During a routine physical, a 30-year-old patient remarks, "I had to buy all new shoes because my feet are growing again.". How should the nurse reply?
1. "Have you noticed any changes in your hands?"
2. "That is not too bad a problem to have.".
3. "We should measure your height.".
4. "Have you noticed your heart beating faster?"
1
Rationale 1: Changes in shoe size, glove size, or ring size in an adult may indicate growth hormone disturbance.
Rationale 2: The nurse should not make light of this remark as it may indicate pathology.
Rationale 3: Growth hormone disturbance would not cause increased height in an adult.
Rationale 4: Increased heart rate is not associated with growth hormone disturbance.
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