NSG 6430 REVIEW BANK 2026 TRUSTED
ANSWERS GRADED A+
⫸ What hormones are attributed to Hypothalamic-pituitary-
GONADAL (HPG) axis? Answer: 1. Gonadotropin-releasing
hormone (GnRH), also called luteinizing hormone-releasing hormone
(LHRH)
2. Luteinizing hormone (LH)
3. Follicle stimulating hormone (FSH)
4. Estrogen
5. Testosterone
⫸ What hormones are attributed to Hypothalamic-pituitary-
ADRENAL axis (HPA)? Answer: 1. Adrenocorticotropic hormone
2. Dehydroepiandrosterone (ACTH)
3. DHEA sulfate (DHEA-S)
⫸ What hormones are attributed to Growth hormone (GH)?axis
Answer: 1. Growth hormone-releasing hormone (GHRH)
2. Growth hormone (GH)
3. Insulin-like growth factors (IGFs)
⫸ What is thought to be three distinct changes in the hypothalamic-
pituitary unit that may trigger puberty? Answer: three distinct changes
in the hypothalamic-pituitary unit:
,(1) a nocturnal sleep-related augmentation of pulsatile LH secretion;
(2) a decrease in the sensitivity of the hypothalamus and the pituitary
to estradiol and testosterone, so that the gonadotropins LH and FSH
begin to increase; and
(3) in the female, development of a positive feedback system,
whereby critical levels of estrogen trigger a large release of GnRH,
stimulating LH to initiate ovulation.
⫸ What scale allows for the accurate classification of physical
pubertal maturation Answer: Sexual Maturity Rating (SMR) scale
(also called the Tanner scale)
⫸ Girls major events of puberty Answer: 1. Thelarche
2. Growth Spurt
3. Menarche
⫸ Thelarche Answer: Often the earliest physical sign of puberty in
girls, although a minority develop pubic hair as the first sign. On
average, breast development starts at age 10.0 for Caucasian girls and
8.9 years for African-American girls
⫸ Growth Spurt Answer: Thelarche and pubarche (pubic hair) may
both be preceded by about 1 year by the growth spurt; thus the growth
curve is an essential tool in the evaluation of precocious puberty.
,⫸ Menarche Answer: This event usually occurs during SMR B3 or
B4 and about 3.3 years after the growth spurt, or roughly 2 years after
breast budding.
⫸ What is the average length of time for completion of puberty ?
Answer: 4 years, but it can range from 1.5 to 8 years
⫸ What is the first physical sign of puberty in the majority of boys ?
Answer: Testicular Growth: The first physical sign of puberty in the
majority of boys is increased testicular volume, although the most
noticeable first event of male puberty is the growth of pubic hair
⫸ What are other signs of male puberty? Answer: 2. Growth Spurt:
Midpuberty, or the time of rising testosterone concentrations, is
associated with the period of most rapid linear growth in boys, in
contrast to the early growth spurt in girls. It is also at this time that the
voice changes axillary hair appears, and possibly also acne. Facial
hair growth typically starts about 3 years after pubic hair growth. The
hair on the face, chest, back, and abdomen may continue to appear
throughout and beyond puberty into adulthood, its amount and
distribution being quite variable and dependent on ethnicity and
family patterns.
3. Attainment of Fertility: Ejaculation usually occurs at SMR G3, as
does the first evidence of spermarche, but fertility is not usually
attained until SMR G4.
⫸ What is the average length of time for completion of puberty for
boys? Answer: average length of time for the completion of puberty is
3 years, but it can range from 2 to 5 years.
, Genital development is initiated at about 10.1 years for white boys,
9.5 years for African-American boys, and 10.4 years for Mexican-
American boys, with completion of puberty at 15.9 years in white
boys, 15.7 years in African-American boys, and 14.9 years in
Mexican-American boys.
⫸ Gonadal Steroids Answer: The target tissues of LH and FSH are
the ovaries and testes, which produce estradiol and testosterone,
respectively. Testicular Leydig cells also produce androstenedione,
dihydrotestosterone, and estradiol, but to a much lesser extent.
⫸ Estrogen. Answer: Estradiol from the ovary accounts for the
majority of the circulating estrogens, although there is a small amount
of extraovarian conversion from androstenedione and testosterone. In
addition to stimulating breast growth and maturation of the vaginal
mucosa, estrogen has been found to have a major impact on the
skeleton, being the primary hormone responsible for epiphyseal
closure.
⫸ Testosterone. Answer: The testes produce most of the circulating
testosterone, but a small amount comes from extratesticular
conversion of the adrenal hormone androstenedione in both males and
females. Testosterone is responsible for the voice change in males and
the attainment of male body habitus, while dihydrotestosterone, the
product of conversion of testosterone by 5a-reductase, causes growth
of the phallus and prostate.
