A nurse is teaching adolescent boys about pubertal changes. The first sign of pubertal change seen with boys is

A sign of increased intracranial pressure (ICP) in a 10-year-old child is a headache. Headache is a common symptom associated with increased pressure within the cranial cavity. It can be a result of various conditions that cause elevated intracranial pressure, such as brain tumours, intracranial haemorrhage, hydrocephalus, or brain trauma. The headache may be described as persistent, worsening, or accompanied by other symptoms such as nausea, vomiting, or changes in neurological status.

tachypnoea (rapid breathing), in (option A) is incorrect because it is not a specific sign of increased intracranial pressure. It can be seen in various conditions, including respiratory and cardiovascular disorders, anxiety, or physical exertion.

bulging fontanel in (option B) is incorrect because it, is more commonly observed in infants and is not typically seen in older children. The fontanelles (soft spots) on an infant's skull normally close by the age of 18-24 months.

an increase in head circumference in (option D) is incorrect because it, may be a sign of increased intracranial pressure in infants. However, in a 10-year-old child, the fontanelles are typically closed, and head circumference growth is not a reliable indicator of increased intracranial pressure

The assessment finding that the nurse should expect in an infant with Hirschsprung disease is option A, constipation with the passage of foul-smelling, ribbon-like stools. Hirschsprung disease is a congenital condition characterized by the absence of ganglion cells in the distal part of the colon, leading to functional obstruction. The affected segment of the colon lacks the normal peristaltic movements, resulting in an accumulation of faecal matter. The stools passed by infants with Hirschsprung disease are often constipated, and the narrow, ribbon- like appearance is a result of the narrowed segment of the colon.

diarrhea (option B) is incorrect because it, is not typically associated with Hirschsprung disease. Instead, the condition presents with constipation due to the obstructed bowel.

foul-smelling, fatty stools in (option C) is incorrect because it, is not characteristic of Hirschsprung disease. This finding may be associated with malabsorption disorders such as cystic fibrosis or celiac disease, but not specifically with Hirschsprung disease.

"currant jelly" stools in (option D) is incorrect because it, is a term commonly used to describe the stools seen in intussusception, which is a different condition involving the telescoping of one segment of the bowel into another. It is not an expected finding in Hirschsprung disease.