The nurse is performing physical assessments on adolescents. What finding would the nurse anticipate concerning female growth spurts?

Correct Answer: A

Rationale: Female growth spurts typically precede males' by about 2 years (around age 11-12).

Correct Answer: D

Rationale: A thorough physical examination provides a comprehensive assessment of nutritional status by evaluating signs like muscle wasting, skin condition, hair health, and edema, alongside weight and lab data. Family dietary reports are subjective and incomplete without clinical correlation. Relying only on weight misses underlying issues like fluid retention or muscle loss. Monitoring intake and output tracks fluid balance but not nutrient absorption or deficiencies. A full exam integrates physical findings with history and tests, offering a holistic view critical for identifying malnutrition or overnutrition and guiding tailored interventions in nursing care.

Correct Answer: D

Rationale: Using handrails and non-slip mats reduces fall risk in patients with impaired mobility by providing physical support and traction, countering weakness or unsteadiness. Walking unassisted heightens danger, especially without strength or balance. A dark room obscures hazards, increasing falls rather than preventing them rest doesn't trump safety. Placing items out of reach forces risky stretching or movement. Nurses implement these environmental aids to create a secure space, empowering safe mobility and minimizing injury, a critical aspect of care for vulnerable patients.

Correct Answer: B

Rationale: Monitoring oxygen saturation regularly prevents complications in oxygen therapy by ensuring levels stay within a safe range (e.g., 92-98% for most), avoiding hypoxia or hyperoxia. High flow rates without monitoring risk toxicity, especially in COPD patients. A tight mask causes discomfort and skin breakdown, not prevention. Limiting fluids is unrelated hydration supports recovery. Nurses use pulse oximetry to adjust delivery, balancing oxygenation with safety, and watch for signs like confusion or cyanosis, making this a proactive, essential step in respiratory care.

Correct Answer: D

Rationale: The Trendelenburg position, with the head lower than the feet, improves venous return by using gravity to enhance blood flow back to the heart, often used in shock or low blood pressure scenarios. Facilitating breathing aligns with Fowler's position, not this lungs may compress here. Digestion isn't directly aided; it's circulatory-focused. Social interaction is unrelated it's a clinical posture. Nurses employ this to stabilize hemodynamics, monitoring for respiratory strain, making it a targeted intervention for circulatory support in acute care.