⫸ GnRH Pulse Generator Answer: At the time of puberty, GnRH is
secreted from the GnRH pulse generator in the hypothalamus, leading
ANSWERS GRADED A+
⫸ What hormones are attributed to Hypothalamic-pituitary-
GONADAL (HPG) axis? Answer: 1. Gonadotropin-releasing
hormone (GnRH), also called luteinizing hormone-releasing hormone
(LHRH)
2. Luteinizing hormone (LH)
3. Follicle stimulating hormone (FSH)
4. Estrogen
5. Testosterone
⫸ What hormones are attributed to Hypothalamic-pituitary-
ADRENAL axis (HPA)? Answer: 1. Adrenocorticotropic hormone
2. Dehydroepiandrosterone (ACTH)
3. DHEA sulfate (DHEA-S)
⫸ What hormones are attributed to Growth hormone (GH)?axis
Answer: 1. Growth hormone-releasing hormone (GHRH)
2. Growth hormone (GH)
3. Insulin-like growth factors (IGFs)
⫸ What is thought to be three distinct changes in the hypothalamic-
pituitary unit that may trigger puberty? Answer: three distinct changes
in the hypothalamic-pituitary unit:
,(1) a nocturnal sleep-related augmentation of pulsatile LH secretion;
(2) a decrease in the sensitivity of the hypothalamus and the pituitary
to estradiol and testosterone, so that the gonadotropins LH and FSH
begin to increase; and
(3) in the female, development of a positive feedback system,
whereby critical levels of estrogen trigger a large release of GnRH,
stimulating LH to initiate ovulation.
⫸ What scale allows for the accurate classification of physical
pubertal maturation Answer: Sexual Maturity Rating (SMR) scale
(also called the Tanner scale)
⫸ Girls major events of puberty Answer: 1. Thelarche
2. Growth Spurt
3. Menarche
⫸ Thelarche Answer: Often the earliest physical sign of puberty in
girls, although a minority develop pubic hair as the first sign. On
average, breast development starts at age 10.0 for Caucasian girls and
8.9 years for African-American girls
⫸ Growth Spurt Answer: Thelarche and pubarche (pubic hair) may
both be preceded by about 1 year by the growth spurt; thus the growth
curve is an essential tool in the evaluation of precocious puberty.
,⫸ Menarche Answer: This event usually occurs during SMR B3 or
B4 and about 3.3 years after the growth spurt, or roughly 2 years after
breast budding.
⫸ What is the average length of time for completion of puberty ?
Answer: 4 years, but it can range from 1.5 to 8 years
⫸ What is the first physical sign of puberty in the majority of boys ?
Answer: Testicular Growth: The first physical sign of puberty in the
majority of boys is increased testicular volume, although the most
noticeable first event of male puberty is the growth of pubic hair
⫸ What are other signs of male puberty? Answer: 2. Growth Spurt:
Midpuberty, or the time of rising testosterone concentrations, is
associated with the period of most rapid linear growth in boys, in
contrast to the early growth spurt in girls. It is also at this time that the
voice changes axillary hair appears, and possibly also acne. Facial
hair growth typically starts about 3 years after pubic hair growth. The
hair on the face, chest, back, and abdomen may continue to appear
throughout and beyond puberty into adulthood, its amount and
distribution being quite variable and dependent on ethnicity and
family patterns.
3. Attainment of Fertility: Ejaculation usually occurs at SMR G3, as
does the first evidence of spermarche, but fertility is not usually
attained until SMR G4.
⫸ What is the average length of time for completion of puberty for
boys? Answer: average length of time for the completion of puberty is
3 years, but it can range from 2 to 5 years.
, Genital development is initiated at about 10.1 years for white boys,
9.5 years for African-American boys, and 10.4 years for Mexican-
American boys, with completion of puberty at 15.9 years in white
boys, 15.7 years in African-American boys, and 14.9 years in
Mexican-American boys.
⫸ Gonadal Steroids Answer: The target tissues of LH and FSH are
the ovaries and testes, which produce estradiol and testosterone,
respectively. Testicular Leydig cells also produce androstenedione,
dihydrotestosterone, and estradiol, but to a much lesser extent.
⫸ Estrogen. Answer: Estradiol from the ovary accounts for the
majority of the circulating estrogens, although there is a small amount
of extraovarian conversion from androstenedione and testosterone. In
addition to stimulating breast growth and maturation of the vaginal
mucosa, estrogen has been found to have a major impact on the
skeleton, being the primary hormone responsible for epiphyseal
closure.
⫸ Testosterone. Answer: The testes produce most of the circulating
testosterone, but a small amount comes from extratesticular
conversion of the adrenal hormone androstenedione in both males and
females. Testosterone is responsible for the voice change in males and
the attainment of male body habitus, while dihydrotestosterone, the
product of conversion of testosterone by 5a-reductase, causes growth
of the phallus and prostate.
⫸ GnRH Pulse Generator Answer: At the time of puberty, GnRH is
secreted from the GnRH pulse generator in the hypothalamus, leading
