NBME Form 7 Practice Test

Pubertal development is beginning in a typical way for an 11-year-old at Tanner stage II, with body odor and acne reflecting hormonal changes and behavioral shifts common during this time. The best next step is to provide anticipatory guidance and education to both the child and the parents about what to expect as puberty continues, including hygiene, acne management, emotional changes, and the timeline of physical development. This approach supports normal development, reduces anxiety, and helps the family navigate questions and privacy needs. Hormonal testing isn’t indicated here because the presentation fits normal pubertal progression. Referring to psychiatry isn’t warranted unless there are ongoing, impairing mental-health concerns. Puberty-blocking therapy is reserved for cases of central precocious puberty or other specific indications after thorough evaluation, not for a routine, normal onset of puberty.