A 13-year-old boy is seen in your office because of tender b…

A 13-year-old boy is seen in your office because of tender breast enlargement over the past 4 months. He has no nipple discharge. He denies marijuana use and is taking no medications. Physical examination reveals the sexual maturity rating to be Tanner stage 2 with pubic hair growth and asymmetric breast buds beneath each nipple. The left breast bud measures 1 cm and the right 3 cm. Of the following, the most appropriate initial management for this boy is:

The primary care nurse practitioner evaluates a child who aw…

The primary care nurse practitioner evaluates a child who awoke with a sore throat and high fever after a nap. The child appears anxious and is sitting on the parent’s lap with the neck hyperextended. The physical exam reveals stridor, drooling, nasal flaring, and retractions. Given this presentation, what is the appropriate next step?  

A parent reports that 3 weeks ago his three and a half year…

A parent reports that 3 weeks ago his three and a half year old daughter has started stuttering when she speaks. Her physical exam is normal and through and questioning you discover that there are no associated signs or symptoms such as grimacing, tics or extreme self-consciousness. What is the most appropriate action step in this situation?