The nurse is assessing a 13-year-old girl. Which event would the nurse expect to have occurred first?
Growth spurt
Evidence of pubic hair
Onset of menses
Development of breast buds
The Correct Answer is D
Choice A: Growth spurt is not the correct answer because it is not the first event that occurs in female puberty. The growth spurt is a period of rapid increase in height and weight that usually occurs between 10 and 14 years of age in girls. It is influenced by various factors such as genetics, nutrition, and hormones. Growth spurt usually follows the development of breast buds and pubic hair by about 6 to 12 months.
Choice B: Evidence of pubic hair is not the correct answer because it is not the first event that occurs in female puberty. Evidence of pubic hair is the appearance of coarse, curly, and pigmented hair on the pubic area and around the genitals. It usually occurs between 8 and 13 years of age in girls. It is caused by the increased production of androgens (male hormones) by the adrenal glands and ovaries. Evidence of pubic hair usually follows the development of breast buds by about 3 to 6 months.
Choice C: Onset of menses is not the correct answer because it is not the first event that occurs in female puberty. The onset of menses is the beginning of menstrual cycles, which are regular changes in the female reproductive system that prepare the body for pregnancy. It usually occurs between 10 and 15 years of age in girls. It is caused by the maturation of the hypothalamus, pituitary gland, ovaries, and uterus, which regulate the levels of estrogen and progesterone (female hormones). The onset of menses usually follows the development of breast buds and pubic hair by about 2 to 3 years.
Choice D: Development of breast buds is the correct answer because it is the first event that occurs in female puberty. Development of breast buds is the enlargement and elevation of the nipples and areolas (dark circles around the nipples), which indicate the beginning of breast growth. It usually occurs between 8 and 12 years of age in girls. It is caused by the increased production of estrogen (female hormone) by the ovaries, which stimulates the growth of ducts (tubes) and lobules (glands) in the breast tissue. The development of breast buds is also called thelarche or breast stage 2.

Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A: White- or flesh-colored papillary growths in the genital area are not the correct answer because they are more likely a finding of another STI, such as HPV. HPV can cause genital warts that look like small bumps on or around the genitals. Genital herpes does not cause warts, but blisters or sores that may burst and crust over.
Choice B: Green penile discharge is not the correct answer because it is more likely a finding of another STI, such as gonorrhea. Gonorrhea can cause a thick, yellow-green discharge from the penis that may have a foul odor. Genital herpes does not cause discharge from the penis but may cause pain or burning during urination.
Choice C: Influenza-like symptoms are the correct answer because they are a possible finding of genital herpes. Genital herpes can cause systemic symptoms such as fever, headache, muscle aches, or swollen lymph nodes during an outbreak. These symptoms may resemble those of influenza (the flu) but are caused by HSV infection.
Choice D: Anuria is not the correct answer because it is not a finding of genital herpes. Anuria is a condition that causes a complete absence of urine output due to kidney failure or obstruction. Genital herpes does not affect the kidneys directly but may cause urinary retention if there is severe swelling or pain in the genital area.

Correct Answer is ["B","C","D","E"]
Explanation
Choice A: Fecal incontinence is not the correct answer because it is not a disorder of pelvic organ prolapse. Fecal incontinence is a condition that causes the loss of bowel control, resulting in involuntary leakage of stool or gas. It can be caused by various factors such as nerve damage, muscle weakness, or diarrhea. It is not related to the displacement or descent of pelvic organs.
Choice B: Rectocele is the correct answer because it is a disorder of pelvic organ prolapse. Rectocele is a condition that occurs when the rectum bulges or sags into the vagina, creating a pouch or hernia. It can cause symptoms such as constipation, difficulty with bowel movements, or a feeling of pressure or fullness in the vagina. It is caused by the weakening or stretching of the pelvic floor muscles and connective tissue that support the rectum and vagina.
Choice C: Urinary incontinence is the correct answer because it is a disorder of pelvic organ prolapse. Urinary incontinence is a condition that causes the loss of bladder control, resulting in involuntary leakage of urine or urge to urinate. It can be caused by various factors such as stress, infection, or medication. It is also related to the displacement or descent of pelvic organs, such as the bladder or urethra, which can affect the function and closure of the urinary sphincter.
Choice D: Cystocele is the correct answer because it is a disorder of pelvic organ prolapse. Cystocele is a condition that occurs when the bladder protrudes or drops into the vagina, creating a pouch or hernia. It can cause symptoms such as urinary frequency, urgency, or retention, or a feeling of pressure or fullness in the vagina. It is caused by the weakening or stretching of the pelvic floor muscles and connective tissue that support the bladder and vagina.
Choice E: Enterocele is the correct answer because it is a disorder of pelvic organ prolapse. Enterocele is a condition that occurs when the small intestine bulges or descends into the vagina, creating a pouch or hernia. It can cause symptoms such as lower back pain, pelvic pressure, or difficulty with bowel movements. It is caused by the weakening or stretching of the pelvic floor muscles and connective tissue that support the small intestine and vagina.

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