LU 10 Puberty, Menarche, Menopause

1. Puberty is best defined as the period when an individual:

A. Develops emotional maturity only

B. Becomes socially independent

C. Attains physiological capability for sexual reproduction

D. Begins menstruation or ejaculation

2. The normal age range of onset of puberty in females is:

A. 7–10 years

B. 9–14 years

C. 12–18 years

D. 10–16 years

3. Which factor has the strongest association with timing of puberty in girls?

A. Environmental temperature

B. Genetic influence between mother and daughter

C. Emotional stress

D. Level of physical activity

4. Early onset of puberty is commonly associated with:

A. Chronic illness and malnutrition

B. High altitude living

C. Improved nutrition and socioeconomic status

D. Hypothyroidism

5. The first sign of puberty in girls is usually:

A. Menarche

B. Pubic hair development

C. Breast development

D. Axillary hair growth

6. In boys, puberty typically begins with:

A. Penile growth

B. Pubic hair development

C. Testicular enlargement

D. Voice deepening

7. Puberty staging is based on Tanner Stages which classify development using:

A. Height and weight only

B. Bone age and dentition

C. Pubic hair and genitalia/breast development

D. Hormonal assay results

8. Tanner Stage 1 is characterised by:

A. Rapid pubertal growth

B. Adult sexual maturity

C. Pre-pubertal status

D. Initial appearance of secondary sexual characteristics

9. Testosterone in males is primarily responsible for:

A. Ovulation

B. Development of secondary sexual characteristics

C. Menarche

D. Estrogen secretion

10. Estrogen in females mainly causes:

A. Regression of uterus

B. Development of secondary sexual characteristics

C. Reduction of follicular growth

D. Cessation of menstruation

11. The correct sequence of pubertal changes in girls is:

A. Pubarche → Menarche → Thelarche

B. Menarche → Thelarche → Pubarche

C. Thelarche → Pubarche → Menarche

D. Pubarche → Thelarche → Menarche

12. Psychological changes in puberty include:

A. Increased dependency on parents

B. Reduced peer influence

C. Risk-taking behaviour

D. Stable mood and emotions

13. Precocious puberty in girls is defined as onset before:

A. 6 years

B. 7 years

C. 8 years

D. 9 years

14. Precocious puberty is more common in:

A. Boys

B. Girls

C. Both equally

D. Children with obesity only

15. Delayed puberty is suspected when secondary sexual characteristics fail to develop by:

A. 12 years

B. 13 years

C. 14 years

D. 15 years

16. Delayed menarche is defined when menstruation has not started by:

A. 14 years

B. 15 years

C. 16 years

D. 18 years

17. A common investigation for abnormal puberty is:

A. Urinalysis only

B. FSH and LH levels

C. ECG

D. Liver function test

18. Management of abnormal puberty includes all EXCEPT:

A. Treat underlying causes

B. Psychological support

C. Hormonal supplementation if required

D. Immediate surgical intervention in all cases

19. Menarche signifies:

A. Completion of puberty

B. Permanent fertility

C. Onset of reproductive potential

D. Menopause

20. Average age of menarche is approximately:

A. 10.5 years

B. 11.5 years

C. 12.5 years

D. 13.5 years

21. Normal menstrual cycle length is:

A. 14–21 days

B. 21–35 days

C. 35–45 days

D. 40–50 days

22. Menorrhagia is defined as menstrual blood loss exceeding:

A. 40 mL

B. 60 mL

C. 80 mL

D. 100 mL

23. Primary amenorrhea refers to:

A. Absence of menstruation for 3 months

B. Failure of menarche by 16 years

C. Irregular menstruation

D. Excessive bleeding

24. Menopause is diagnosed when there is absence of menstruation for:

A. 6 consecutive months

B. 9 consecutive months

C. 12 consecutive months

D. 18 consecutive months

25. The usual age range for menopause is:

A. 35–45 years

B. 40–50 years

C. 45–55 years

D. 50–60 years

26. Perimenopause refers to:

A. The period after menopause only

B. The transition phase before menopause

C. The reproductive period

D. Early adolescence

27. A common symptom of menopause is:

A. Polyuria

B. Hot flushes

C. Menorrhagia

D. Dysmenorrhea

28. FSH level used to support diagnosis of menopause in women <50 years is:

A. >10 mIU/mL

B. >20 mIU/mL

C. >30 mIU/mL

D. >40 mIU/mL

29. Hormone Replacement Therapy (HRT) is contraindicated in women with history of:

A. Anaemia

B. Breast cancer

C. Osteoporosis

D. Early menopause

30. One important nursing advice for menopausal women is to:

A. Avoid exercise

B. Reduce calcium intake

C. Maintain healthy lifestyle and regular check-ups

D. Ignore emotional changes

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SECTION B

High Probability Essay Questions (Answer ALL)

1. Define puberty and discuss the physical and psychological changes that occur in adolescents during this period.

2. Describe precocious puberty and delayed puberty, including causes, investigations and management.

3. Explain menarche and normal menstruation. Discuss common menstrual disorders seen in adolescents and their nursing management.

4. Define menopause and describe its symptoms, effects and diagnostic criteria.

5. Discuss the management of menopausal syndrome, including Hormone Replacement Therapy, its benefits, contraindications and nursing responsibilities.

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ANSWER KEY – SECTION A

1. C

2. B

3. B

4. C

5. C

6. C

7. C

8. C

9. B

10. B

11. C

12. C

13. C

14. B

15. C

16. C

17. B

18. D

19. C

20. C

21. B

22. C

23. B

24. C

25. C

26. B

27. B

28. C

29. B

30. C