NUR 505 Advanced Health Assessment
Module 10 Female GU Study Guide
complete solutions.
Questions 1–20: Anatomy & Tanner Staging
1. At what Tanner stage does menarche most commonly occur?
A) Stage 2
B) Stage 3
C) Stage 4
D) Stage 5
Correct Answer: C
Rationale: Menarche most commonly occurs at Tanner Stage 4 (75% of females).
It is unusual before Stage 3. Stage 5 is post-menarcheal adult breast.
2. Which breast structure is most likely to harbor a palpable mass due to its
extension into the axilla?
A) Areola
B) Tail of Spence
C) Inframammary ridge
D) Lactiferous ducts
Correct Answer: B
Rationale: The Tail of Spence extends superolaterally into the axilla. It is a
common site for palpable breast masses and lymph nodes.
,3. A 12-year-old female presents with breast bud formation without areolar
enlargement. What Tanner stage is this?
A) Stage 1
B) Stage 2
C) Stage 3
D) Stage 4
Correct Answer: B
Rationale: Tanner Stage 2 is the breast bud stage: small mound of breast tissue
with enlargement of areola but no areolar mound separation.
4. Which finding is consistent with Tanner Stage 5 breast development?
A) Areola and breast form a single smooth contour
B) Areola is a secondary mound above the breast
C) Only the nipple projects forward
D) No palpable breast tissue
Correct Answer: A
Rationale: In Stage 5, the areola recesses to the general breast contour, leaving
only the nipple projecting. Stage 4 has the areola as a secondary mound.
5. A 14-year-old female is Tanner Stage 3 and asks when she will likely start her
period. What is your best estimate?
A) Within 1 month
B) Within 6 months
C) Within 2 years
,D) She already should have started
Correct Answer: C
Rationale: The average interval from Stage 2 to menarche is 2 years. Stage 3 is ~1
year after Stage 2, so menarche is typically ~1 more year away.
6. Which Tanner stage describes elevation of the areola as a secondary mound
above the breast?
A) Stage 2
B) Stage 3
C) Stage 4
D) Stage 5
Correct Answer: C
Rationale: Tanner Stage 4 is characterized by the areola and nipple forming a
secondary mound projecting above the breast contour.
7. What percentage of females have not yet reached menarche by Tanner Stage 4?
A) 0%
B) 10%
C) 25%
D) 50%
Correct Answer: C
Rationale: Approximately 75% of females have menarche by Stage 4, meaning
25% have not yet begun menstruation by Stage 4.
, 8. Which condition is associated with delayed puberty and webbed neck in a
female adolescent? A) Turner syndrome
B) Klinefelter syndrome
C) Graves’ disease
D) Polycystic ovary syndrome
Correct Answer: A
Rationale: Turner syndrome (45,XO) presents with short stature, webbed neck, low
hairline, and streak ovaries → delayed puberty/absent menarche.
9. During breast development, which change occurs first?
A) Menarche
B) Pubic hair
C) Thelarche (breast budding)
D) Axillary hair
Correct Answer: C
Rationale: Thelarche (breast budding, Tanner Stage 2) is the first sign of puberty in
females, occurring before pubic hair in most girls.
10. A 16-year-old has no breast development but has normal pubic hair. What is
the most likely cause?
A) Normal variation
B) Androgen insensitivity syndrome
C) Turner syndrome
D) Hypothyroidism
Module 10 Female GU Study Guide
complete solutions.
Questions 1–20: Anatomy & Tanner Staging
1. At what Tanner stage does menarche most commonly occur?
A) Stage 2
B) Stage 3
C) Stage 4
D) Stage 5
Correct Answer: C
Rationale: Menarche most commonly occurs at Tanner Stage 4 (75% of females).
It is unusual before Stage 3. Stage 5 is post-menarcheal adult breast.
2. Which breast structure is most likely to harbor a palpable mass due to its
extension into the axilla?
A) Areola
B) Tail of Spence
C) Inframammary ridge
D) Lactiferous ducts
Correct Answer: B
Rationale: The Tail of Spence extends superolaterally into the axilla. It is a
common site for palpable breast masses and lymph nodes.
,3. A 12-year-old female presents with breast bud formation without areolar
enlargement. What Tanner stage is this?
A) Stage 1
B) Stage 2
C) Stage 3
D) Stage 4
Correct Answer: B
Rationale: Tanner Stage 2 is the breast bud stage: small mound of breast tissue
with enlargement of areola but no areolar mound separation.
4. Which finding is consistent with Tanner Stage 5 breast development?
A) Areola and breast form a single smooth contour
B) Areola is a secondary mound above the breast
C) Only the nipple projects forward
D) No palpable breast tissue
Correct Answer: A
Rationale: In Stage 5, the areola recesses to the general breast contour, leaving
only the nipple projecting. Stage 4 has the areola as a secondary mound.
5. A 14-year-old female is Tanner Stage 3 and asks when she will likely start her
period. What is your best estimate?
A) Within 1 month
B) Within 6 months
C) Within 2 years
,D) She already should have started
Correct Answer: C
Rationale: The average interval from Stage 2 to menarche is 2 years. Stage 3 is ~1
year after Stage 2, so menarche is typically ~1 more year away.
6. Which Tanner stage describes elevation of the areola as a secondary mound
above the breast?
A) Stage 2
B) Stage 3
C) Stage 4
D) Stage 5
Correct Answer: C
Rationale: Tanner Stage 4 is characterized by the areola and nipple forming a
secondary mound projecting above the breast contour.
7. What percentage of females have not yet reached menarche by Tanner Stage 4?
A) 0%
B) 10%
C) 25%
D) 50%
Correct Answer: C
Rationale: Approximately 75% of females have menarche by Stage 4, meaning
25% have not yet begun menstruation by Stage 4.
, 8. Which condition is associated with delayed puberty and webbed neck in a
female adolescent? A) Turner syndrome
B) Klinefelter syndrome
C) Graves’ disease
D) Polycystic ovary syndrome
Correct Answer: A
Rationale: Turner syndrome (45,XO) presents with short stature, webbed neck, low
hairline, and streak ovaries → delayed puberty/absent menarche.
9. During breast development, which change occurs first?
A) Menarche
B) Pubic hair
C) Thelarche (breast budding)
D) Axillary hair
Correct Answer: C
Rationale: Thelarche (breast budding, Tanner Stage 2) is the first sign of puberty in
females, occurring before pubic hair in most girls.
10. A 16-year-old has no breast development but has normal pubic hair. What is
the most likely cause?
A) Normal variation
B) Androgen insensitivity syndrome
C) Turner syndrome
D) Hypothyroidism
