A 15-year-old girl tells the school nurse that she has not started to menstruate yet.Onset of secondary sexual characteristics was about 2 1/2 years ago.The nurse should take which action?

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A referral is indicated.Menarche should follow the onset of secondary sexual development within 2 1/2 years.A careful examination is done to reveal any physical abnormalities,signs of androgen excess,and congenital defects of the genital tract.The lack of the onset of menstruation at this age is a potential indication of a physical problem.Assuming that the adolescent is pregnant is inappropriate.The nurse does not have any indication that the adolescent is sexually active.The amount of exercise should be assessed before suggesting that the adolescent stop exercising until menarche occurs.

A 15-Year-Old Girl Tells the School Nurse That She Has