pediatric nurse practitioner is performing a well child exam on an 8-year-old girl and notes the presence of breast buds. What will the nurse practitioner include when initiating anticipatory guidance for this patient? a. A discussion about the risks of pregnancy and sexually transmitted diseases b. Information about sexual maturity and menstrual periods c. Material about the human papillomavirus vaccine d. Sexual orientation and the nature of sexual relationships b. Information about sexual maturity and menstrual periods The primary care pediatric nurse practitioner is counseling the parents of a 13-year-old female who has Down syndrome about sexual maturation. What will the nurse practitioner tell these parents? a. It is important to discuss and support healthy sexuality. b. Providing too much information about sexuality may be confusing given the child's cognitive level of understanding. c. Suppressing periods with contraceptives will lessen their daughter's distress. d. They should give her information about periods but not about sexuality. a. It is important to discuss and support healthy sexuality. During a well child examination, a 15-year-old female tells the primary care pediatric nurse practitioner that some of her friends have begun having sex. She has a boyfriend but denies engaging in sex with him. What will the nurse practitioner do initially? a. Ask her for her definitions of "sex." b. Discuss the risks of sexually transmitted diseases. c. Find out if she is considering sexual relations. d. Give her information about contraception. a. Ask her for her definitions of "sex." During a well child examination of a 6-year-old girl, the primary care pediatric nurse practitioner notes that the child becomes embarrassed and resists taking off her underwear for the exam. What should the nurse practitioner infer from this observation? a. The child has been sexually molested. b. The child is feeling violated by the examiner. c. The parent is exhibiting regressive behavior. d. This is a normal reaction in a child of this age. d. This is a normal reaction in a child of this age. The primary care pediatric nurse practitioner is providing anticipatory guidance to the parent of a school-age boy. The parent expresses concerns that the child prefers to play with dolls, is worried that the child will be a homosexual, and asks what can be done to prevent this from happening. What will the nurse practitioner tell this parent? a. Homosexual identity formation cannot be predicted by early childhood behavior. b. Masculinizing boys from an early age helps to determine heterosexual orientation. c. Sexual orientation identification begins late in adolescence and not in childhood. d. The development of sexual orientation is generally a multifaceted process. d. The development of sexual orientation is generally a multifaceted process. What are the clinical findings suggestive of Down syndrome? (Select all that apply.) a. Brushfield spots b. Brachycephaly c. Protruding tongue d. Large ears e. Double palmar creases a. Brushfield spots b. Brachycephaly c. Protruding tongue Which clinical findings tend to support a diagnosis of Klinefelter syndrome? (Select all that apply.) a. Short arm span b. Scoliosis c. Small penis d. Large testes e. Gynecomastia b. Scoliosis c. Small penis e. Gynecomastia Which developmental cues are associated with Prader-Willi syndrome? (Select all that apply.) a. Language delays b. Poor coordination c. Low pain tolerance d. Attention deficient/Hyperactive Disorder (AD/HD) e. Mild intellectual disability a. Language delays b. Poor coordination d. Attention deficient/Hyperactive Disorder (AD/HD) e. Mild intellectual disability Which assessment finding noted at birth is an indication of Beckwith-Weidemann syndrome? a. Underdevelopment of one side to the body b. Abnormally long umbilical cord c. Small eyes d. Microglossia b. Abnormally long umbilical cord What is the primary care provider's (PCP) primary care intervention for a child diagnosed with achondroplasia? a. Visual screening b. Monitoring for hydrocephalus c. Skin cancer screening d. Monitoring for signs of depression b. Monitoring for hydrocephalus The primary care pediatric nurse practitioner evaluates children's growth to screen for endocrine and metabolic disorders. Which is a critical component of this screening? a. Measuring supine length in children over the age of 2 years b. Obtaining serial measurements to assess patterns over time c. Using the CDC growth chart for children under age 2 years d. Using the WHO growth chart for children over age 2 years b. Obtaining serial measurements to assess patterns over time The primary care pediatric nurse practitioner is performing a well child examination on a 5-year-old girl. The parents ask if the child's adult height can be predicted. The nurse practitioner learns that the mother is 5'8" tall and the father is 5'11" tall. The nurse practitioner will estimate which expected adult height for this child? a. 5'11" tall b. 5'7" tall c. 5'8" tall d. 6' tall b. 5'7" tall The mother of a female infant is concerned that her daughter is developing breasts. The primary care pediatric nurse practitioner notes mild breast development but no pubic or axillary hair. What is the likely diagnosis? a. Congenital adrenal hyperplasia causing breast development b. Precocious puberty needing endocrinology management c. Premature adrenarche which will lead to pubic hair onset d. Premature thelarche which will resolve over time d. Premature thelarche which will resolve over time A 7-year-old female has recently developed pubic and axillary hair without breast development. Her bone age is consistent with her chronological age, and a pediatric endocrinologist has diagnosed idiopathic premature adrenarche. The primary care pediatric nurse practitioner will monitor this child for which condition? a. Adrenal tumor b. Congenital adrenal hyperplasia c. Polycystic ovary syndrome d. Type 1 diabetes mellitus c. Polycystic ovary syndrome A 6-year-old female has had a recent growth spurt and an exam reveals breast and pubic hair development. Her bone age is determined to be 8 years. What will the primary care pediatric nurse practitioner do next? a. Order LH and FSH levels and a long-acting GnRH agonist. b. Order thyroid function tests to exclude primary hypothyroidism. c. Reassure the parent that this is most likely idiopathic. d. Refer the child to a pediatric endocrinologist for management. d. Refer the child to a pediatric endocrinologist for management.