Chapter 39: The Adolescent and Family
MULTIPLE CHOICE
1. What is the initial indication of puberty in girls?
a. Menarche
b. Growth spurt
c. Growth of pubic hair
d. Breast development
ANS: D
In most girls, the initial indication of puberty is the appearance of breast buds, an event
known as the thelarche. The usual sequence of secondary sexual development
characteristic in girls is breast changes, rapid increase in height and weight, growth of
pubic hair, appearance of axillary hair, menstruation, and abrupt deceleration of linear
growth.
DIF: Cognitive Level: Comprehension REF: p.
1136 OBJ: Nursing Process: Assessment
2. What is the mean age of menarche for North American girls?
a. 11.8 years
b. 12.3 years
c. 13.7 years
d. 14.2 years
ANS: B
The average age of menarche is 12 years and 4 months (12.3 years) in North American
girls, with a normal range of 10.5 to 15 years.
DIF: Cognitive Level: Comprehension REF: p.
1136 OBJ: Nursing Process: Assessment
3. By what age should the nurse be concerned about pubertal delay in boys?
a. 12 to 12.5 years
b. 12.5 to 13 years
c. 13 to 13.5 years
d. 13.5 to 14 years
ANS: D
, Concerns about pubertal delay should be considered for boys who exhibit no
enlargement of the testes or scrotal changes from 13.5 to 14 years. Ages younger than
13.5 years are too young for initial concern.
DIF: Cognitive Level: Comprehension REF: p. 1137
OBJ: Nursing Process: Assessment
4. A 14-year-old mentions that he now has to use deodorant but that he never had to
before. What knowledge is the nurse’s response based on?
a. Eccrine sweat glands in the axillae
become fully functional during puberty.
b. Sebaceous glands become extremely
active during puberty.
c. New deposits of fatty tissue insulate the
body and cause increased sweat
production.
d. Apocrine sweat glands reach
secretory capacity during puberty.
ANS: D
The apocrine sweat glands, which are nonfunctional in children, reach secretory
capacity during puberty. They secrete a thick substance as a result of emotional
stimulation that, when acted on by surface bacteria, becomes highly odoriferous. They
are limited in distribution and grow in conjunction with hair follicles in the axilla,
genital, anal, and other areas. Eccrine sweat glands are present almost everywhere on
the skin; they also become fully functional and respond to emotional and thermal
stimulation. Sebaceous glands become extremely active at this time, especially those
on the genitals and the “flush” areas of the body such as face, neck, shoulders, upper
back, and chest. This increased activity is a factor in the development of acne. New
deposits of fatty tissue that insulate the body and cause increased sweat production is
not part of the etiology of apocrine sweat gland activity.
DIF: Cognitive Level: Comprehension REF: p. 1139 OBJ:
Nursing Process: Implementation
5. According to Erikson, what is the psychosocial task of adolescence?
a. Intimacy
b. Identity
c. Initiative
d. Independence
MULTIPLE CHOICE
1. What is the initial indication of puberty in girls?
a. Menarche
b. Growth spurt
c. Growth of pubic hair
d. Breast development
ANS: D
In most girls, the initial indication of puberty is the appearance of breast buds, an event
known as the thelarche. The usual sequence of secondary sexual development
characteristic in girls is breast changes, rapid increase in height and weight, growth of
pubic hair, appearance of axillary hair, menstruation, and abrupt deceleration of linear
growth.
DIF: Cognitive Level: Comprehension REF: p.
1136 OBJ: Nursing Process: Assessment
2. What is the mean age of menarche for North American girls?
a. 11.8 years
b. 12.3 years
c. 13.7 years
d. 14.2 years
ANS: B
The average age of menarche is 12 years and 4 months (12.3 years) in North American
girls, with a normal range of 10.5 to 15 years.
DIF: Cognitive Level: Comprehension REF: p.
1136 OBJ: Nursing Process: Assessment
3. By what age should the nurse be concerned about pubertal delay in boys?
a. 12 to 12.5 years
b. 12.5 to 13 years
c. 13 to 13.5 years
d. 13.5 to 14 years
ANS: D
, Concerns about pubertal delay should be considered for boys who exhibit no
enlargement of the testes or scrotal changes from 13.5 to 14 years. Ages younger than
13.5 years are too young for initial concern.
DIF: Cognitive Level: Comprehension REF: p. 1137
OBJ: Nursing Process: Assessment
4. A 14-year-old mentions that he now has to use deodorant but that he never had to
before. What knowledge is the nurse’s response based on?
a. Eccrine sweat glands in the axillae
become fully functional during puberty.
b. Sebaceous glands become extremely
active during puberty.
c. New deposits of fatty tissue insulate the
body and cause increased sweat
production.
d. Apocrine sweat glands reach
secretory capacity during puberty.
ANS: D
The apocrine sweat glands, which are nonfunctional in children, reach secretory
capacity during puberty. They secrete a thick substance as a result of emotional
stimulation that, when acted on by surface bacteria, becomes highly odoriferous. They
are limited in distribution and grow in conjunction with hair follicles in the axilla,
genital, anal, and other areas. Eccrine sweat glands are present almost everywhere on
the skin; they also become fully functional and respond to emotional and thermal
stimulation. Sebaceous glands become extremely active at this time, especially those
on the genitals and the “flush” areas of the body such as face, neck, shoulders, upper
back, and chest. This increased activity is a factor in the development of acne. New
deposits of fatty tissue that insulate the body and cause increased sweat production is
not part of the etiology of apocrine sweat gland activity.
DIF: Cognitive Level: Comprehension REF: p. 1139 OBJ:
Nursing Process: Implementation
5. According to Erikson, what is the psychosocial task of adolescence?
a. Intimacy
b. Identity
c. Initiative
d. Independence
